Kenya on Thursday secured a landmark direct health funding of $1.6 billion (Sh208 billion) from the United States over five years, becoming the first African country to sign a government-to-government health cooperation agreement with Washington.
Historic shift from NGOs to direct funding
The deal, signed in Washington, channels money straight to Kenyan institutions instead of international non-governmental organisations. President William Ruto attended the ceremony alongside US Secretary of State Marco Rubio.
Rubio praised Kenya’s Universal Health Coverage system as “a model for emulation across the continent” and said the new approach ends decades of donor money being routed through third parties.
Ruto promises accountability
Ruto thanked President Donald Trump and Rubio, pledging that every shilling and dollar would be used efficiently.
“This adds momentum to our push for modern hospital equipment, timely medicine supply and health insurance that leaves no Kenyan behind,” he said.
Where the money will go
Funds will flow directly to the Social Health Authority, Kenya Medical Supplies Authority (KEMSA), Ministry of Health and National Public Health Institute, among others.
KEMSA is expected to fully handle procurement and distribution of essential drugs by December 2026. Kenya will also absorb 13,293 health workers and 515 laboratory staff into permanent public service by 2028.
The agreement strengthens outbreak response using the global 7-1-7 benchmark: detect within seven days, report within one day and respond within seven days.
End of old donor model
For more than 25 years, the US has pumped over Sh9.1 trillion into Kenyan health, mostly through PEPFAR and Global Fund programmes run by non-state actors. Officials say only 40% of those funds reached frontline workers due to high administrative costs.
The new model aims to eliminate waste and give Kenya full ownership.
Strict conditions attached
US support is tied to sharp increases in domestic health spending: Sh10 billion extra in 2026/27, Sh20 billion in 2027/28, Sh35 billion in 2028/29 and Sh50 billion in 2029/30.
Kenya will gradually take over costs now covered by Washington, rising from Sh4.6 billion in 2027/28 to Sh18.5 billion annually by 2031/32, when Nairobi must fully fund the programmes.
Data protection safeguards
Kenyan health data is declared a strategic national asset. Any information shared with the US must comply with the Data Protection Act 2019 and Digital Health Act 2023.
Rubio spells out new US policy
“If we’re trying to help countries, help the country — not the NGO looking for new business,” Rubio said, adding that Washington hopes to replicate the model across Africa with Kenya as the pioneer.
Mixed reactions at home
Supporters hail the deal as a victory for sovereignty and a vote of confidence in Ruto government reforms. Critics question whether counties can absorb the extra spending amid tight finances and point to persistent gaps in rural health facilities.
Health experts agree that, if well managed, bypassing middlemen could deliver the biggest upgrade to public healthcare in decades.
The partnership aligns with Vision 2030 and Ruto’s Bottom-Up Economic Transformation Agenda, potentially positioning Kenya as East Africa’s leading health hub.
