Kenyan HIV Patients Face Uncertainty as U.S. Aid Freeze Disrupts Drug Supply

Alice Okwirry, 50, a widow living with HIV/AIDS, sits inside her house in Kianda village within Kibera district of Nairobi, Kenya February 28, 2025. 

HIV patients in Kenya are living in fear as the U.S. government’s freeze on foreign aid has caused a significant disruption in the distribution of life-saving antiretroviral (ARV) drugs. Alice Okwirry, a 50-year-old HIV patient from Nairobi, now only receives one-month refills of her medication instead of the six-month supply she once relied on. The shortage is due to a halt in the distribution of critical HIV medicines, which are sitting unused in a warehouse in Nairobi due to the freeze.

The warehouse, stocked with U.S.-donated HIV medications, sits just a short distance from Okwirry's clinic, but she, like many others, has no access to these vital supplies. The freeze, initiated by former President Donald Trump in January 2020, has paralyzed the global supply chain for HIV treatment and other medical aids, including those that have already arrived in the countries they were meant for.

"I was just seeing death now coming," Okwirry said, describing her distress as her supply of ARVs dwindles. Okwirry, who was diagnosed with HIV in 2008, is also concerned for her 15-year-old daughter, Chichi, who is also HIV-positive. "I told Chichi: what about if you hear the drugs are doomed? She told me, 'Mom, I'll be leaning on you,'" Okwirry said, fighting back tears.

Despite the freeze, the U.S. State Department issued a waiver last month exempting HIV treatment funding from the ban. However, logistical problems remain, with the USAID payment system in Kenya still down, leaving contractors unpaid and halting the distribution of critical medicines. Mackenzie Knowles-Coursin, a former USAID official, described the situation as a “standstill,” noting that although waivers had been granted, they were essentially "waivers on paper."

The warehouse in question contains essential supplies, including 2.5 million bottles of ARVs, 750,000 HIV test kits, and half a million malaria treatments. However, the funds necessary for their distribution have not been released, leaving Kenya's medical programs in limbo. The Kenyan government estimates that $10 million is needed to unlock the supplies, which are meant for over 2,000 clinics across the country.

Kenya has one of the highest HIV rates globally, with around 1.4 million people living with the virus, according to the World Health Organization. The U.S. is responsible for providing around 40% of Kenya’s HIV drugs through the President's Emergency Plan for AIDS Relief (PEPFAR). The impact of the aid freeze has led to severe shortages of crucial drugs such as Dolutegravir, used to treat HIV and tuberculosis coinfections, and Nevirapine, used to prevent mother-to-child transmission.

In the meantime, some HIV patients are being given only weekly ARV refills, contributing to increased anxiety among those relying on the medications to stay healthy. Kenya’s Health Minister, Deborah Barasa, has expressed confidence that the government will mobilize the required funds to release the medicines within the next few weeks.

As the funding gap widens, the Kenyan government is considering emergency funding options, but with an estimated shortfall of $80 million, the situation remains dire. The future of thousands of HIV patients in Kenya is uncertain as they await the resolution of this crisis caused by the U.S. aid freeze.