On Sunday, teachers across the globe will mark World Teachers’ Day. But in Kenya, teachers living with HIV are using the occasion to call attention to what they describe as the “deteriorating quality of HIV services” in the country.
In a letter addressed to the National AIDS and STI Control Programme (NASCOP), networks of people living with HIV (PLHIV), including teachers and community advocates, demanded urgent interventions to safeguard the gains made in the fight against HIV.
“We, the people living with, at risk of and affected with HIV and related co-infections, including Tuberculosis and related comorbidities, having noticed the deteriorating quality of HIV services in the past few months, do hereby issue this letter to NASCOP calling for the sustained improvement of quality of HIV care even in the face of integrated people-centred health services,” the statement reads in part.
Among the concerns raised is the quality of HIV care, with patients warning that treatment has been reduced to the issuance of antiretroviral therapy (ARVs), while other crucial services in the “Minimum Package of Care” are overlooked.
“PLHIV deserve quality care as per the guidelines, including access to laboratory services, not just issuance of ARVs,” the letter notes.
The networks also questioned the imposition of user fees, asking whether it is government policy to charge PLHIV when seeking care. “If so, can there be a waiver for the most vulnerable recipients of care?” they asked.
Another major issue is the frequent stock-outs of essential laboratory and diagnostic supplies. Patients report shortages of HIV testing kits, viral load reagents, CD4 count machines, and even TB diagnostic tools such as Xpert® MTB/RIF Ultra.
“Make lab tests and diagnostics free for PLHIV as part of care, including creatinine, liver function tests, and drug resistance testing,” the statement demands.
The groups further urged NASCOP to provide clear documentation on PLHIV numbers and needs for consideration under the Social Health Authority (SHA) coverage package.
“This documentation should be shared with NEPHAK for follow-up advocacy and communications,” the letter adds.
Anne Okaro a teachers’ representative said educators living with HIV are facing growing challenges that need urgent policy attention.
“For me, being a teacher is something that I’m passionate about, but I’m even more passionate about teachers and learners living with HIV,” she said.
Okaro commended the Teachers Service Commission (TSC) for its continued support.
“This is an employer who has supported us, despite being HIV-positive. They have not discriminated. They have given us a platform as a network of HIV-positive teachers to excel in everything we are doing. We don’t take it for granted.”
But she warned that the “big elephant in the room” is mental health.
“As far as our health is concerned, what I’m advocating for is a comprehensive package for teachers living with HIV that is inclusive of mental health. Teachers are getting into depression. Some are turning to drugs and substance abuse because of the stigma and discrimination that comes with living with HIV,” Okaro said.
Disclosure, she added, remains a major barrier—particularly for men.
“Not everybody is bold enough like me to come out and speak about their HIV status. We need to support the male teachers living with HIV and bring them to the table so they can speak about their issues.”
Teachers’ Mental Health in Crisis
The issue of mental health among teachers extends beyond those living with HIV, with new data painting a grim picture:
- 3 out of 10 teachers show symptoms of depression and anxiety.
- In Kiambu County alone, 50 teachers have taken their lives in the past two years.
- 50.5% of secondary school teachers in the county suffer from moderate depression, while 31.8% show signs of anxiety.
- 81.9% experience stress or burnout, with more than 60 suicide cases reported nationally since 2022.
Experts and unions link this crisis to several factors:
- Poor medical cover
- Delayed salaries
- Lack of counseling services
- Overwork due to understaffing
- Harsh economic conditions
Okaro stressed that without psychosocial support, the burden becomes unbearable.
“Imagine a teacher who got infected and has lived their life being positive. The moment you test positive, the goalpost in your life changes. Retirement is knocking, yet some of us don’t even have a home to go to. That alone can push someone into depression,” she said.
Okaro also appealed for dignity for HIV-positive teachers nearing retirement.
“Despite us living with HIV, we want to be treated with dignity even as we transit into retirement. Some of us are almost retiring. We want to retire honourably, despite the challenges,” she said.
She acknowledged the courage of teachers who have managed to retire after decades of living with HIV.
“Reaching retirement as a teacher living with HIV is a milestone. We celebrate life. We celebrate being here even as we lose many colleagues along the way.”
The Network of HIV-Positive Teachers, which has over 2,000 members, echoed her sentiments.
“Of course, the number should be more, but disclosure is a process. It takes a lot of courage to speak about HIV openly,” Okaro explained.
As Kenya advances towards universal health coverage, PLHIV are insisting their needs must not be sidelined.
“Train and sensitize healthcare workers on privacy, confidentiality, and screening for co-infections and comorbidities. Engage PLHIV as mentor mothers, adherence counselors, and peer educators to support peers through care,” the letter urges.
For teachers like Okaro, World Teachers’ Day is as much about resilience as it is about recognition.
“Every year on World Teachers’ Day, we celebrate life. We celebrate the support from the Teachers Service Commission and the Kenya National Union of Teachers, who have walked this journey with us. But we also call for stronger health systems that protect us and ensure we retire honourably,” she said.
The networks say they now await a formal response from NASCOP and the Ministry of Health on how the concerns raised will be addressed.
