© Quentin Top

Kenya

130,000

people who use drugs, including 18,000-30,000 people who inject drugs

36%

of people who inject drugs in Nairobi have HIV

42%

of people who inject drugs in Nairobi are living with hepatitis C

Kenya’s devastating drug problem: a humanitarian emergency

These alarming figures show that medical assistance is urgently needed in Kenya.

Lack of prevention and treatment for people who use drugs

Since the early 2010s, Kenya has become a prime transit route for heroin trafficking. Drug use has spread through communities which are already fragile and is accompanied by transmission of AIDS and hepatitis. The country has over 130,000 people who use drugs, of whom almost one in six inject drugs.

The impact on people’s health is significant

Lack of adequate prevention and treatment services that are tailored and accessible to these communities means that high-risk practices such as sharing used needles and unprotected sex are widespread among people who use drugs. The impact on people’s health is significant: over a third of people who inject drugs are infected with HIV and almost half are living with hepatitis C.

Humanitarian assistance boosted by Médecins du Monde in Kenya

Having long been reluctant to adopt any approach other than the promotion of abstinence, the Kenyan government, encouraged by Médecins du Monde and local partners, has finally introduced promising measures to make healthcare accessible to people who use drugs. Over the last few years, tailored harm reduction services have been provided throughout the country. These include access to opioid substitution treatment, needle exchange programmes, HIV and tuberculosis testing, and closer links with the health service. 80% of people who use drugs now have access to sterile injecting equipment, although supplies are still frequently disrupted.

Stigmatisation and discrimination seriously impede access to healthcare

However, the existing services are unable to meet the scale of the need and stigmatisation and discrimination from healthcare staff and the general population seriously impede access to healthcare. Furthermore, the legal framework remains very repressive in relation to people who use drugs and insufficient resources are invested in implementing the encouraging policies adopted by the Ministry of Health for the comprehensive management of the consequences of drug use.

Drug users are stigmatised by the population and by health professionals.© Quentin Top
Drug users are stigmatised by the population and by health professionals.© Quentin Top

Our humanitarian mission in Kenya

Caring for marginalised communities

Since 2012, Médecins du Monde has established a humanitarian healthcare project in Kenya which provides comprehensive prevention and treatment for people who use drugs through a reception centre and mobile activities to reach the most isolated and vulnerable users. In 2019, Médecins du Monde sought to ensure the sustainability of its projects by continuing work to strengthen the capacity of local partners and prepare for the planned transfer of the programme to a local organisation. The transfer was completed by Médecins du Monde in January 2020 and the organisation SAPTA is now continuing the work of implementing the programme we initiated.

With almost half of those who inject drugs being infected with hepatitis C, Médecins du Monde, in partnership with Médecins Sans Frontières Belgium, developed a pilot project in 2016 to provide hepatitis C treatment for people who use drugs. Following the pilot project and intensive advocacy work by the team to enable people who use drugs to access the treatment, national guidelines on viral hepatitis were produced in 2018 and a strategy is being developed for the treatment of 1,000 people infected with the hepatitis C virus, thanks to support from the Global Fund.

Promoting harm reduction: a milestone in our humanitarian action in Kenya

 

 

From 2018 Médecins du Monde made the most of the favourable political context in Kenya to develop a pilot project which sought to integrate harm reduction services (in particular, the distribution of sterile injecting equipment) into existing public healthcare facilities in the country. In 2020, Médecins du Monde thus strengthened the integration initiated in 2019 within a first health centre in Nairobi, Kenya’s capital. This centre provides harm reduction services to over 50 drug users every month. In the light of the success of this initiative and at the request of local authorities, Médecins du Monde has rolled out the project to two other healthcare facilities in 2020.

 

At the same time, the Médecins du Monde team is working with Kenyan institutions to develop long-term national policies on harm reduction. We are also engaged in advocacy work around reforms to the legal framework for drug policy which is currently repressive and harmful to people’s health. The aim of this work is for people who use drugs to be decriminalised.

Advocacy is a key component of our humanitarian activities in Kenya. It is an effective way to sound the alarm and define priorities, such as the roll-out of medical assistance to Kenyans experiencing drug-related harm.

Long-term humanitarian assistance in Kenya

In 2020 Médecins du Monde sought to ensure the sustainability of the initiatives we had been delivering and to secure the gradual closure of our humanitarian programme in Kenya. We provided consolidation and support (equipment and training) as the programme was transferred to a local organisation.

A year after harm reduction services were incorporated into a public health facility we conducted an evaluation. This enabled us to measure the results and review the practical manual covering the stages and procedures required to replicate this process in other health centres in the country.

After eight years of work, two pilot projects and significant progress in harm reduction, Médecins du Monde’s programme in Kenya closed in December 2020.

 

 

Nairobi
Nairobi

In 2020

through our humanitarian action in Kenya we:

  • transferred our humanitarian programme to a local partner organisation which is maintaining regular follow-up of around 3,000 people who use drugs
  • consolidated, evaluated and scaled up the incorporation of harm reduction services into public health centres as part of the provision of medical assistance to Kenyans
  • developed and disseminated a practical handbook for the replication of this approach of integrated harm reduction to other health centres in the country
  • produced a document charting MdM’s ten years of work on harm reduction in Kenya

 

 

 

our institutional support

L'Organisation mondiale de la santé soutient Médecins du Monde

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