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May, 2018


Trailblazer who molded the ‘Jitegemea’ spirit

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It is a year since the death of the Very Reverend Dr John G Gatu, the respected clergyman who was the first African Secretary-General of the Presbyterian Church of East Africa (PCEA) and Moderator of the ninth and tenth General Assembly of the same church.

Family and friends are unveiling the cross today at the burial site in his Karen home after a memorial service at the PCEA Muteero, Karen. Rev Gatu was a trailblazer in many spheres. In church, he shocked the faithful in Africa, Europe and North America when he, the most senior Presbyterian cleric in Kenya, called for the immediate stoppage of both missionary personnel and material support to the local church.

This gave rise to the moratorium debate in which the churchman argued that continued charity by Western missionaries inevitably resulted in the destruction of the dignity of the recipients of aid, turning them into perpetual beggars. Rev Gatu drew a blueprint for a self-supporting, self-governing and self-propagating church whose clarion call was Jitegemea, or self-hood.

This pastoral policy brewed in the crucible of the PCEA had far-reaching implications and impacted on many other Christian denominations.

Talented with remarkable attributes, he was a bold man who stoutly stood his ground. In his book Fan into Flame, he narrates how early in life as a peacekeeping trooper in Abyssinia, he threw an Ethiopian off a moving train. Decades later, as a minister of the gospel, he returned to that country in contrition to confess the sin publicly and to seek forgiveness, which he was grateful to receive.

Besides being a person of courage, Rev Gatu was also a poet, as evidenced by his Gikuyu book He Gatu, Nguhe Kanua (Lend Me Your Ear, I have Something to Tell You). He had the rare gift of being a fine writer and a great orator. Many of these matters are in the public domain. He owned other attributes that are less known and which offer an insight into his persona.

Since the 1950s, the Rev Gatu made careful notes, some handwritten, others typed, on important matters and themes. This writer had the benefit of consulting with Mr Kibacia Gatu, son of the departed prelate and who is also the custodian of Rev Gatu’s personal papers. The documents reveal a man of great character and discipline.

In a file on the Moratorium Debate, one marvels at the number and variety of people Rev Gatu had conversations with before he finally called for a suspension of missionary agents and aid to Africa.

Thinkers and theologians consulted included Canon Burgess Carr, who was General Secretary of the All Africa Conference of Churches; Fr Adrian Hastings, a leading Roman Catholic theologian who was a professor at Makerere University; Rev Paul Hopkins of the United Presbyterian Church, USA; Mr John Mpaayei, the first person to translate the New Testament into the Maa language; Bishop Zablon Nthamburi of the Methodist Church and Bishop John Henry Okullu of the Anglican communion.


Rev Gatu is systematic and methodical in his personal records. Only after consulting this wide variety of people did he offer his reasoned position. The personal papers reveal a person who thought deeply on subjects such as pastoral challenges facing the Church, tribalism, liberating cultures, health and development, and the role of the Christian in bringing about a fairer economic order.

Two of the recurring motifs are self-hood and culture. Rev Gatu is greatly inspired by Brazilian thinker Paulo Freire and his concept of conscientisation in a bid to attain self-hood. While Rev Gatu draws from the seminal thinking of Henry Venn to envision a self-supporting, self-governing and self-propagating church, the Kenyan prelate recast the idea to make it relevant in the African context.

Rev Gatu is a champion of inculturation, even as he opposes retrogressive practices such as female genital mutilation.

As the debate rages on whether it is proper for PCEA believers to join traditional councils that discuss matters of culture and community welfare as they consume goat-meat, it may be helpful to ask: What would be the attitude and spirit of Rev Gatu in this matter of faith and culture?   

 Father Lawrence Njoroge is a professor of Development Studies and Ethics at JKUAT, where he serves as Catholic Chaplain.  [email protected] 

Terrorists common enemy

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Visiting Somali President Mohammed Farmaajo was admirably blunt in his criticism of the terrorist group in his country that has caused untold suffering both at home and in the region. He didn’t mince his words, mentioning Al-Shabaab by name and casting doubt on its claim to be based on religion.

