Scandal rocks Aids Council

The suspension of Dr Margaret Gachara from the directorship of the scandal- ridden National Aids Control Council (NACC) came as no surprise to those who have been closely following developments at the top Aids body.

The Council - established in 1999 under the State Corporations Act and mandated to co-ordinate efforts towards the prevention and control of HIV/AIDS - has been embroiled in controversies and there seems to be no end in sight unless some miraculous restructuring takes place.

Sadly, the controversies rage at a time when the pandemic is decimating thousands of Kenyans in their prime and leaving in its wake hundreds of hapless orphans.

But it is allegations of financial misappropriation that have severely dented the council s image. The June 2002 internal auditor s report revealed that the council had irregularly paid out US$ 240000 to suppliers in contravention of public procurement regulations.

This revelation did not go down well with the Kenya Medical Association (KMA), which publicly accused the NACC management of being dishonest and corrupt.

Last month, Gachara was suspended after the Efficiency monitoring Unit (EMU) the investigative arm of the Office of the President discovered that she had inflated her salary on the pretext that she used to earn the same amount from her previous employer, John Snow Incorporated, a US based charity. She was earning KES 2000,000 (US$26,666), when her actual salary should have been KES 200,000 (US $2,666).

Accusations of fraud at the Aids body has also led to the delay of disbursement of funds intended to stem the epidemic and provide treatment to the victims. A total of US$ 15 billion was to be disbursed by the US government to be shared out between Kenya, Uganda and Tanzania and eleven other African countries. Kenya was to get the lion s share.

Whereas a lot has been reported on NACC s financial mismanagement and fraudulent tendering procedures, not much has been said about the council s original goals and whether they are being met.

Owing to the council s lacklustre performance, it is yet to make any impact in its efforts towards mitigating the socio-economic impact of the HIV/AIDS pandemic, whose declaration as a national disaster in 1999 led to its creation.

Soon after its establishment, NACC prepared a five-year strategic plan titled Kenya National HIV/AIDS Strategic Plan 2000-2005 . The document, with a foreword written by none other than retired president Daniel arap Moi, was unveiled at the 2000 World Aids Day celebrations by the then Office of the President Minister Marsden Madoka.

However, a keen observer would not fail to punch holes in the plan, which is being implemented at a staggering Sh 14 billion (US$18000,000). For one, the plan states its main objective as that of reducing HIV prevalence rates in Kenya by between 20-30 per cent among the youth aged 15-24 by the year 2005.

But the document does not provide the haziest idea of how this goal is going to be achieved. There is no gainsaying that given the current HIV trends and the fatalistic and callous attitude of many Kenyan youth, the targeted percentage reduction is clearly far-fetched.

While the strategic plan also hopes to create an impact at the provincial, district and constituency levels, what has emerged from the ground is blatant duplication of resources. Not to mention that the provincial administration and MPs were for a long time embroiled in squabbles over who should be in charge of the Constituency Aids Control Committees (CACCs). They fought themselves and momentarily forgot to fight the common enemy Aids.

The document s weakness also stems from the fact that it gives prominence to safe blood transfusion, while mentioning nothing on tackling behaviour change. Not even the outdated cultural practices like widow inheritance and Female Genital Mutilation which are responsible for fuelling the spread of Aids are mentioned in the document.

With only two years to go before the lifetime of the document expires, the NACC fat cats will be hard put to report to their donors, especially after stunning revelations to the effect that a huge chunk of the donor funds is being spent on their emoluments.

Whether NACC should continue operating from the Office of the President or be relocated to the Ministry of Health has been a subject of debate for sometime now, with emerging divergent views. No doubt, previous government Aids control programmes have been implemented under the Ministry of Health.

But unknown to many, there has been a serious duplication of resources and activities between NACC and its precursor, the National Aids and STDs Control Programme (NASCOP), which operates under the Ministry of Health.

Since its inception, NASCOP has been in charge of the medical component of prevention and care. Besides being an Aids Control Unit, it is also in charge of monitoring the epidemic to know the trends of infection, a function it now shares with NACC.

Consequently, it has become difficult to draw a line between NACC and NASCOP. For a country surviving on meagre resources, and whose populace is dying by the million, one wonders why efforts should be duplicated.

The continued stay of NACC at the Office of the President also puts the Health Minister and the OP counterpart on a collision course. The ugly confusion was first brought to bear in 2001, at the height of a spirited campaign for cheap generic versions of Antiretrovirals (ARVs), when the then Public Health Minister Prof. Sam Ongeri and his Office of the President counterpart Madoka aired different opinions on the matter publicly.

The scenario was mirrored again early this year when Health minister Charity Ngilu and Dr Chris Murungaru were embroiled in an argument over which ministry should be in charge of NACC.

Still, the composition of the council has also attracted a lot of controversy. NACC has a chairman, who is a presidential appointee and a director who is the secretary to the council.

While membership comprises representatives from government ministries, private sector, religious sector, women organizations and HIV positive people, grumbles abound over the criteria used in nominating organizations to the council.

For instance, Women Fighting Aids in Kenya (WOFAK) is the only Aids NGO represented at the council, while Maendeleo Ya Wanawake is the only women s organization.

NACC has also failed to provide for the most stigmatized people in society those living with HIV/AIDS. Strange as it may sound, the council lacks a permanent desk for People Living with HIV/Aids (PLWHAs), with the council only using a few of them for window dressing during celebrations such as the World Aids Day.

Owing to unco-ordinated efforts, Kenya is far from winning the war against Aids. It took the government a whole 15 years to declare Aids a national disaster by which time the pandemic had taken a heavy toll. Then followed the lacklustre policies.

If the current government is serious in its efforts to stem the tide of the pandemic, there is a need to re-constitute NACC and clearly define its role. As a matter of urgency, more heads should roll at NACC.

As Dr Peter Piot, the Executive Director of the joint United Nations Programme on Aids (UNAIDS) once said at an international Aids conference in 2000, We do not need a super-technological weapon to fight Aids. The answers are already in Africa .