Kenya must urgently find new ways of paying for healthcare as donor funding dries up, with the government warning that the country can no longer rely heavily on traditional development partners to sustain critical health programmes.
Medical Services Principal Secretary Ouma Oluga said about 35 per cent of Kenya’s health budget is currently supported by development partners, leaving the health system exposed as countries that have traditionally financed key programmes begin to reduce their support.
Speaking on Radio Generation on Wednesday, Oluga said the changing global funding environment meant Kenya had to build a health financing system that could support its needs using more domestic resources.
“The era of using somebody else's money to finance your healthcare system is gone,” Oluga said.
He said the decline in external health financing had been taking place progressively since 2016, partly because of growing nationalism in donor countries, where governments are increasingly directing resources towards problems within their own borders.
“The days of going to America with a picture of a starving child in Kibra and people sympathise with you are long gone,” he said.
Oluga said the shift meant Kenya could no longer depend on appeals to wealthy countries to fund programmes targeting diseases such as malaria, tuberculosis and HIV.
He stressed that healthcare requires consistent funding, whether the money is being used to provide treatment, employ health workers, buy equipment or maintain health records.
“Health costs money. Somebody must pay for something,” Oluga said. “There is no intervention in health, whether it's a vaccine or whether you want to put clinics for mothers or whether you want to pay health workers or whether you want to buy a computer that is used for records, health costs money.”
Oluga said Kenya’s total health expenditure was about Sh550 billion, with the private sector contributing roughly Sh250 billion.
Of this amount, he said about Sh150 billion comes from out-of-pocket payments by patients, while another Sh100 billion is spent through private insurance premiums.
However, private insurance covers only about 2.7 per cent of the population, meaning the country still needs a financing system that can reach and protect the wider population from the cost of healthcare.
At the government level, Oluga said county governments spend about Sh120 billion on health, while the national Ministry of Health accounts for between Sh150 billion and Sh160 billion. Other government agencies also contribute to healthcare financing.
The PS said Kenya was already feeling the impact of reduced donor support, pointing to Germany’s GIZ, Denmark’s Danida and British development support among partners whose contributions are declining.
He also said the United States had indicated that its health support would eventually come to an end following a five-year transition programme negotiated with Kenya.
The changes have raised the need for the country to take greater responsibility for financing programmes that deal with some of its biggest health challenges.
“We are saying how can we stand on our own feet? How can we take care of our malaria, our TB, our HIV, our diabetes, our cancer with our own money?” Oluga said.
He said the solution was not simply to increase spending but to establish a health financing system that can provide funds consistently and allow the government to plan for health programmes over the long term.
Oluga said the mechanism should be “stable, predictable, sustainable” and should reflect Kenya’s own health priorities.
Those priorities, he said, should focus on diseases that are responsible for the highest number of deaths as well as illnesses that leave families struggling financially because of the cost of treatment.
“We are intervening on the things that are causing Kenyans deaths and the things that are causing Kenyans to poverty,” he said.