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Tumaini Project: HAART Grants for Kenyans Living with AIDS

February 2003
Introduction
In 1999, 180,000 Kenyans died an AIDS-related death and it is estimated that at least 2.1 million Kenyans will die of AIDS by 2005. While there is no drug to cure HIV infection, highly active antiretroviral therapy (HAART) can successfully treat AIDS and keep many HIV infected patients alive almost indefinitely. Unfortunately, the ability to afford AIDS treatment is beyond the reach of most Kenyans. The cost of treating infected Kenyans with antiretroviral drugs is estimated to be USD 25 billion or 238 percent of the annual GDP of Kenya. In contrast, the total health care expenditure in Kenya was 7.8 percent of the GDP in 1998.3 Thus, many HIV infected Kenyans die without ever receiving treatment.

The Tumaini Project is a mechanism created by physicians at the University of Washington and the University of Nairobi to assist Kenyans who are dying from AIDS and are unable to afford treatment. The primary goal of the project is to provide HAART for Kenyans until antiretroviral therapy becomes universally available or affordable. The Project assigns grants in the amount of USD 1,000 for each of its participants. One thousand US dollars can provide medical testing, treatment, and antiretroviral therapy for each participant for approximately one year. At that time, additional grants will be assigned to continue treatment.
Participant Selection
Persons are asked to participate in the Tumaini Project if they meet the following criteria:
  • AIDS ø Person are considered for treatment if they present with a clinical illness consistent with AIDS and their blood tests positive for HIV.
  • Economic Status ø An assessment of the household economic status is undertaken at that time to determine whether he or she is able to afford AIDS treatment.
  • Adherence ø An assessment is performed to determine whether the patient has a high likelihood of adhering to treatment and attending clinic regularly.
  • Residence in Nairobi ø Those who are invited to participate are required to stay in Nairobi for at least 12 months to ensure proper treatment.
  • Family ø Infected nuclear family members of previously selected participants are considered in advance of unrelated participants.
Project Guidelines
  • The Tumaini Project steering committee is composed of Drs. Michael Chung, James Kiarie, and Grace John Stewart.
  • Grants of USD 1,000 are assigned to each participant on the basis of the above outlined selection criteria. This sum is allocated to this participant regardless of how long the grant can be used to treat him or her.
  • Funds allocated to a participant are used for HIV medications, prophylaxis and treatment of AIDS-related illnesses, medical laboratory and radiological testing, and necessary referrals to physicians outside the Project.
    • Funds are only used to diagnose and treat illnesses associated with AIDS and HIV unless a medical emergency otherwise threatens the life of the patient.
    • Funds are not used to support the patientÕs household expenses unless such circumstances are deemed life-threatening.
  • Physicians in the Tumaini Project work voluntarily and do not receive any remuneration from project funds.
  • If a participant reaches the 9th month of HAART therapy or USD 750 of his/her grant without having received additional funding, the Project will allocate any donations given at this time to said participant first. No new participants will be enrolled at this time unless funding permits.
Financial Matters
  • Funds for the Tumaini Project reside in a joint Kenyan bank account opened by Drs. Michael Chung and James Kiarie. The bank account is used solely to receive and give money associated with the Tumaini Project.
  • Copies of bank account statements and expense receipts are freely available and are sent to donors on a quarterly basis.
  • Donations are accepted from both international and domestic sources. International donors can wire funds directly into the Kenyan bank account.
Education
One goal of the Project is to educate the international community about AIDS and its impact on people living in Kenya. The Project seeks to personalize the relationship between donors and recipients and to put a human face on the suffering. After a participant is given a grant, the individual is asked whether he or she would be willing to share his or her photo and story with other people. If a participant is willing, then such material is shared with the community through personal communications and the web. It is hoped that through glimpses into a life lived with AIDS, others will better understand the need and the hope they can offer. If the participant is reluctant to share then no information will be revealed. This does not affect a participantÕs eligibility in the Project in any way. Social stigma surrounding HIV in Kenya is severe and protection of participants is of the highest concern.
Partnerships
Tumaini is the Kiswahili word for hope. Hope for this project derives primarily from its international partners. The Tumaini ProjectÕs partners include the Slum Doctor Programme in Nairobi and the Northwest Coalition for AIDS Treatment in Africa (NCATA).

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