No mother should ever breastfeed on an empty stomach. No life living with HIV should be lost because hunger makes treatment impossible.
KISUMU, Kenya, September, 24th –In Marsabit, hunger has become the cruellest epidemic, a crisis that medicine cannot cure.
People living with HIV (PLHIV) and TB are taking their medication faithfully, but on an empty stomach.
Pause and picture this: mothers breastfeeding while hungry themselves, their bodies too weak to sustain both their own lives and those of their children. Imagine this grim irony. HIV has not killed them, but hunger now threatens to.
Just days ago, in the National Empowerment Network of People living with HIV and AIDS in Kenya, widely known as NEPHAK, a member, Halima Guyo (not her real name), raised an urgent concern in the WhatsApp group.
She reported six lactating mothers in a ward at a health facility breastfeeding without anything to eat. Six mothers, six babies, and nothing to eat. Later she informed us that one of our brothers living with HIV had died not from AIDS, but from hunger. Her plea for support lit a spark among many.
And so, in the true spirit of solidarity, NEPHAK member organisations stood up. They agreed that each of the 501 members would contribute at least Sh200. So far, 120 have responded. Funds are being sent immediately to where the need is most intense, in real time. This is not charity. No, this is survival.
This is the community saying loudly and clearly: Say YES to life.
But, as the community pulls its weight, one must ask: what are those in power doing? Where is the county emergency relief? Where is the national response to a crisis that strips people of dignity, health, and the right to life?
We cannot accept that people living with HIV die not because of AIDS, but because there is no food on their plate.
Taking Anti-Retroviral Drugs (ARVs)on an empty stomach is not just uncomfortable. No, it is brutal. It burns like fire in the gut, causes dizziness, nausea, and weakness. It makes life-saving medicine feel like poison.
For a lactating mother, hunger means double agony, her child cries for milk, yet her own body has no strength to provide. This is the torment faced in Marsabit every single day.
This hunger crisis is not only about food. It is a test of political will. If the government can marshal billions for infrastructure, campaign projects, and political trips, then surely it must act urgently to protect its citizens from starvation.
Donors who once stood firm are retreating under freezes and cuts, but that cannot be the excuse for inaction. Domestic resource mobilisation must stop being a slogan and finally become the lifeline that communities desperately need.
Kenya is home to about 1.4 million people living with HIV, making it the country with the fourth largest epidemic globally. National HIV prevalence stands at 3.3 percent, with women disproportionately affected.
In counties like Kisumu, Homa Bay, Migori, and Siaya, prevalence exceeds 10 percent.
Marsabit’s prevalence may be lower, at about 0.5 percent, but extreme poverty, food insecurity, and poor access to health services magnify the risk of death from hunger.
And yet, funding gaps are widening. Kenya requires about Sh28 billion annually for HIV commodities such as ARVs, test kits, and other essentials, yet more than a third of this remains unfunded.
The Kenya AIDS Strategic Framework had projected that full implementation of the HIV response from 2020 to 2025 would require Sh647.7 billion, but only about a third has been raised domestically.
Recent budget documents for 2025/26 show a proposed Sh11.4 billion cut in HIV, TB, and malaria programmes, even as the need grows.
The Global Fund allocations to Kenya have also fallen by nearly Sh7 billion, while foreign aid cuts, especially from PEPFAR and the United States support, have disrupted ARV and diagnostic supplies.
The Kenya Health Service Disruption Assessment by the National Syndemic Disease Control Council laid bare the impact.
Following the withdrawal of United States government funding, 40.6 percent of health facilities (2,127 out of 5,245) reported major service interruptions. Rural facilities experienced disruptions at over three times the rate of urban centres, with arid and semi-arid regions like Marsabit suffering most.
The Council’s Rapid Results Initiative Report further showed that 80.9 percent of counties rely on donor funding for more than half their HIV, TB, and malaria programme budgets.
With this dependency, 74.5 percent of counties have been forced to deprioritize HIV and TB when reallocating limited domestic funds.
Even worse, nearly 30 percent introduced user fees for services once free, pushing patients deeper into suffering.
These are not just numbers. They are mothers breastfeeding on empty stomachs. They are patients swallowing fire in their bellies with every ARV pill. They are children watching parents weaken not because of disease, but because of hunger.
NEPHAK is leading from the front, showing resilience, courage, and compassion. But communities alone cannot carry this burden.
Government ministries, county administrations, donors, and all stakeholders must answer this call.
No mother should ever breastfeed on an empty stomach. No life living with HIV should be lost because hunger makes treatment impossible.
We have shown the way. Now it is time for the government and partners to rise. Hunger is preventable. Starvation is political. Saving lives is not optional. It is our obligation.
Erick Okioma is a TB HIV Advocate and the Vice Chairperson of the Network of TB Champions Kenya.
