How we spend money

For the current Kenya Inhaler Project 2024/5 we aim to raise £38,010 per annum on a rolling basis (figures may change with inflation) to be spent on Project Delivery, Salaries, Fundraising and Reserves. Donors are welcome to ring-fence their donations for any or all of these components:

Project delivery

Project delivery includes asthma diagnosis, spirometric testing, modern asthma medications, periodic check-ups, travel bursaries for patients (from far-flung rural areas), and staff training on-site in Kenya. Please see Project Delivery sections below for more details.

£21,100 per annum

Salaries

A salary for one Project Director has been agreed by the trustees under the guidance of the Charity Commission. This allows for a minimum wage payment of £11.44 per hour, capped at 15 hours per week. Please see 'Salaries: what does the Project Director do?' below for more details.

£8,923 per annum

Fundraising

This includes advertising, printing, leaflet delivery, computers and peripherals, social media promotions, legacy fundraising, text-to-give programmes, website and email set-up and maintenance and other fundraising tasks.

£4,221 per annum

Reserves

11% of all donations are put aside to meet challenges in Asthma International's operations. These might include an unplanned hiatus in project delivery or the unexpected need for new capital equipment. Why 11%? Please see below (Asthma International's reserve policy) for more details.

£3,766 per annum

TOTAL £38,010 per annum

Project Delivery costs: Year 1

Year 1 project costs are the highest, because they include initial diagnosis and spirometry (tests that measure air volume expelled from the lungs to distinguish e.g. asthma from Chronic Obstructive Pulmonary Disease) and initial dispensing fees and patient travel bursaries. Compare Project Delivery Year 3 costs, which diminish considerably from £210 per patient per year to £78 per patient per year.

Project Delivery costs: Year 3

Skipping Year 2, by Year 3, many of the initial costs in consultation, diagnosis, spirometry and review have been reduced or eliminated. There have been one or more stepdowns in the initial high dose of medication prescribed. 'Stepdown' here refers to a system recommended by the World Health Organization in which asthma treatment is progressively reduced (without compromising patient health or safety) until a successful minimum treatment regime is reached. As the table shows, an average figure for Year 3 is £78 per person per year, from an initial Year 1 figure of £210. Years 4, 5 and thereafter would be expected to remain at approximately the same level as Year 3.

Managing patient intake per year

Each year we aim to spend the same rough figure on project costs (figures may change with inflation) in order to stabilize funding at a constant level, with, around year 6, a stable number of patients (around 240) on long-term year-on-year asthma care. This will help the hospital plan years ahead for consistent treatment and build up to a large outpatient department specializing in asthma treatment for the surrounding area. The low cost (£17,015) in Year 1 is a result of capital expenditure in that year, chiefly on diagnostic equipment, which displaces patient intake to keep the year-on year figure at around £21,100. It also allows for a gentler start in getting the project up and running.

Salaries: what does the Project Director do?

A salary for one Project Director has been agreed by the trustees under the guidance of the Charity Commission. This allows for no more than a minimum wage payment of £11.44 per hour, capped at 15 hours per week. The Project Director is answerable to the trustees and is not a member of the board of trustees; he or she can therefore be assessed on performance and replaced.

A Project Director's duties include the following: meeting the public and soliciting donations; speaking at events; making grant applications to funding bodies, both governmental and private; giving updates to donors and supporters; budgeting; liaising with programme partners; maintaining the website; managing advertising; updating social media and crowdfunding campaigns; attracting legacy and in memoriam donations; organizing text-to-give programmes; managing volunteers; administering gift aid; assessing programme performance; managing payroll giving; and generating match-funding.

Without this work, any inhaler programme in Kenya would struggle to find consistent year-on-year support.

Asthma International's Reserve Policy

Reserves are the funds a charity keeps back so as to strengthen its resilience against, for example, drops in income or the unforeseen demands of a new project.

Asthma International puts aside 11% of all donations to meet these challenges in its operations. They include:

Operational challenges - for example if there is an unplanned hiatus in, or closure of, operations, and the impact on beneficiaries (children and adults with asthma) needs to be cushioned;
Capital purchase challenges - for example when an additional spirometer (an instrument designed to diagnose asthma) needs to be bought or upgraded.

Why does Asthma International have this particular reserve figure? The main reason is to do with protecting asthmatic children and adults. Asthma is a serious and life-threatening condition, and patients must be protected from patchy or intermittent treatment. This protection can only be achieved with a substantial figure for reserves.

However, Asthma International’s trustees regularly monitor and review the reserves policy in response to changing funding and reserve levels. Currently, a level of 11%, neither too large to accumulate an unspent reservoir of money, nor too little to be unable to respond to the challenges above, is adjudged, in light of Charity Commission guidance, to be a reasonable level.

For the charity's Annual Report please see here.

Kenya Inhaler Project 2024/5