President William Ruto has called for a major shift in Kenya’s relationship with the United States, urging the two countries to move away from traditional donor-recipient ties and build a partnership based on equal footing, investment and greater Kenyan responsibility for development.
Speaking at the AmCham Business Summit in Nairobi on Wednesday, Ruto said Kenya wanted a relationship in which American capital, technology and expertise are matched with the country’s human capital, natural resources, talent and expanding markets.
“We want to have a new type of engagement. We want to have a relationship that is better than what we have had in the past, and that relationship must be built on sovereign equality, where it is a relationship and a partnership of equals.”
The President said the new approach should also shape health cooperation, an area where Kenya has depended on substantial US support for decades, particularly in the fight against HIV, tuberculosis and malaria.
He cited the five-year, Sh322.5 billion Kenya-US Health Cooperation Framework signed on December 4, 2025, as an example of the shared responsibility he wants to see in the bilateral relationship.
The agreement provides for up to Sh206.4 billion in US support over five years for HIV/AIDS, tuberculosis, malaria, maternal and child health, polio, disease surveillance and infectious disease preparedness.
Kenya, meanwhile, committed to raise its domestic health spending by Sh109.65 billion over the same period.
“In December 2025, our countries in Africa signed a five-year, 2.5 billion dollar health cooperation framework, including specifically for Kenya, 850 million dollar commitment. It represents a new model of shared responsibility and increasing self-reliance.”
The framework was signed in Washington by US Secretary of State Marco Rubio and Kenya’s Prime Cabinet Secretary Musalia Mudavadi, with Ruto witnessing the signing. Kenya was the first African country to conclude a new government-to-government health partnership under the revised US global health strategy.
President William Ruto arrives at the AmCham Business Summit 2026 at the Windsor Golf Hotel and Country Club in Nairobi on September 9, 2026. PHOTO/PCS
Implementation has since begun. In July 2026, Kenya and the US signed a Strategic Objective Grant Agreement setting out financing arrangements, targets and performance measures for the cooperation.
The Ministry of Health says the wider framework is expected to mobilise about Sh206.4 billion in US support while strengthening Kenyan institutions and increasing domestic financing.
The partnership covers reforms at the Kenya Medical Supplies Authority, efforts to fight HIV, TB and malaria, expansion of digital health services, health-system strengthening and improved access to affordable healthcare.
Ruto also pointed to the long history of American support to Kenya’s health sector, saying the contribution had helped deliver major gains.
“Over the past 25 years, the United States has invested more than $7 billion in Kenya’s health sector, helping to save millions of lives. This significant contribution demonstrates the depth of the friendship and partnership between our two countries.”
According to the Ministry of Health, new HIV infections have fallen by 86 per cent since 2010, while AIDS-related deaths have dropped by 67 per cent. TB incidence has declined by more than 40 per cent since 2015, with about 91,000 people diagnosed and started on treatment in 2025.
Malaria incidence also fell from 104 cases per 1,000 people in 2023 to 72 per 1,000 in 2025.
Ruto said Kenya’s next step should be to take greater ownership of programmes previously supported through external assistance, including primary healthcare, malaria and TB control, maternal and newborn health and preparedness for disease outbreaks.
“We do not seek to remain a city. We intend to be a capable and independent partner of the United States.”
He said the same principle should guide cooperation beyond health, with partnerships focused on investment, jobs, technology transfer and stronger national capacity.
“We do not want relationships that extract from Africa or that are exploitative or extractive. We want a relationship built on the solid condition of investment for mutual benefit. We want a nexus between our assets, our minerals, our human capital, our talent, with friends who come with investment, technology, and skills.”
The government-to-government health model is expected to reduce reliance on parallel programmes while strengthening public institutions and supporting a more sustainable health system.
Ruto urged American businesses and institutions to deepen their engagement with Kenya, saying the country was ready to combine its resources and talent with US investment, technology and expertise.
“Kenya is keeping its part of that bargain,” he said, calling for partnerships that move beyond short-term transactions towards last