How communities are leading fight against malaria, TB and HIV

Communities have emerged as one of the most powerful forces behind Kenya's progress against HIV, tuberculosis (TB) and malaria, leading killer diseases in the country.

Health experts have said the communities have helped drive down infections, improve treatment outcomes in eliminating the diseases, in addition to strengthening accountability in health services.

For example, in malaria, the communities have been able to screen and diagnose malaria at household levels, referring patients for treatment in hospitals.

Amref Kenya Country Director Meshack Ndirangu said communities have helped reduce cases of malaria, and also deaths, more so in children below five years.

“National malaria prevalence among children declined from eight per cent to six per cent over the past decade, while under-five mortality dropped from 52 deaths per 1,000 live births to 41,” said Ndirangu.

Ndirangu added that communities have also been central to malaria prevention and control efforts, carrying health education into homes, promoting early testing and treatment, and protecting pregnant women and children from malaria infection.

“The reduced cases is because communities are key, they help identify cases at household level, screen and treat individuals, including ensuring pregnant women get mosquito nets, and also babies immunised against malaria,” he added.

Data by Ministry of Health shows at least 2.4 million suspected malaria cases tested at households by Community Health Promoters (CHPs) since July 2024 to date.

In Kenya, at least 10,700 malaria deaths are reported annually, with 11,478 people having died of the disease in 2023.

Malaria endemic counties in the country include Vihiga, Homa Bay, Kisumu, Migori, Siaya, Busia, Bungoma and Kakamega.

 Additional data shows that through iMonitor platform, residents across 25 counties have reported 44,553 service delivery challenges affecting HIV, TB and malaria programmes, with six out of every ten issues already acted upon.

For HIV, community health workers and peer networks help identify people in need of care, trace those who have dropped out of treatment and support them to return to medication.

Their efforts have contributed to Kenya achieving an HIV viral suppression rate of 89 per cent among people on treatment.

National Empowerment Network of People Living with HIV (NEPHAK) CEO Nelson Otwoma said through community sensitisation, individuals are able to adhere to treatment, averting Advanced HIV, which results in deaths.

Use of mentor mothers and peer educators at the communities have also helped reduce infections more so mother to child HIV infections.

“Mother-child HIV infection has reduced because mothers who are HIV positive are stationed in hospitals, and at communities walking with pregnant mothers, advising them how to avoid transmitting the disease to their unborn babies. This is kety in reducing infections,” said Otwoma.

The  national HIV prevalence in Kenya stands at 3.22 percent, with an estimated 1,481,853 people living with HIV (PLHIV), as of 2026, according to data by National Syndemic Disease Control Council (NSDCC).

Overall, new HIV infections declined by 56.5 percent, from 32,027 in 2021 to 13,936 in 2026.

The rate of mother-to-child transmission of HIV reduced from 9.3 percent in 2024 to 8.04 percent in 2026, against the global targets of less than 5 percent.

Additionally, in the fight against Tuberculosis, communities are documented to have supported patients through lengthy treatment regimens, including difficult multidrug-resistant TB cases.

Ndirangu said their involvement helped Kenya move off the World Health Organization's list of countries with the highest burden of multidrug-resistant TB.

To enhance quality care, Ndirangu added that communities are now playing an additional role in supporting the rollout of the Social Health Authority (SHA) by helping families register for health coverage and access essential services.

However, he warned that despite their contribution, community systems remain underfunded and heavily dependent on donor support.

Ndirangu called on the government to move beyond recognising community health workers and invest in sustainable financing for community-led health programmes, accountability mechanisms, digital monitoring tools, and emergency preparedness.

"The last three years have shown what investment can do. Communities have strengthened networks, held services to account and solved problems affecting the people they serve. The next step is ensuring these systems survive long after donor funding declines," emphasised Ndirangu.