The terrorists have been waging an indiscriminate war that has claimed many innocent lives. Of course, Somalia has suffered most. But the region’s other countries, especially Kenya, have not been spared the bloodletting in brutal attacks.


President Farmaajo declared the murderous outfit the common enemy of the peace-loving Somalis and other East Africans.

We could not agree more with the Somali leader. There are active terrorist cells, especially in the northeastern region, where the people live in constant fear of these mindless hooligans.

Living proof of our commitment to help restore normality in Somalia is the presence of the Kenya Defence Forces troops in the United Nations Mission in Somalia (Unisom).

They continue to soldier on, at a great sacrifice, with some paying the ultimate price in the campaign to help stabilise our neighbouring country. President Farmaajo’s candid words are the best signal about a solid commitment to defeating the evil that hovers over Somalia, threatening national and regional stability.

Concretise the push for national unity

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President Uhuru Kenyatta and opposition leader Raila Odinga have upped their peace mission as they lead their troops in committing to reconciliation and opening a new chapter of national rebirth.

The bonhomie among the leaders marked the climax of Thursday’s national prayer breakfast, whose rallying call was tolerance, national unity and coexistence.

Since entering a truce on March 9, President Kenyatta and Mr Odinga have tried to push for a common agenda of national unity, but which has been resisted by some of their supporters and top allies, seeing in it a move to scuttle their ambitions for high political offices.

Yet, following the acrimonious elections last year, the country was thrust onto the path of self-destruction as the government and the opposition clashed on everything. It was only after the handshake between the two leaders that the ice thawed and sanity has prevailed.


Our concern all along, however, has been that the rapprochement was solely between two individuals and that it was not predicated on a strong foundation, and risked being swept away as the rank of the political elite felt left out and the public kept in the dark about the details. We still insist that the deal is built on quicksand. Many politicians and their acolytes are not convinced, more so the fellows whose political careers have thrived on the animosity between the two leaders.

Beyond calming bruising political rivalry, the amity should focus on cleaning up the national mess – run-away corruption, insecurity, poor governance, failing services, crippling inflation and rising unemployment.


Already, there are indicators that the camaraderie has blunted the opposition, which is getting cosy with the government, hence failing to ask critical questions and play its oversight role. The comradeship should not serve selfish political interest while exposing the public to grave dangers.

We acknowledge that the two leaders have appointed a team to advise on the unity pact. Even then, the arrangement is tenuous; there is nothing concrete about it.

We need a breakdown of the deal in concrete terms and clear roadmap of where we are going.

Joy as Madaraka train marks first anniversary

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Passengers in Thursday’s 2.30pm train from Nairobi to Mombasa could not help feeling a little special as the engine roared in readiness to leave the Syokimau station.

Cheers and ululations from observers at the station’s platform rent the air as the train accelerated.

Some passengers in the Economy Class coaches could not resist the urge to capture the moment with their phones. Even the First Class lot, often disinterested and sleepy, could not afford to just slouch on their coaches.

It was exactly a year since Madaraka Express was launched by President Uhuru Kenyatta, and various dignitaries were there to celebrate the moment.

The train coloured red, white and yellow fast gathered speed, with its coaches quickly fusing into a reddish haze. Soon it was out of eye view.

To senior Transport ministry officials, the train’s top speed of 120 kilometres per hour has been the pace of many things around Madaraka Express from the time it was launched.


The income, for instance, has been flowing in at a satisfactory pace, according to Kenya Railways.

KR’s managing director Atanas Maina said on Tuesday that the passenger service has so far made Sh1.1 billion in revenue, attributing it to consistently high booking rates.

At no given time, he said, has the booking capacity gone lower than 90 per cent.

