Kenya stares at a looming health crisis following US President Donald Trump’s defunding orders for three killer diseases; HIV/Aids, Tuberculosis and Malaria. Trump has ordered the United States Agency for International Development (USAID), Centre for Diseases Control (CDC) and President's Emergency Plan for Aids Relief (PEPFAR) to halt operations in Third World countries.
Trump further directed these donor agencies not to distribute drugs that have already arrived in the countries they are intended to be distributed to the millions of beneficiaries. No doubt, this directive is insensitive considering the negative health implications it will have on millions of people whose survival depends on these drugs.
That said, this directive underscores the urgent need for the government to shift focus from reliance on donor funding for health services to domestic funding. The government has had ample time to put mechanisms for self-reliance in place but has seemingly failed to utilise the chance if the challenges surrounding the Social Health Authority (SHA) are anything to go by. Donor agencies that have largely financed our health sector started scaling down funding since 2017 after Kenya was up-scaled to a middle-income country. Pepfar first reduced its funding for Kenya from Sh68 billion in 2017 to Sh40.7 billion in 2022.
USAID, the Department for International Development (UK) and the Bill and Melinda Gates Foundation warned that the cut-backs would be gradual until this year when the government is expected to fully take over the funding of health services. Trump’s directive to halt funding is therefore not entirely out of the blue.
It is incumbent upon the government to ensure the withdrawal of funding will not adversely affect the 137,8457 people living with HIV/Aids in Kenya, which is ranked seventh globally in HIV prevalence. It should not reverse gains already made in the fight against malaria and tuberculosis.
There is a need to invest more in health, yet the government has already cut back the 2024/2025 health budget from Sh138 billion in the 2023/2024 Financial Year to Sh127 billion in the 2024/2025 Financial Year. The fight against diseases cannot be won through rhetoric, it calls for planning and concrete action.
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