Kenya's HIV Treatment Programme Reaches 98% of Eligible Patients

Kenya has reached a landmark 98 per cent antiretroviral therapy (ART) coverage rate among eligible HIV-positive patients, according to figures released by the National AIDS and STI Control Programme (NASCOP) at the annual HIV treatment symposium in Nairobi. The achievement places Kenya well ahead of the UNAIDS 95-95-95 targets — under which 95 per cent of people living with HIV should know their status, 95 per cent of those should be on treatment, and 95 per cent of those on treatment should have suppressed viral loads — and comes ahead of the 2030 global deadline.

Kenya now has 1.38 million people living with HIV, of whom an estimated 1.35 million are on ART — the highest absolute treatment number and proportional coverage the country has ever recorded. Viral load suppression rates, the critical metric that determines whether treatment is preventing transmission, stand at 94 per cent among those on ART.

"When I started in HIV medicine in this country twenty years ago, ART was a privilege of the wealthy. Today it is a right that reaches nearly every Kenyan who needs it. That transformation is extraordinary," said NASCOP Director Dr Catherine Ngugi at the symposium.

The Pillars of Success

Several structural changes have driven the improvement in treatment coverage over the past three years. The integration of HIV services into the SHA benefits package has eliminated user fees at the point of ART dispensing in public facilities, removing a persistent access barrier particularly for patients in the informal economy. SHA-linked drug dispensing also allows patients to collect monthly ART refills at any accredited facility or community health post nationwide, ending the era when patients had to return to the specific facility where they were enrolled — a system that created interruptions when people moved for work or family reasons.

The Community Health Promoter (CHP) network, expanded to over 112,000 members under the government's universal health coverage push, has been central to tracing patients who had fallen out of care — a population estimated at 87,000 individuals as recently as 2023. CHPs conduct home visits, track defaulting patients through mobile phone follow-up, and deliver a three-month ART supply to housebound patients. NASCOP data shows that loss-to-follow-up rates have fallen from 9.3 per cent in 2022 to 3.1 per cent today.

Domestic antiretroviral production at the new Thika pharmaceutical manufacturing plant has also begun to reduce supply disruptions. Tenofovir and lamivudine — the backbone of first-line ART in Kenya — are now being produced domestically, reducing the country's vulnerability to the Indian generic supply chain disruptions that caused temporary shortages in 2021 and 2023.

Closing the Remaining Gaps

The 2 per cent of eligible patients not yet on treatment represents approximately 27,600 individuals whose circumstances present particular challenges. NASCOP analysis shows this group disproportionately includes men aged 25 to 44, people who use drugs, and sex workers in high-prevalence urban zones such as parts of Nairobi, Kisumu, and Mombasa. Stigma, fear of disclosure in social and workplace settings, and distrust of health facilities remain documented barriers for these groups.

The government's HIV differentiated service delivery strategy includes peer-support programmes operated by community-based organisations such as Kenya Network of Women with AIDS (KENWA) and the Kenya Sex Workers Alliance (KESWA), which reach populations that formal health facilities struggle to serve. A new drop-in ART dispensing model piloted in Nairobi's Eastleigh and River Road areas allows patients to collect medication without registering in a formal outpatient queue — a design specifically intended for people who fear being recognised at a health facility.

Kenya's HIV response continues to rely significantly on funding from the United States President's Emergency Plan for AIDS Relief (PEPFAR), which contributes approximately 68 per cent of total HIV programme costs. Against the backdrop of ongoing US foreign aid reviews in 2025 and 2026, the government has been accelerating domestic financing mechanisms — including SHA's HIV coverage — to reduce the programme's vulnerability to external funding changes. "We cannot build a 98 per cent treatment programme on foundations that can shift with another country's budget cycle. Domestic financing is not optional — it is existential," said Treasury Principal Secretary Dr Chris Kiptoo at a health financing forum in May.