“The overall seat occupancy is about 96.7 per cent, which I think is tremendous,” he said in an interview on Tuesday. “Once in a while, you go down to overall seat occupancy of about 90 per cent, but on the whole, the trains have been full throughout.”

Transport Cabinet Secretary James Macharia said on Thursday that the train’s demand keeps rising.

“In terms of passengers who are using the train, already we have exceeded the 1.3 million mark. And the demand is growing,” he told journalists in his office.

Currently, there are two passenger trains plying the standard gauge railway. They make two trips from Mombasa to Nairobi per day and two in the opposite direction.


By Tuesday, the trains — being managed by the China Road and Bridge Corporation — had made about 1,142 trips, according to Mr Maina. Another fast-rising aspect about Madaraka Express, according to the government, is the number of domestic tourists at the Coast.

“Before the launch, hotels in Mombasa were struggling in occupancy. On average, we had like 50 per cent occupancy in Mombasa. Currently, it has gone to almost 90 per cent,” said Mr Macharia.

The way the public has taken up Madaraka Express services, according to Mr Maina, has been “surprising”. Even after fare prices rose from Sh700 to Sh1,000 in the economy class, he said there was no reduction in booking numbers.

“We didn’t think that the uptake could be as much as it has been. And we are now challenged to look at how we can bring in additional services,” said Mr Maina.

Currently, a passenger can book a train online or through dialling a code on their phone. A person can book as many as 30 days earlier.


Mr Maina said no Kenyan has reached the training threshold required to be in control of the trains. “A passenger train, ferrying 1,100 people, is bigger than the Boeing A380,” he said. “So, the amount of responsibility you place on that person is enormous.”

He said that until Kenyan drivers acquire the proper training, they will continue to serve as assistants to the Chinese.

“It’s only a year from the time we started. We’ll have to make sure that safety standards are maintained, timelines are kept and training is properly done,” said Mr Maina. “They’ll go through a lot of testing before they can be allowed to steer a train ferrying 1,000 people.”

While the reviews for the passenger service have been largely positive, the cargo function of the standard gauge railway, which is now entering its sixth month, has had many hiccups.


In March, cargo handlers complained that the government was forcing them to use the cargo service.

Head of Public Service Joseph Kinyua in a March 7 circular directed all government departments to use the cargo services offered by the standard gauge railway, which implied that truck transports would be dumped forthwith.

But the Transport ministry officials responsible say that the cargo service has been making many strides away from the public eye.

Mr Macharia said they have so far transported 25,000 containers between Nairobi and Mombasa. He described the growth of the cargo service as tremendous and exuded confidence that it would bring in the desired returns. If it goes on like that, he said, a time may come when income from cargo will be used to subsidise passenger services.

Openness can promote patient safety

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Most Kenyans believe that patient safety standards in our country are a drastic far cry from global benchmarks, citing a recent case at Kenyatta National Hospital as well as others in various public and private hospitals.

But while it is tempting to believe this, the reality is that medical error is a global problem. In a recent study, John Hopkins patient safety experts estimated that medical error was the third-highest cause of death in the United States. In findings published in the British Medical Journal in May 2016, medical errors accounted for 10 per cent of all US deaths.

Medical error is not unique to Kenya. It occurs elsewhere, sometimes with greater prevalence and direr consequences on human life. The difference is how cases are handled and whether a culture of sharing information and addressing core issues is promoted.

We need to create an environment in which health workers feel that they can share information about medical errors without being unjustly victimised. Accurate and timely information empowers decision makers in the healthcare system to identify and address the root causes of preventable errors.


In most cases, the root issue is human error. At KNH, measures taken to address human error include tightening enforcement of standard operating procedures and improving patient-provider communications and patient tagging.

In some cases, the challenge is a broader health systems issue — such as shortage of health workers. The shortage of nurses in Kenya, is particularly worrying, and has a material effect on patient safety standards. The Kenya Healthcare Workforce Report shows the ratio of practising nurses to the population as 8.3 per 10,000 against the World Health Organisation (WHO) recommended limit of 25:10,000.

