The United Nations estimates that 40 million people worldwide are HIV positive. Given the uncertainty to correctly diagnose the cause of death of the vast majority of people in the developing world, it is likely that the figure may be higher.

The United Nations also estimates around 65 per cent of all HIV positive people live in sub-Saharan Africa. Thus, about 25 million people in Africa are HIV positive. Those infected are in the most productive ages and the fact that a large proportion of the productive population is wiped out by the pandemic has a huge detrimental effect on the economic growth of the region.

Employers appreciate that HIV/AIDS is having an increasing adverse impact on the operations of many companies and employee households in Kenya. The high cost of training new people to replace those who succumb to HIV/AIDS, time lost attending funerals of colleagues lost to the pandemic, time lost to absenteeism, high out of pocket/employer expenses for providing medical care for those whose immune system has been compromised by the virus and the trauma of caring for families and friends have a direct impact on the costs of production, reduce profits and lead to greater difficulty delivering products and services. The companies can now, also see the benefits of providing anti-retroviral therapy to those in need and at the same time keep them productive. Where employers provide healthcare and/or medical insurance, provision of anti-retroviral therapy is now possible.

The monthly cost for a fixed dose combination of anti-retroviral drugs is US$20. Thus, the annual cost for prolonging life for an HIV positive person, in need of anti-retroviral therapy, and to keep the person economically productive and at the same time, reduce the risk of spreading the virus to others is about US$240 (not including the CD4 and other laboratory tests). It is obvious that any kind of remedy is, now, not beyond the reach of most Africans.

The overall goal is to increase access to ART to the organized private sector workforce and their families. The two strategies that will be used are:

The incorporation of ART into the medical scheme of private sector enterprises, and the provision of ARV’s to designated pharmacies at ACCESS prices if they meet stringent criteria for pricing their products and ensuring compliance with ACCESS, WHO, and Government of Kenya guidelines for ART.

Training of pharmacy staff on ARV’s, adherence counselling, referral to designated doctors and centres, and follow up are an integral part of the project. The project also provides computers to the participating pharmacy to help them track stocks and inventories of ARV’s and for all the products that they carry, as they wish.

We are working closely with a number of large private sector and parastatal employers who now provide anti-retroviral therapy to their employees, spouses, children and in some cases the community at no/subsidized cost. Currently, some 50 worksites provide ART to close to 1,100 patients. Close to 60 service providers have been trained in provision of comprehensive care.

Private sector partnership is an important ingredient in HIV and AIDS programming, however, it is not always easy to find partners in the business arena that have the same goals and vision as the IMPACT Project implementing partners. Pharm Access Africa Limited fits this bill and with Presidential Emergency funds a contract was signed with Family Health International in April 2004. Pharm Access Africa Ltd. was established in 2001 to increase access to healthcare in general and to medications for HIV/AIDS-related infections and anti-retroviral therapy (ART) in East and Central Africa.

The purpose of the IMPACT contract with Pharm Access Africa Limited, is to assist employers of large companies who have some health infrastructure or medical scheme to provide HIV-related medicines including ARV’s. Another major component is to upgrade selected pharmacies to provide similar drugs.

To ensure that the standard of pharmacy practice in these selected sites is enhanced, the pharmacies have been computerized to record supply and dispensing of drugs, including ARV’s. In addition, CD-ROM software versions of Martindale’s 34 edition and the British National Formulary Version 48 have been installed on the pharmacy computers and other selected sites.

This project’s value is that there is now an inexpensive private source of high quality and other drugs for Kenyans outside the public health system. More access to these commodities means more lives are saved.