The health clinic where Alice Okwirry collects her HIV medication in Kenya’s capital Nairobi has been rationing supplies of antiretrovirals to one-month refills since the U.S. government froze foreign aid.
On the outskirts of the city, meanwhile, millions of life-saving doses sit on the shelves of a warehouse, unused and unreachable.
The clinic is a half hour’s drive from the warehouse, but for Okwirry, they may as well be an ocean apart.
Without U.S. funding, distribution from the warehouse, which stocks all U.S. government-donated HIV medicine to Kenya, has ceased, leaving supplies of some drugs worryingly low, according to a former USAID official and a health official in Kenya.
The 90-day foreign aid freeze, ordered by U.S. President Donald Trump after taking office on January 20, has upended the global supply chain for medical products to fight HIV and other diseases. It is also blocking the distribution of drugs that long ago reached their destination countries.
“I was just seeing death now coming,” said 50-year-old Okwirry who was diagnosed with HIV in 2008 and has a 15-year-old daughter, Chichi, who is also HIV-positive.
Okwirry used to receive six-month supplies of ARVs from the clinic but now can only get one month.
“I told Chichi: what about if you hear the drugs are doomed?” Okwirry said, growing emotional. “She told me: Mom, I’ll be leaning on you.”
The State Department issued a waiver last month exempting funding for HIV treatment from the freeze.
But the USAID payments system in Kenya is down after the cuts, meaning contractors who implement the programmes cannot be paid, said Mackenzie Knowles-Coursin, who was the deputy head of communications for USAID, East Africa, until resigning on Feb. 3 in protest at the dismantling of the agency.
“Projects are left wondering: ‘Well, how am I going to resume activities if you’re not paying me money?” he said. “The waivers that have been given are really waivers on paper.”
In Kenya, officials in Washington have not authorised the release of money required to distribute the $34 million worth of medicine and equipment at the warehouse, he added.
According to a Kenyan government document seen by Reuters, about $10 million is needed for that distribution. The Mission for Essential Drugs and Supplies, the Christian charity that runs the warehouse, supplies drugs to some 2,000 clinics nationwide, its website says.
Knowles-Coursin told Reuters the commodities at the warehouse include 2.5 million bottles of ARVs, 750,000 HIV test kits and 500,000 malaria treatments.