The dire shortage against huge demand contributes to fatigue and increases chances of human error. This points to the need to increase training of nurses and review recruitment. We also need to treat individual cases as a window into our health system. For instance, why are our referral hospitals perpetually overcrowded, with bed occupancy at KNH sometimes hitting 120 per cent?


Primary healthcare has, historically, been given limited attention in Kenya. A patient who could have received basic treatment at a local clinic ends up at KNH, leading to overcrowding and compromising patient safety standards. These issues need to be addressed.

However,  a few cases of medical error are caused by reckless behaviour among health practitioners who violate patient safety rules. If this is suspected, disciplinary action should be taken, subject to proper investigations. In most cases around the world, state medical boards are charged with punishing medical malpractice with some incidents escalated to law courts.

A case in point is the highly publicised case involving Dr. Conrad Murray, who was Michael Jackson’s personal physician. In 2012, the American doctor was convicted of involuntary manslaughter in the death of the pop star and received a four-year jail sentence.


He routinely administered Propofol as a sleeping remedy to Jackson at the comfort of the late musician’s home, despite the fact that any patient who receives the surgical anaesthetic requires continuous monitoring of heart rate and breathing in an equipped medical facility.

But health practitioners also need to be reminded of their commitment to not only deliver clinical excellence, but also treat patients with respect and empathy. This promotes a good patient-provider relationship, making it easier for the former to share information that would lead to better treatment and higher safety standards.

I want to be a tenderpreneur when I grow up, then ‘eat’ life

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I want to be a tenderpreneur when I grow up.

A Toyota Landcruiser VX-driving, arrest-prone, scandal-scarred, million-minting, dummy company-owning, air-supplying tender cooker.

Why, you ask, would I want to be such a widely vilified, ethics-challenged animal.

Here is the reason. The scales have dropped off my eyes. I have been looking at my car the way a man looks at his wife: You don’t see the years. Every time you look at her, you see the small girl who caught your eye decades ago.

My car is the oldest daily use car in Kenya. Its paint is cooked in the sun until it has browned like onion.

Its nose is ugly and broken — the result of a head-on crash that I never quite got round to fixing — it looks like it’s been kicked.


It doesn’t even have a perfect record. It has rolled twice — once with me — and has suffered an engine knock as well.

I think part of the reason I keep it is because I don’t know what to do with it. The other one is related to my renaming it “The Write-off Artist”; it exists to manufacture write-offs.

It is the easiest and best car to drive on Kiambu Road and Thika ‘Superjamway’, where Kenya’s worst drivers are to be found.

When somebody cuts in suddenly in front of me, I never molest the old brakes.

A couple of matatus have crashed into me from the rear, especially the 14-seater vans; I don’t stop and I never look back.

My car’s ugliness seems to be contagious; every time it comes into contact with another vehicle, the other vehicle ends up looking like it.

I want to be a tenderpreneur because only a tenderpreneur can afford very nice cars — I mean, five-litre petrol engine type of nice cars.


Cars with so much power the nose rises to the air and the car takes off every time you caress the gas.

I want to go to Monaco for massage. I want to own an apartment in Jumeirah Beach. I want to stay at the Burj Khalifa, not Deira, when I go to Dubai.

I want a Maybach waiting for me at Heathrow, not the damn tube. I want villagers to do a traditional jig every time I drop by.

The only way I can have all this is if I am cooking tenders. Just one tender for army bisquits and pineapple in syrup is more than enough, I suppose Mr Mbogo?

But how does one become a successful tenderpreneur, apart from having no scruples and loving money more than you love Jesus?

I have been doing some research. It is very important to ‘slay’. If you do, you will find clerks lining up the streets of NYS waving LPOs and begging you to flood the place with air. Why, they may even issue the LPOs along with payment vouchers all authorised and ready for Ifmis.


