13 April 2023


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In 2022, HRI partnered with Wambui Karanja, who used an HRI tool to assess the landscape for increasing domestic financing for harm reduction in Kenya. This report outlines the process used and the findings that emerged, covering the operational landscape for community-led, community-based and civil society organisations and the financial landscape for harm reduction. It maps advocacy opportunities and partnerships and makes key recommendations for increasing the domestic harm reduction financing.

Key Findings

  • The registration process for civil society organisations is not easy, especially when they work on human rights issues. Organisations are subjected to significant scrutiny. It may be particularly challenging for key population networks, including people who use drugs.
  • Social contracting in Kenya is carried out via public procurement. Article 227 of the Constitution of Kenya provides for a procurement and asset disposal system that is fair, equitable, transparent, competitive, and cost-effective.
  • However, even with this in place, social contracting with regards to harm reduction in Kenya is not currently in practice.
  • The Kenya National AIDS Strategic Plan (KNASP III) and National Guidelines for HIV/STI programming with Key Populations (2014) are the policies and guidelines that introduced harm reduction in Kenya.
  • In 2018, Kenya began piloting universal health coverage (UHC). Although the essential service package offered under the pilot mentions HIV, by 2018 it had still not been included within the National Hospital Insurance Scheme.
  • Harm reduction is funded through HIV prevention and treatment for key populations and remains heavily donor funded at 63.5% in 2021/2022. PEPFAR remains the largest donor to HIV programmes, contributing 37% of annual total investments across all HIV programmes, including harm reduction.
  • The Global Fund is the main funder for HIV-related human rights programmes.
  • The Kenyan Government has provided financial support to OAT programmes.

Recommendations for actions to improve the domestic funding landscape in Kenya

  • Policy change and advocacy to remove legal barriers and punitive laws in order to create an empathetic environment for people who use drugs.
  • Remove social barriers, stigmatising and discriminatory attitudes among the general public, as well as internalised stigma among affected community members.
  • Pursue protective laws and policies by drafting, advocating for, and implementing laws that recognise and protect the full rights of people who use drugs.
  • Ensure specialised and efficient formal training and sensitisation is given to key staff where harm reduction staff are provided.
  • Conduct community-led research on the impact of harm reduction strategies in Kenya.
  • Support budget authorities (ministries, legislative bodies, etc.) through different stages of the budget cycle to integrate policy, programme, and funding/financing changes.
  • Build civil society capacity to develop alternative approaches to budget analysis.
  • Build partnerships with stakeholders, i.e., leaders, policy makers, law enforcement officers, prosecutors, judiciary, media, and policy implementers.
  • Collect and share best practices.

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