Kenya is facing a nationwide shortage of antiretroviral (ARV) drugs as a court case continues to hold up the purchase of the life-prolonging medication.
The High Court in the capital, Nairobi, barred the Ministry of Health from procuring ARVs after a consortium of drug suppliers challenged the tender process.
According to James Ole Kiyapi, permanent secretary in the Ministry of Public Health, unless the court allows the government to purchase ARVs, there is a real risk that people who depend on government hospitals for their medication could go without.
"We have very little medicine left and there is nothing we can do to get the drugs because we have to abide by the court order; we can do very little at the moment unless the court reverses the order," he said.
More than 200,000 Kenyans are enrolled in government ARV programmes; it supplies about 75 percent of all ARVs in the country.
"As a government we feel it is our obligation to provide services to Kenyans in the best way we can; it is unfortunate when we are put in a situation where we cannot do that," Ole Kiyapi added.
Earlier this year, the Public Procurement Administrative Review Board (PPARB) - responsible for monitoring the government's purchases – issued an order forcing the Kenya Medical Supply Agency (KEMSA) to accept tender documents by an Indian company, Hetero Drugs Limited, and start the tender process afresh. KEMSA had rejected the company's tender documents because they allegedly did not comply with procurement rules.
A consortium, including the UK-based procurement company, Crown Agents; the German NGO, Deutsche Gesellschaft für Technische Zusammenarbeit (GTZ); and public health research group John Snow, Inc., which won the controversial tenders has now gone to court to reverse the order of the PPARB; the case is due to be heard on 11 November.
KEMSA declined to comment on the grounds that the case was still ongoing.
People reliant on government-supplied ARVs may now be forced to enrol on new NGO-run drug programmes, raising convenience and adherence issues.
"The thought that I might go for my medicine and miss them is chilling," said Emily Nyabari, who has been living with HIV for three years.
According to James Kamau, coordinator of the Kenya Treatment Access Movement, the tender wrangle is likely to delay the supply of ARVs for many months.
"Even when it is finally over, it takes months to procure drugs and it will take some time before these drugs are available," he said.