You must know people. As you may have guessed, it does take much, in the way of brains, to be an air supplier. Supplies is not a competence challenge; it is a networking assignment. You have to look for people from your tribe who are in a position to issue LPOs and push payments.

You need a strong and hard body. If you are soft, then you cannot live through the day-long court sessions and brutal interrogation by detectives trying to find out how much money you have and where you have hidden it.

You must be a collector of heavy jackets. These are both mattress and duvet in the cell when your luck finally runs out — as it often will.

You must be strong in prayer. You have to pray and believe that the government is not serious about fighting corruption, that you will always be able to buy your way out of trouble and that you will not, for real, end up in Kamiti Maximum Prison, eating air supplied by one of your comrades in business.


Knowledge of chemistry is an added advantage. If you are going to trade in air, you must understand its properties, how to capture it, store it and transport it to NYS.

You must possess one or two big spoons with which to eat life. You can’t go El Bulli to order chips for crying out aloud!

You must know how to inhale caviar like snuff and to rinse your ears with champagne. This is the big league, my brother, not Mama Baby’s chicken eatery in Kaloleni.

And dare you tell me that my dreams are evil, that I should play by the rules and aspire to be a thief. I have lived by the rules, I have bought cars with loans and hustled myself half to death. And where did that ever get me?

I have never been to Monaco, I don’t have an apartment in Jumeirah Beach and my car looks like it’s been kicked.

Readers ask ‘Nation’ to galvanise the public to ensure justice is done

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Many readers have called to congratulate the Nation for its bold, fresh and robust approach to journalism in which it exposes corruption and seeks to secure public interest. And it is doing this with powerful front-page headlines and a dash of striking images and punchy teasers that invite readers to exciting news in inside pages.

It has, indeed, been a time of veritable exposés that began with the May 9 Patel Dam tragedy in Solai, Nakuru County, followed by a series of corruption cases. Frequent Nation critic Caxton Muune calls it a “progressive shift in the NMG news coverage and presentation away from the drab political gossip”, a view echoed by many.

He says the Nation is giving more space to news beneficial to the majority of readers and reportage is drifting towards people-centred journalism.

In covering the miscarriage of justice in the Pastor James Ng’ang’a trial and the assault of businessman Timothy Muriuki, the Nation has adopted the “stronger language previously confined to the opinion pages in the protection of the public interest”.


However, he says, the media should educate the public about such disasters as the Solai dam tragedy. He would like NMG to build on the need for educative content and programming to support the mitigation of disasters and protection of the public interest.

“The media have traditionally made public calls to action over certain issues, activities and practices that threaten to harm the cause of the common people,” he says. “Calls to action are couched in news coverage with information, procedures and guidelines, which the people can use to impact their lives as repeatedly explained and illustrated by CNN.”

In this context, Mr Muune adds, NMG should make a public call to action over the NYS scandal to force tangible action from the relevant agencies. It should go even further and provide the email addresses of public officers and institutions directly involved in the investigations — such as the Ethics and Anti-Corruption Commission, the Attorney-General, Central Bank, National Treasury and Directorate of Criminal Investigation — to write to them.


On this Madaraka Day, Mr Muune says, he would like the media to rally the public to the support of the “Handshake”, which he says is a most worthy cause. The public should spare a moment to reach out to the next person to exchange greetings and pleasantries on the streets, matatus, schools, mosques, churches, homes, stadiums and such places “to anchor the national healing and reconciliation with the people themselves”.

The celebrations, says this American-educated transportation engineer, offer a unique opportunity for national healing. NMG should disseminate information to help the public to organise social activities to support the ‘Handshake’.

The public should organise such activities as neighbourhood lawn parties, potlucks, games and keshas “to stitch and patch the battered national fibre networks”. That could help to “build bridges for sustainability of the national reconciliation and stabilisation launched by the Handshake”.


