Isoniazid is an inexpensive and effective drug that has been used for the prevention and treatment of Tuberculosis since the 60s. However, this treatment therapy was available mostly in Europe and the USA but a rarity in places like Kenya. The menace that is HIV/AIDS triggered a new approach to the handling of TB around the world. This new approach necessitated a turn of events starting with the intervention by the World Health Organization (WHO) which conducted a global policy meeting to review the evidence regarding ICF and IPT. This meeting was in 2010 and among its objectives was to re-conceptualize the 1998 WHO/Joint United Nation Programme on HIV/AIDS policy on TB prevention.
It was found that HIV is the strongest risk factor for the development of TB with a probability ratio of between 20 to 37 times greater especially with people living with HIV than among those who do not have HIV. Further, TB was found to be responsible for more than a quarter of deaths in people living with HIV. Arising from these dual epidemics, the WHO recommended 12 collaborative TB/HIV activities as part of core HIV and TB prevention, care and treatment services. They included interventions that reduce the morbidity and mortality from TB in people living with HIV, such as the provision of antiretroviral therapy (ART) and the Three I’s for HIV/TB: intensified case-finding of TB (ICF), isoniazid preventive therapy (IPT), and infection control for TB. These interventions were packaged as guidelines which were published and disseminated in Kenya in 2011.
The implementation of IPT for PLWHIV in Kenya started in 2012 through PEPFAR implementing partners such as AMREF, USAID and AMPATH among others. The programme was rolled out in predetermined pilot treatment facilities across the country which gave the basis of development of health systems to ensure IPT is optimally provided. From that time, various workshops have been held with the aim of summarizing the findings of the IPT pilot sites. The information from these workshops has led to the publishing of Kenya’s first IPT Standard Operating Procedures (SOP) document that was launched on March 24th 2015 in Siaya County. Further, IPT patient information pamphlets have also been developed, printed and distributed to the public.
IPT for PLHIV was then launched for implementation country wide with Siaya, Kisumu, Migori, Nairobi and Homa-bay being the first Counties to implement it with other counties following suit in September 2015. According to Dr. Christine Wambugu, the TB/HIV coordinator at the National TB, Leprosy and Lung Disease Program, 120,000 PLWHIV have been initiated on IPT by March 2016. This number is expected to rise to 500,000 by June 2016 when PLWHIV are expected to be initiated on IPT. With these numbers, Kenya will have the highest number of people accessing this intervention globally.