The Crisis in Kenya’s Healthcare System
Kenya’s healthcare system is facing a critical juncture. As donor funding continues to decrease, health experts are expressing growing concern over the deterioration of data systems that once supported disease tracking, patient management, and drug distribution. These systems have been vital for ensuring effective healthcare delivery across the country.
During a thought leadership forum on the reduction in Official Development Assistance (ODA), hosted by the Kenya Editors’ Guild (KEG) in Nairobi, Dr. Willis Akhwale, special advisor at the End Malaria Council and former Chair of Kenya’s COVID-19 Taskforce, highlighted the importance of robust data systems. He warned that without these systems, decision-making in healthcare is compromised, affecting everything from drug supply to patient follow-up.
“Without robust data systems, we’re likely to see more mother-to-child HIV transmissions, and a rise in malaria, TB, and other infectious diseases,” he said. Dr. Akhwale emphasized that data should guide what medicines are stocked in specific regions. For example, if a community is prone to malaria, anti-malarial drugs should be available. If hypertension is common, those medications should be prioritized. Without accurate data, there will be mismatches in drug availability and treatment effectiveness.
Historically, global funding targeted specific vertical programs such as HIV, tuberculosis, malaria, and immunization. While these programs were expensive, they significantly reduced deaths and improved lives. However, with the withdrawal of donor support, the systems that monitored treatment, tracked medication, and identified high-risk patients are being scaled back or shut down entirely.
Dr. Akhwale warned that without these data systems, healthcare workers are operating in the dark. This could lead to a rise in preventable conditions like mother-to-child HIV transmission and multidrug-resistant TB. Additionally, some of the most immediate consequences include job losses for highly skilled health workers who managed these programs, as well as ripple effects in industries like travel and hospitality, which previously hosted donor-related health activities.
He added that the reduction in donor funding did not start recently. It has only been exacerbated by significant cuts, particularly from the U.S. government.
Why Data Systems Matter
Accurate health data is essential for planning and response. Systems built with donor funding helped track who was taking medication, who had defaulted, and who was likely to develop complications. Without this information, it becomes challenging to stock the right drugs, predict outbreaks, or intervene early.
“If we don’t know how many TB patients are adhering to medication or which regions are showing spikes in malaria, we are blind to the next health emergency,” said Dr. Akhwale.
According to Dr. Githinji Gitahi, CEO of Amref Health Africa, Kenya spends about KES 650 billion ($5 billion) annually on health. Of this, only KES 129.2 billion ($1 billion) comes from donors, while KES 516 billion ($4 billion) is sourced from local taxes and citizens’ out-of-pocket spending.
“Eighty percent of our health budget is already financed by Kenyans either through taxes or by families selling land to pay hospital bills,” said Dr. Gitahi. “So, this isn’t about charity. It’s about asking: how can we reorganize the money we already have to protect the most vulnerable?”
He added that programs supporting HIV treatment, TB care, and family planning previously funded by donors must now be prioritized in national and county budgets.
Shifting Focus to Health Production
Health experts argue that Kenya and Africa more broadly must shift focus from expensive treatment to health production: investing in clean water, sanitation, nutrition, walkable communities, and disease prevention.
“Treating disease is costly and unsustainable. But producing health helps keep people healthy and saves money and lives,” said Dr. Gitahi.
He emphasized that non-communicable diseases (NCDs) such as cancer, hypertension, and diabetes now account for 50% of hospital admissions, surpassing HIV, TB, and malaria. Many of these diseases are preventable through better regulation of food, urban safety, and active lifestyles.
While many Kenyans believe private hospitals offer better care, Dr. Gitahi pointed out that the best specialists, labs, and facilities often reside in public institutions. The problem lies not in medical quality but in customer service, compassionate care, and patient experience.
“We must invest in making public hospitals the first choice for all citizens, not just those who can’t afford private care,” he said. “Let private hospitals complement, not replace, public services.”
Embracing Precision Public Health
To maximize limited resources, Kenya must embrace precision public health, using local data to make local decisions.
KEG CEO Rosalia Omungo reiterated, “We need to reframe the narrative on African agency. We believe in advancing a narrative of co-responsibility one that clearly outlines the roles that African governments, the private sector, and philanthropists must play in financing sustainable health systems.”