The Nation’s uninhibited exposés are grounded in the NMG editorial policy. It is the duty of the media, the policy says, to uncover and disclose matters that ought to be subjected to public debate, analysis, scrutiny or criticism in keeping with the universally acknowledged principle that the media’s primary responsibility is to the people.

But I think reader Mathew Mwangi should have the last word: “It is good that the media is doing its job to expose corruption. I think all Kenyans can agree that corruption is a cancer that must be fought because it is destroying our nation.

“However, the media should not engage in the public lynching of suspects. Every person is presumed innocent until found guilty. As much as Kenyans want to see people pay for their crimes, let the law be followed — otherwise, some innocent people may be caught up in the public ‘baying for blood’.

I must say Amen to that.

New tax scheme could push up cost of medicine

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You could soon pay more for medication if a proposal by the government to raise taxes on imported pharmaceutical products is implemented.

The Kenya Association of Manufactures (KAM) and the Federation of Kenya Pharmaceutical Manufacturers (FPKM) are lobbying the government to include the proposal to increase taxes in the VAT Amendment Bill, which seeks to increase taxes on the ingredients, as well as the finished products entering the country.

The proposals are aimed at boosting local manufacturing, one of the four main deliverables of President Uhuru Kenyatta’s last term.

Tariffs are taxes imposed by governments on goods entering a country. Non-tariff barriers are any trade measures other than tariffs imposed by governments to restrict imports.

“While tariffs have been reduced, non-tariff barriers have increased dramatically worldwide. The situation has further been compounded by more than 300 trade agreements between countries and 930 tariff schemes applied by 132 countries,” reports the World Trade Organisation reports (WTO).


According to the WTO’s September 2007 policy brief, The impact of tariff and non-tariff barriers on essential drugs for the poorest people, about 39 per cent of countries do not impose tariffs on finished pharmaceutical products. Of those that do, 76 per cent apply tariffs of less than 10 per cent.

A suggestion by the Global Health Council (the WTO’s health arm), to harmonise the tariffs has emboldened local manufacturers, who feel the market has long been skewed in favour of cheap imports, thus hurting local production.

FKPM has requested for increased duties on a smaller list, as well as another request for an increase in verification fees for imported medicines.


But Dr Daniela Munene, CEO of the Pharmaceutical Society of Kenya (PSK), says they do not favour rushed implementation of the proposals, since that would do more harm than good to the country.

“The proposals might appear positive from a manufacturing point of view since they are meant to stimulate and expand local pharmaceutical production in line with the “Big Four” agenda. On the other hand, a tax increase could end up hiking the price of medicines since suppliers will pass the extra costs of doing business to the consumer, posing a serious challenge to universal health care which is another ‘Big Four’ pillar,” she said.

This proposal could signal good news for local manufacturers, who have long complained that cheap imports are making it hard for them to sustain profitable operations.

The stakeholders suggest a comprehensive assessment of the impact of an increase in inspection fees to 12 per cent and the introduction of inspection duties of 25 per cent on imported medicines.

In a document entitled “Regional Pharmaceutical Manufacturing Plan of Action (EAC PRMPOA)” the stakeholders called on the government to support local production of drugs.

She added it could also make generic medicines more expensive, further increasing the costs for poor Kenyans who may not be able to afford the original brands.


“The purchase of most medicines in the country is mostly dependent on what the doctors prescribe for their patients. Most medics prescribe drugs by brand as opposed to their chemical name or molecule identity, and the patients trust these prescriptions and brands,” she said.

The medic said patients will maintain their loyalty to preferred brands despite increased prices.

Dr Munene said the patients also prefer drugs made abroad and are unlikely to switch preference to relatively little-known local products.

“Even as we work to convince doctors to use local medicines in their management of health complications, we must also convince patients that the products are just as good as the imports they are used to,” she said.

Dr Munene was quick to say the PSK supports the development of local industry but said the current capacity is very low.


