The HIV/AIDS pandemic has emerged as one of the leading challenges to global public health and development. Sub-Saharan Africa, in particular, has become the epicenter of the pandemic, with over 29.4 million people currently living with the virus and more than 2.4 million people having succumbed to the
disease. In Kenya, the agonies of the HIV/AIDS to individuals, families and societies are overwhelming. Much of the hard-won gains in economic growth, life expectancy and child survival have been wiped out. Besides, many sectors, including education, agriculture, industry and health are staggering under the
burden of the disease. These sectors lose trained professionals and have to contend with higher costs of production and delivery of services.
In Kenya, the Sessional Paper No.4 of 1997 on AIDS lays down the contemporary long-term framework for response to the pandemic. After declaring AIDS a national disaster in 1999, the government established the National AIDS Control Council (NACC) to guide implementation of the National HIVIAIDS Strategic
Plan 2000-2005, within the framework of the multi-sectoral approach. But despite these efforts, successes have been far too few and on too small a scale to reverse the pandemic. This study looked into the priorities and allocation of resources among alternative HIV-related interventions within the framework of the AIDS strategic plan. It also examined the link between the national HIV/AIDS Programme, the macroeconomic framework and the participatory role played by various actors in HIVIAIDS-related activities. Finally, the study
assessed the impacts of alternative patterns of resource allocation with regard to reduction of HIV prevalence, programme coverage and future expenditures averted.
The study entailed the use of both qualitative and quantitative analysis. HIV related demographic, behavioral and financial data, gathered by the National AIDS Control Council during the year 2002 was heavily used. In particular, we used the GOALS simulation model to assess the consequences and trade-offs
of HIVIAIDS resource allocation options. The study also investigated the policies, planning and budgetary commitments to HIV/AIDS-related priorities using secondary data sources, complemented with primary data collected mainly through in-depth interviews with key informants based in Nairobi.
The study established that the costing of the multi-sectoral HIVIAIDS strategic plan lies outside the center of the national budget allocation decisions and the Mid Term Expenditure Framework (MTEF), despite the existence of a strong institutional framework and enabling policy environment. Further, our analysis showed that given available resources, there is great potential to improve the national response to HIV/AIDS by increasing expenditures on preventive measures and treatment and care services as opposed to policy development and management in the coming years. The study therefore strongly recommends,
among others, the need to fully integrate the HIV/AIDS strategic plan into the national framework of the poverty reduction and economic recovery strategies in order to achieve a more comprehensive and effective response to the pandemic. An effective way of mainstreaming HIV/AIDS and supporting an
effective multi-sectoral response to illY/AIDS will be through ensuring that HIV/AIDS is adequately addressed as part of the poverty reduction agenda and economic recovery strategies, the objective being to get HIV/AIDS routinely mainstreamed into government planning, programming and budgeting processes
(ERS and MTEF). This will ultimately result in HIV/AIDS being mainstreamed into sector strategies.