Public-private partnerships vital in fighting chronic kidney disease

A kidney patient undergoes dialysis at Kenyatta National Hospital. FILE PHOTO | NMG

Most people know that the role of kidneys is to remove waste from the blood in the form of urine. In truth, however, the two bean-shaped organs, located just below your rib cage and next to the spine, play other important roles as well.

These include controlling blood pressure, contributing to the making of red blood cells and maintaining a healthy balance of water, salt and minerals in your blood.

Kidney health is also important for the well-functioning of nerves, muscles and other tissues. In short, you cannot remain healthy if your kidneys are not functioning optimally.

Like all life-threatening illnesses, the most effective measure towards the management of kidney disease is knowing one’s status by having kidney functions tested.

Symptoms of kidney disease include high blood pressure; anaemia (low blood count), weak bones, nerve damage, swollen ankles and fatigue.

Fortunately, there are lifestyle changes that are known to reduce the chances of developing kidney disease or slowing its progression.

These include regular exercise, healthy eating, reduced salt intake, avoidance of cigarette smoking, and controlling one’s blood sugar and pressure.

People who have diabetes, hypertension, obesity and a family history of chronic kidney disease (CKD) should have regular kidney function tests.

As such, governments and policymakers should prioritise public health interventions that promote healthy lifestyles and reduce exposure to risk factors for kidney diseases.

Other than causing a high level of illness and death in poorer countries, CKD puts a very heavy burden on countries’ and households’ health budgets.

In Kenya, the lowest cost of dialysis is $73 per session, while the cost of a kidney transplant is equivalent to US$2,300 at Kenyatta National Hospital.

With the National Hospital Insurance Fund (NHIF) subsidising kidney dialysis, dialysis has become its single-largest medical insurance claim, with the payouts for treatment of kidney failure increasing by 41 percent in 2019 when the agency released approximately Sh1.8 billion ($ 13.8 million).

On average, a single dialysis session costs between Sh9,500 and 16,000 per session in Kenya. With costs for the management of CKD being the major factor in the evident inequity in access to these services, governments on sub-Saharan Africa have had to explore ways of progressing towards equitable access to care for people living with chronic kidney disease.

The most plausible of these is nurturing partnerships with the private sector and other non-state actors.

In Kenya, one such partnership is the Interlife Kidney Transplant Project. The project, which was established in 2009, is a collaboration between Kenyatta National Hospital and Novartis.

It is aimed at improving the transplant system and supporting the reduction of the cost of post-kidney transplant drugs.

All patients transplanted under the program receive subsidised-cost drugs from Novartis.