 “Local manufacturers supply a small part of the total products consumed in the country. I doubt whether they have capacity to fill the huge gap that would be created by pricing the imported medicines out of range through tariffs and high taxes geared at discouraging importation,” said the PSK boss.

She said the pharmaceutical industry was still largely dependent on imports despite the Health Act of 2015 which zero-rated imports of medicines and raw materials for medical products’ manufacture.

She says the state should now focus on encouraging more investment in the local manufacturing industry

“Our industry is skewed in favour of imports and the manufacturing pillar should provide incentives to investors intending to set up industries for local production of pharmaceutical products,” said the medic.


According to Director of Inspection, Surveillance and Enforcement at Pharmacy and Poisons Board Dr Jacinta Wasike, the local pharmaceutical manufacturing sector can only meet 28 per cent of Kenya’s pharmaceutical demand currently.

Speaking to the press in an earlier interview during the opening of Bangladeshi firm Square Pharmaceuticals’ factory site in Athi River’s Export Processing Zone, Dr Wasike had indicated that the remaining 72 per cent is covered by imports worth an estimated USD 600 million (Ksh 61.3 billion) with a regular import growth of 11.45 per cent in the last three years on average.

At the East African Community level, there has been a request by manufacturers for duty to be imposed on a list of products containing approximately 36 simple formulas or molecules or medicinal mixtures which the region has sufficient capacity to manufacture.

Also suggested is an automatic immigration quota limiting foreign firms to hire just five expatriates at the initial stage of each project they undertake within the region.

Policy to shield drug users against HIV

Drug use in East Africa has risen phenomenally over the past few years, courtesy of international cartels that have turned the region into a major narcotics transit route.

Consequently, the number of injecting drug users has increased. These have been linked to new HIV and Hepatitis C infections, piling pressure on the region’s inadequate healthcare systems. With the persistent increase of the infections in sub-Saharan Africa, policy makers have begun a drug policy dialogue as leaders consider shifting focus to approaches based on evidence and embrace public health and human rights perspectives in tackling the drug menace.

Collectively, these approaches form the concept of “harm reduction”, which projects drug abuse as a public health issue with users deemed to be in need of medical assistance and not punishment. For instance, Uganda’s Ministry of Health is piloting a needle exchange programme in five referral district hospitals as Burundi MPs committed to support the relevant legislation.

The region’s MPs have come together under the Global Fund regional grant fronted by KANCO-Kenya and declared unequivocal support for such legislation.

Eastern Africa is characterised by a generalised HIV epidemic — whose main mode of transmission is sex — that is disproportionately severe among people who inject drugs.


Inasmuch as drug policies have focused on supply reduction and law enforcement, the legal environment is blind to the public health reality that people who inject drugs are vulnerable groups with high-risk behaviours. Indeed, most have overlapping relationships with other key populations that play a significant role in HIV epidemics. Due to limited research, most regional policy makers possess limited knowledge on trends and impacts of unsafe injecting drug use and related risks. Lack of action and weak policies have further occasioned a constant state of denial.

This has limited homegrown interventions to support healthcare access. For instance, across the board, legal and policy environments continue to criminalise possession of needles and syringes despite the obviously negative impacts. Fear of arrest and harassment by law enforcement agencies also pose obstacles for such people.

As a result, KANCO together with the East Africa Community (EAC) have embarked on an ambitious process to formulate a joint regional draft policy on harm reduction services for people who inject drugs.

Experts drawn from the five EAC member states have been meeting since May 2016 to deliberate on the draft policy ahead of further consideration and validation by the East African Legislative Assembly.


East Africa would be the first region on the continent to formulate such a policy, to be known as the EAC Regional Policy on Harm Reduction Services for People Who Use Drugs (PWUD).

The policy is intended to guide EAC states in responding to drug use as a public health problem — and build on lessons and experiences of harm reduction services. Besides informing the actions of policy makers, health workers and law enforcement officials, it also seeks to customise EAC’a approach and commitment to harm reduction.

