The Kenya National Pre-UN High-Level Meeting Civil Society Consultation, held on September 12, 2023 in Nairobi, Kenya, was a significant gathering that focused on the global priority of Universal Health Coverage (UHC). With Kenya facing persistent health challenges, including TB ,Malaria ,and HIV/AIDS, the consultation aimed to refine health priorities, strategize for post-UN HLM 2023 engagement, and enhance awareness of human rights and gender concerns. The primary objective was to establish a clear position on inclusivity and the ongoing implementation of UHC, while also creating a framework for holding leaders accountable for the meeting’s decisions and directives.

Opening Remarks

Kenya AIDS NGOs Consortium (KANCO) Executive Director,Allan Ragi, opened the engagement with an acknowledgment of the progress made in the battle against TB and other health-related issues. He shared some insights about the changing landscape of HIV/AIDS in line with Tuberculosis infections while also citing a previous lack of addressing TB-related issues in the early years due to negligible funding. Nonetheless, he acknowledged the progress that has taken place over the years, including increasing donor funding and programmatic support from Kenyan authorities, including the Ministry of Health (MOH), Kenyatta Hospital, and the Health Committee at the Council of Governors (COG). These initiatives have seen the growth of the TB champions movement, with a focus on issues such as drug-resistant TB. At the same time, he emphasized that everyone should aim to make a difference, reminding everyone that ‘you never get it unless you ask for it or identify the issue.’ The emphasis was placed on collective responsibility and collaboration towards making a substantial impact in the health sector.

Overview of High-Level Meeting Processes and Updates

Evaline Kibuchi  The Chief National Coordinator at Stop TB Kenya delivered a comprehensive presentation that detailed the extensive preparations for the upcoming UN High-Level Meeting (HLM) scheduled for September 2023. The presentation emphasized the significant progress and developments that have taken place since the initial TB HLM in 2018. 

During the presentation, there was a thorough exploration of the organization and themes of the HLM, highlighting a shared global commitment to two key priorities: expanding Universal Health Coverage (UHC) and strengthening efforts related to Pandemic Prevention, Preparedness, and Response (PPPR). This indicates a global consensus on the importance of these critical health objectives as part of the UN HLM’s agenda.

Achievements and Commitments

The consultation celebrated Kenya’s noteworthy achievements in reducing new infections and TB-related mortalities from 33,000 in 2019 to 21,000 by 2021, along with its significant progression out of the high MDR-TB countries category. The outlined provisions of the Political Declaration reiterated a commitment to ensuring an all-encompassing, equitable, and people-centered approach in TB responses nationwide.

Inputs from Consultative Meeting with Key Populations

The Consultative Meeting with Key Populations resulted in the presentation of valuable insights, emphasizing the need for more comprehensive and diversified strategies to ensure the continued effective implementation of Universal Health Coverage (UHC). Key populations stressed the importance of addressing specific concerns related to the Lesbians,Bisexuals, Transgender, Queer, Intersex & Gender Non Conforming (LBTQIGNC) communities, along with other vulnerable groups, to ensure their equitable access to health resources and protection. These contributions highlighted the significance of promoting transparency and accountability in national health initiatives, ultimately enhancing the resilience and responsiveness of healthcare systems.

After a thorough review of existing National Health and Human Rights Policies, an assessment of Community-Led Responses, an examination of societal enablers, and an evaluation of external support and investments, the following key action points were identified;

• Acknowledging diverse perspectives within Civil Society Organizations (CSOs).
• Advocating for legal reforms to support Key Populations and the LBTQIGNC communities.
• Documenting achievements to shape evidence-based policies.
• Promoting community-driven initiatives for healthcare ownership.
• CSOs monitoring and allocating funds effectively.

These key action points serve as the foundation for a more inclusive and equitable approach to healthcare delivery and policy formulation, ultimately enhancing the well-being and healthcare access of Key Populations and the LBTQIGNC community.

Conclusion

In conclusion, our journey toward fostering true inclusivity and equitable representation for Key Populations and LBTIGNC communities is one that demands our unwavering commitment and persistence. The reflections from our consultative meeting have illuminated essential next steps on this path.

First and foremost, we must recognize that inclusion is intricately linked to the presence of supportive laws and policies, as well as accessible data. These foundational elements are pivotal in our quest for comprehensive reform. Moreover, as we navigate this journey, we must understand that all reforms involve processes. It becomes imperative to ensure that these processes are underpinned by protective laws that safeguard all communities, especially our Key Populations and LBTIGNC communities. 

To operate programs safely and without victimization, we must harness existing safety mechanisms, allocate resources effectively, and uplift those who carry our message. This underscores the urgency of enhancing our safety nets. In our pursuit of inclusivity, we must avoid using language that inadvertently discriminates against sexual and gender minorities. Our conversations and documents should reflect a commitment to eradicating such biases.

The prevailing tendency to exclude communities in planning, policy development, and implementation must change. Communities are urged to push for representation in financial processes and decision-making spaces from grassroots to the national level. To achieve this, we must foster intentional inclusion and meaningful engagement with political representatives and authorities through the proper channels and procedures. Capacity building, particularly through CSOs, is instrumental in this endeavor. Finally, comprehensive guidelines for Community-Led Monitoring (CLM) and monitoring of other diseases and chronic illnesses must be developed, extending beyond HIV care to address the diverse healthcare needs of our communities.

Our journey towards inclusivity and equitable representation is undoubtedly challenging, but with collective dedication and adherence to these vital reflections and next steps, we are poised to effect transformative change and ensure that no one is left behind in the pursuit of better health and well-being.

Fahe Kerubo

AfNHi Mentee 2023