1. Dr. Kenneth L. Chebet Director NASCOP/NLTP Division Kenya
Phased Implementation of TB/HIV Collaborative Activities From National to Peripheral Levels in Kenya
Dr. Kenneth L. Chebet
Director
NASCOP/NLTP Division
Kenya

2. Situation in Kenya Economics:
Health expenditure per capita: < US$ 4
Life expectancy dropped last decade from 60 to 50 years.
HIV
Seroprevalence 13%
5-10% know status
1 million orphans TB
2001: 73,000 cases, 2005: ~150,000 cases projected
Estimated 44% case detection rate
40-50% HIV +
SCC treatment success 78%

3. Defining the problem TB case detection rate too low
TB patients don’t know their HIV status
HIV positives have limited access to essential package of care, including screening for TB
Sub-optimal cooperation between National AIDS and STD Control Program (NASCOP) and National Leprosy and TB Control Program (NLTP)

4. Selected Objectives and Outcomes
Expected Outcome
Improve collaboration
Implement shared TB/HIV control strategy
Expand access to TB screening diagnosis and treatment
80% of VCT services linked to TB screening and treatment services
Expand and improve access to HIV counseling and testing
Provide diagnostic counseling and testing for all TB patients/voluntary counseling and testing for partners
Promote preventive therapies among HIV+ VCT clients and TB patients
All HIV+ TB patients offered cotrimoxazole

5. Progress So Far Formation of one division
Stakeholders workshop with WHO facilitation –2001
Joint Training and supervision: DARE/CDC support
Core functions of administration, supplies, logistical and procurement harmonized
Incorporation of TB in HIV/AIDS policy documents/guidelines
GFATM: Catalyst to the collaboration
Drafting of IPT policy document
Rapid scale-up of VCT sites (entry to TB services)

6. Way Forward Gap between programs still exists
WHO to give mentorship and catalyse process, give country support (Nairobi proposal should be implemented ~$100,000)
Refocus integration to lower implementors: districts/provinces
Donors/development partners should be encouraged to support joint activities
Resource gaps should be filled: feasible to integrate
TB Programme Manager should be integrated with National AIDS Control Council structures
Health System development should remain the backbone—decentralisation/reforms