Measurable objectives

The policy further seeks to promote and ensure access to comprehensive, evidence-based harm reduction services for PWUDs — thereby reducing the levels of drug-related health and social harm experienced by these individuals and their families and communities. This is in line with the EAC HIV & Aids, TB and STI Multi-Sectoral Strategic Plan and Implementation Framework 2015-2020.


Behind the over-arching goal, the policy contains a series of measurable objectives that relate to areas covered by EAC in the health strategic plan, which are to support, promote and collate national-level research regarding PWUD and drug-related harms and also to promote the adoption of domestic harm reduction policies.

It also seeks to ensure the delivery of sustainable, quality, comprehensive harm reduction interventions for PWUD — including tailored services for women who use drugs and other groups in need; strengthen the capacities, awareness and capabilities of stakeholders to support the development and implementation of cost-effective harm reduction programmes and to promote supportive legal, policy and social environments.

Once validated by the Eala and domesticated by EAC member states, the policy will, definitely, make the fight against drug abuse and addiction more humane while according those addicted more protection against HIV infection.

Ms Apondi is the regional policy manager, KANCO-Kenya. [email protected] Twitter: @apondibernice

Dirty markets the bane of counties

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Disused or unrepaired markets in the counties could be adding to the challenge of low revenues since traders keep away from the facilities, which are meant to boost business.

In Kakamega, leaking roofs and blocked sewers have turned the modern  market into a nightmare for traders.

The stench from the blocked  manholes is keeping away customers, thus taking a toll on revenue collection.

According to the Controller of Budget,  Kakamega’s revenue dropped  by 30.9 per cent in the first half of the 2017/18 financial year. The county raised Sh132 million, compared with Sh191.07 million for a similar period in the 2016/17 financial year.

The report does not indicate the reasons for this decline,   but the county executive for the Treasury, Mr Geoffrey Omulayi, said the prolonged electioneering period last year adversely affected business in the region.


“Most of our markets were not operational because of issues related to last year’s election campaigns but we are back to the drawing board to address the shortcomings,” he said.

But the condition of the  markets is another problem. When the market was opened in 2013, it was considered one of the key projects that would boost revenue collection for the county government.

But in the last four years, infrastructure at the Sh120 million facility has crumbled, making it unattractive to both traders and residents who might want to shop there. 

Traders have complained of poor sanitation and the county government’s failure  to improve the conditions.

The heavy rains have only  made things worse, after the blocked manholes started spewing sewage, making the market inaccessible.

The chairman of the Kakamega County Traders Association, Mr Benard Oundo, said traders were incurring losses as a result.


“The county government has carried out some renovations on the leaking roofs but most of the infrastructure is in poor condition, making it difficult for traders to operate smoothly,” said Mr Oundo.

Maintenance of the facility has been erratic.

“We have complained to the county government to fix the blocked sewers and manholes but we have been asked to wait for money to be released before complete repairs can be done,” said Mr Oundo.

In the last three months, traders have threatened to stop paying levies if their grievances are not addressed, but little seems to have been done to make things better.

The situation is no different  in Vihiga, where rehabilitation of major markets is yet to begin, even as the financial year draws to an end, despite a Sh135.1 million budgetary allocation for repairing them.

For instance, work on the stalled Luanda market – the county’s main revenue earner – is yet to start despite a Sh10 million allocation.


Mudete Market was built by the National Government at a cost of Sh250 million and handed over to the county government late last year. But it continues to suffer power supply cuts due to a Sh50,000  bill. This has affected water supply, leading to poor sanitation.

Besides,  plans to erect mast floodlights at the markets in Mbale, Majengo, Gambogi, Luanda, Chavakali, Cheptulu, Serem and Shamakhokho have yet to be effected. The estimated cost of each floodlight was Sh5 million.

 On Thursday, Trade Executive Geoffrey Vukaya said the county government had mapped all the businesses in the county.

He said this will help track the status of every market and classify businesses, as well as improve revenue collection.