By Wallace Mawire
Recent withdrawal of US government funding has opened a major financing gap in Kenya’s health sector, threatening healthcare delivery and outcomes while exposing the country’s deep dependence on external aid, a new report reveals.
The new report, Immediate Impact of External Funding Withdrawal on Kenya’s Health Sector, by the Centre for Epidemiological Modelling and Analysis (CEMA), University of Nairobi, provides a comprehensive analysis of the external funding landscape and tracks the funds within the health care system, highlighting the areas that are the most affected.
Kenya’s health system is financed through the government, the private sector, and external funders. In 2018/19, external funders contributed 18 percent of total health expenditure, with the US government accounting for over 60 percent of all external funding to the overall health sector.
To arrive at its findings, the report authors assembled data from the Kenya Ministry of Health (MoH) approved budgets, commodity quantification reports, human resources (HRH) budgets, donor-specific annual reports, and development partners’ operational and grant reports. Their focus was mainly on service disruptions, equity in service access, workforce implications, and impact on the commodity supply chain and infrastructure.
Key report findings include external funding for health fell significantly from KES 126 billion to KES 54 billion in Financial Year 2025/26, following the withdrawal of US government support and the decline in government funding, in Financial Year 2025/26, reproductive, maternal, neonatal, and child health (RMNCH) was the most funded program by external sources, receiving KES 5.85 billion, up from KES 1.04 billion in Financial Year 2024/25. However, the government contribution was reduced from KES 1.04 billion in FY 2024/25 to KES 0.54 billion in FY 2025/26, suggesting a crowding-out effect of external funding, adecline in external and government funding for HIV, TB, and Malaria:, both external funding from the Global Fund and the government towards the HIV budget declined in the Financial Year 2025/26 the external funding from the Global Fund for TB reduced substantially from KES 4 billion in the FY2024/25 budget to KES 1.74 billion in FY 2025/26, the Global Fund budgeted for KES 1.53 billion for Malaria in FY2025/26, down from KES 4.25 billion., the commodity funding gap widened to KES 34.655 billion in FY 2025/26., counties would need KES 47.8 billion annually to absorb all the 41,170 PEPFAR-supported staff, the majority of whom are deployed in high HIV burden counties, health information systems used to collect, analyze, and disseminate health information in Kenya are highly dependent on external vulnerable populations, including pregnant women, children, adolescents, and adolescent girls and young women (AGYW), are likely to be disproportionately affected, widening inequities in access to HIV prevention and treatment services.
In addition, the multilateral external funders are also affected by the change in the US government’s foreign aid policy. Global Fund, World Bank, WHO, and GAVI are recipients of the US government funding. A cut in their global budgets may lead to a reprioritization of their interventions in the country to fit within their resource envelopes.
While the withdrawal of external funding poses serious risks to health service delivery, the report argues it also presents a critical opportunity for Kenya to reset and build a more self-reliant, resilient health system.
Dr. David Khaoya, Lead Author and Senior Research Fellow at CEMA, said, “External funding has long played a significant role in Kenya’s health sector, but it is unpredictable and unsustainable.”
“This funding shock is a wake-up call. While the challenges are significant, Kenya and other African countries now have an opportunity to rethink how health systems are financed and build long-term resilience.”
“Increasing domestic investment, strengthening national ownership, and reducing overreliance on external aid are essential if we are to protect health outcomes in the future,” he added.
A long-term impact analysis of this withdrawal is currently underway and will be released in due course.
The Centre for Epidemiological Modelling and Analysis (CEMA) is a research center at the University of Nairobi dedicated to improving health outcomes in Kenya and across Africa through data-driven decision-making. It was established as a multidisciplinary consortium of infectious disease specialists, epidemiologists, computer scientists, and data analysts to rapidly gather and analyze clinical, mobility, and epidemiological data, guiding Kenya’s pandemic response. In our work, we recognize the vital interconnectedness of human, animal, and environmental health– essential for safeguarding public health and maintaining the balance of our planet’s ecosystems.
