Immediate Risks and Disruptions

1. Human Resources Impact:
   • Affected Personnel: Doctors, clinical officers, nurses, laboratory technologists, pharmacists, community health workers and staff funded by the US Government have been impacted.
   • Service Disruptions: Some facilities providing Antiretroviral Therapy (ART) were closed without clear referral pathways. However, some have since reopened except for PEPFAR supported DICEs. Community-led and peer-led services have stopped, including community-led monitoring and community-based HIV prevention outreach programs.
2. Commodity Shortages:
   • Health products and technologies: The Country has adequate stocks for most HIV products and technologies except Nevirapine, Viral Load, HIV test kits, and Early Infant Diagnosis (EID) that are running low, with stock-outs foreseen in the coming days if PEPFAR supported commodities are not distributed.
3. Service Reductions:
   • Pediatric HIV Treatment: Facilities are working at reduced capacity, particularly for sample networking for Early Infant Diagnosis and Viral Load.
   • Prevention Services: Disrupted for Adolescent Girls and Young Women (AGYW) and key populations, including PrEP and HIV counseling and testing. The DREAMS programme has been impacted, and outreach prevention activities for AGYW have been stopped. Additionally, community-led responses and community based out reaches have been disrupted.
4. Supply Chain Challenges:
   • The USAID funded procurement agency is unable to distribute products due to the stop-work order, affecting the supply chain for HIV commodities.

Politically Relevant Updates

1. Government Actions:
   • Supplementary Budget: The government is analyzing the cost of covering US Government-funded human resources as well as other affected services to be presented to the Cabinet through a cabinet memo.
   • Resource Reallocation: Advocacy for reallocation of domestic resources to priority HIV programs.
   • Integration of Services: The Government has advised the integration of HIV services into other health services for continuity and sustainability. Plans are underway to conduct rapid assessment of integration of HIV services to inform documentation of case studies and development of the integration blueprint.
   • Social Health Authority (SHA) and Social Health Insurance Fund (SHIF): Ongoing advocacy to include HIV in the SHA benefit package.
2. Civil Society and communities Impact:
   • CSO Challenges: Civil society, including community-led and community-based organizations face funding cuts and loss of staff, leading to reduced or suspended services.
   • Increased Demand: Remaining organizations face increased demand with fewer resources.
   • Communities have reported   abrupt integration without preparation, anxiety and panic leading to hoarding of ARV, unintended disclosure by health care workers leading to increased incidences of stigma and discrimination.
3. UN Response:
   • Impact Assessment: UNAIDS Kenya Country office supported communities to assess the impact of US Government stop work order. The UN country team continues to guide assessment of the impact on the UNSDCF programs across Agencies.