NACC calls for inclusion of HIV in the NHIF to attain Universal Health Care
Talks on modalities of implementing Universal Health Coverage have gained momentum, so has the National AIDS Control Council similarly embarked on a process of ensuring HIV and AIDS is included in the Universal Health Coverage. The Council has constituted a multi sectoral coordination team to aid in voicing the need to have HIV and AIDS condition included in the National Health Insurance Fund (NHIF) in an effort towards attaining Universal Health Coverage. Currently health care related to HIV and AIDS is partly absorbed from the opportunistic infection perspective given that ARV are publicly provided by the government. However, the full and direct HIV and AIDS spectrum of treatment is not included due to high cost of retroviral therapy largely supported by donor funds.
The Ministry of Health has already put in place a Rapid Results Initiative (RRI) to fast track the implementation of Universal Health Coverage which is one of the pillars of the Governments Big Four Agenda. Others pillars being Housing, Manufacturing, and Food Security. Anchored on Four Pillars the National AIDS Control Council coordination and reporting model seeks to guide the realization of Universal Health Care with the Inclusion of HIV and AIDS as well as People Living with HIV in the essential benefits package. Through the model, a replica of a similar coordination structure by the Ministry of Health, The NACC will be reporting to the Ministry in a well laid down mechanism up to the Presidency. The four committees namely communication, service delivery, HIV Financing and legal teams are critical in this process. The composition of the team includes representation drawn from the private sector, civil society, development partners and the community of People Living with HIV.
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Proposed Coordination structure and reporting mechanism Why leverage on HIV for Universal Health Care.[/caption]
The fight against HIV and AIDS like many other conditions is essential in the ongoing talks on the implementation of Universal Health Care. Cushioning People Living with HIV from expensive life-long anti-retroviral treatment certainly is critical in the realization of this Agenda. At the Centre of Universal Health Coverage is the issue of affordability. Thus Universal Health Coverage means people have access to health services required, not necessarily free but without suffering financial problems. It’s on this premise that the National AIDS Control Council is spearheading the inclusion of HIV response in the attainment of Universal Health Coverage through three pronged proposal under the rallying call of ‘Leaving no one behind’ in this important course.
- Attaining Universal Health Coverage requires that People Living with HIV and AIDS are also included in the Social Health Insurance Scheme under the Social Protection theme.
Kenya has 1.6 Million People Living with HIV. This constituency cannot be left behind in the Universal Health Coverage reach. Today, HIV and AIDS accounts for 29% of annual deaths in the country. Besides, it contributes to 15% of the country’s disease burden. Thus including HIV Testing and Prevention services as well as Anti-retroviral therapy in the Universal Health Coverage essential package is important. This is envisaged to increase the contribution to the social health insurance as it will encourage more people to enroll through the National Health Insurance Fund.
- Leveraging anti-retroviral therapy funding through the National Health Insurance to cover resources gaps and significantly accelerate achievements targets.
There’s a gap of approximately 280 USD per capita between essential Total Health Expenditure (THE) and the projected needs for ensuring 80% of the population has access to an essential benefit package for health. According to the Kenya National AIDS Spending Assessment 2017, there’s need to channel Ksh 47.02 Billion through a support mechanism to contribute to the risk pool of the national insurance scheme which is needed to support pooling of resources for Anti-Retroviral Therapy(ART). This essentially will bridge the funding gap, increase efficiency in money flows with reduced fragmentation and better link inputs with outcomes.
- Attaining Universal Health Coverage demands that the rising epidemic of Non-Communicable Diseases (NCDs) is controlled.
Non-communicable diseases are on the rise contributing to 50% of all adult hospital admissions and 40% of adult deaths. Over the last decade their contribution to overall mortality has increased by more than 60% while that of HIV has decreased by the same amount. Kenya’s significant progress has been through a multi-sectoral approach. Therefore the most effective and efficient way for the Ministry of Health to invest in the integration of Non Communicable Diseases (NCDs) prevention in to HIV and AIDS. The integration should be geared towards optimal utilization of the existing HIV prevention infrastructure and modalities. This will promote better health and control escalation of Non Communicable Diseases associated costs to the national health insurance scheme.