A Lifeline In Jeopardy: How USAID’s Freeze Threatens HIV-Positive Orphans In Kenya

Two-year-old Evans arrived at Nyumbani Children’s Home in Nairobi, Kenya, a year ago, battling HIV and tuberculosis. With no family to care for him, a health center referred him to the orphanage after he stopped responding to medical treatment. Today, Evans is alive because of Nyumbani—but political decisions made thousands of miles away could determine how long that lasts.

Nyumbani provides antiretroviral medication (ARVs) to Evans and about 100 other children, a lifeline made possible by the U.S. Agency for International Development (USAID) through the Kenyan government. But a recent executive order by then-U.S. President Donald Trump to freeze USAID funding has put this vital support in jeopardy, threatening the future of children like Evans.

A Life-or-Death Crisis

For the children at Nyumbani, the uncertainty is a matter of life and death. While Evans plays happily with other preschoolers, unaware of what’s at stake, his caregivers are deeply concerned.

The tiny graves at the orphanage serve as a grim reminder of what could happen if access to ARVs is lost. Sister Tresa Palakudy, who has cared for children at Nyumbani for 28 years, remembers a time before USAID’s intervention.

“When we first started taking in HIV-positive children, they barely clung to life,” she recalled. “One by one, they passed away. It was heartbreaking, and I never want to witness that again.”

Founded in 1992 by Christian missionaries, Nyumbani initially operated as a rescue center for orphaned and abandoned children living with HIV, offering mainly palliative care. Everything changed in 2003 with the introduction of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), which expanded access to life-saving treatment across Africa, including Kenya. USAID became a critical partner, providing free ARVs and funding programs that allowed Nyumbani’s children to thrive.

Over the past two decades, the U.S. government, through PEPFAR, has invested more than $8 billion in Kenya’s fight against HIV/AIDS, ensuring treatment for nearly 1.3 million people. Nyumbani alone has received over $16 million in USAID support between 1999 and 2023, enabling it to care for thousands of vulnerable children through its outreach programs, Lea Toto and Nyumbani Village.

Controversy and Funding Cuts

In 2023, USAID abruptly stopped direct funding to Nyumbani amid allegations of sexual abuse by volunteers and staff. A Washington Post investigation reported that six former residents accused the home’s administrators of covering up abuse cases. Nyumbani denied any cover-up, stating that all allegations were handled according to established protocols, including reporting to authorities and providing counseling.

Executive Director Judith Wamboye clarified that USAID’s decision to halt direct funding was unrelated to the allegations and was instead part of a broader policy shift to channel aid through government programs rather than individual organizations. This change forced Nyumbani to scale back its outreach programs and refer children to government-run facilities.

Running Out of Time

Despite losing direct funding, Nyumbani continued receiving ARVs from USAID. But with the recent funding freeze, the Kenyan government has warned that ARV supplies may only last six more months.

“The future is uncertain,” Wamboye admitted. “If PEPFAR’s support ends, children with HIV will be left without treatment, and many will not survive.”

According to amfAR, the Foundation for AIDS Research, 1.3 million Kenyans rely on HIV treatment, including 1,602 orphans and vulnerable children supported by PEPFAR. Without USAID’s assistance, their access to life-saving care is at risk.

One of those children is Mercy, a 12-year resident of Nyumbani whose life was saved by ARVs.

“I used to fall sick all the time—tuberculosis, skin infections, everything,” she said. “But after I started treatment, I got stronger.”

Now, Mercy is preparing for college, but the funding freeze fills her with fear.

“I’m scared my past illnesses will come back. I’ve worked so hard to get to this point, but if my treatment stops, everything could fall apart,” she said.

Nyumbani needs $1,139 per child annually for HIV treatment, covering ARVs, viral load testing, and medication for opportunistic infections. If USAID’s support is permanently withdrawn, the cost of ARVs could become unaffordable, putting countless lives at risk.

“This isn’t just about policy—it’s about human lives,” Wamboye stressed. “We can’t sit back and wait. Something must be done before it’s too late.”