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NAIROBI, Kenya (AP) — Evans, a two-year-old brought to Nyumbani Children’s Home in Nairobi, Kenya a year ago, was suffering from HIV and tuberculosis. Without family to care for him, Evans was referred to the orphanage by a health center after he stopped responding to medical treatment. Nyumbani Children’s Home has been instrumental in keeping Evans alive. However, decisions made at a political level thousands of miles away could jeopardize his life. The orphanage provides Evans and approximately 100 other children with antiretroviral medication, a supply facilitated by the U.S. Agency for International Development (USAID) through the Kenyan government. President Donald Trump’s recent executive order to freeze USAID’s funding raises concerns that Nyumbani’s access to vital antiretroviral drugs, crucial in halting the replication of the HIV virus in the body, may soon be cut off. Trump’s order mandates a review of nearly all U.S. foreign aid for a 90-day period, with steps to shut down USAID already in motion. The repercussions are being felt globally, with numerous job losses and disruptions to humanitarian programs worldwide. For the children at Nyumbani Children’s Home, this poses a stark life or death situation. Unaware of the uncertainty surrounding his future, Evans plays with his peers, while his caregivers bear the weight of anxiety on their faces. The small graves at one end of the orphanage serve as a somber reminder of the potential outcome for the children without USAID assistance. Sister Tresa Palakudy, overseeing the children’s welfare for 28 years, vividly recalls the stark difference before USAID’s involvement. She reflects on the immense progress achieved since the aid began and dreads a return to the past losses. Nyumbani, established in 1992 by Christian missionaries, initially functioned as a refuge for orphaned HIV-positive children, offering mainly palliative care. The inception of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) in 2003 brought renewed hope to children grappling with HIV, including those at Nyumbani, with USAID funding playing a key role. USAID’s provision of free antiretroviral drugs significantly transformed the lives of the children, enabling them to thrive and lead normal lives. USAID and PEPFAR have been pivotal to Nyumbani’s operations, contributing over $16 million to the home from 1999 to 2023. This support has extended to approximately 50,000 children through the rescue center, in addition to the outreach programs Lea Toto and Nyumbani Village. Funding directly from USAID ceased in 2023, coinciding with allegations of sexual abuse involving volunteers and staff at the orphanage. Despite these challenges, Nyumbani remains committed to its mission of caring for vulnerable children and providing a safe
A cover-up was alleged, with claims that all accusations were addressed in compliance with protocols, involving the notification of local authorities and providing counseling to affected residents. Executive Director Judith Wamboye stated that investigations carried out by the Kenyan police were inconclusive. The termination of funds was unrelated to the investigations but aligned with a modification in USAID policy shifting aid distribution through the government rather than directly to organizations. This policy alteration impacted all funded organizations, redirecting financial support through government initiatives addressing similar needs. Consequently, Nyumbani downsized its outreach initiatives, directing beneficiaries to governmental establishments.
Subsequent to the cessation of direct USAID funding, Nyumbani reduced the scope of its two outreach programs, referring enrolled children to alternative facilities. Nonetheless, Nyumbani continued to rely on USAID for the provision of essential PEPFAR HIV treatment medications at no cost. “The future is uncertain,” remarked Wamboye. “The Kenyan government indicated that their current ARV supplies will only last six months.” AmfAR data indicates that approximately 1.3 million individuals are undergoing HIV/AIDS treatment in Kenya, with 1,602 orphans and vulnerable children reliant on PEPFAR. amfAR cautioned that President Trump’s foreign aid freeze could jeopardize their access to critical medical care.
One such child is Mercy, under Nyumbani’s care for the past 12 years, whose life was saved by ARVs. “I had a very weak immune system,” she recounted. “This led me to contracting many serious illnesses like tuberculosis and skin diseases.” Initiation of HIV treatment provided Mercy with a lifeline, but recent freeze news has instilled fear for her life. “I am very afraid that previous illnesses will reoccur. And now that I have completed high school and am set to join college, I fear it will jeopardize everything,” she expressed.
On average, the children’s home incurs $1,139 annually per child for HIV treatment. Apart from antiretrovirals, the facility requires reagents for regular viral load testing among the children, along with medications for treating opportunistic illnesses prevalent in HIV patients. Wamboye warned that a permanent discontinuation of PEPFAR could escalate ARV costs to unaffordable levels, resulting in fatal consequences for children living with HIV. “This is a life-saving situation, and we cannot delay action or haggle when human lives are at stake. Our focus is on preserving human life, on the lives we must safeguard. Urgent measures are imperative,” she emphasized.
