Kenya’s healthcare system is staring at a crisis- born from the ballooning public debt that experts warn is undermining allocations for essential services, particularly healthcare.
Of greater concern, according to stakeholders in the sector, is the cost of servicing the Sh13 trillion public debt that has held the country in a chokehold.
Approximately 65 to 71 per cent of our budget is going to repaying debt and with only eight per cent of the money going to investment.
According to Dr Samuel Kinyanjui, Country Director for AIDS Healthcare Foundation (AHF), the figures are worrying and cannot fund a sustainable system.
“A country that spends nine times as much on repaying creditors as on its own health system is not investing in the future of the population; this is auctioning the lives and prosperity of our future generations.” He recently said in Nairobi during a forum that brought together stakeholders in the sector.
Servicing this debt, they warned, has seemingly taken precedence over the common good, and this, according to health advocates, could be detrimental to the country’s ambitions of realising Universal Health Coverage.
“If a huge percentage of the income we make as a country goes into debt servicing then it means only a few percentage can ensure healthcare, education employment systems roads, security can actually function for us one of the most important thing is to institutionalize and recognize the voices of communities and young people in borrowing decision,” said Jerop Limo, a n Ambassador for Youth and Adolescent Rep Health Programme (AYARHEP).
As the fiscal space for healthcare continues to shrink, so does the external support that plunged sharply, leaving a financial gaping wound that experts warn continues to threaten HIV, Malaria and Tuberculosis response in the country.
The Global Fund, which has pumped at least Sh258 billion towards Kenya’s HIV, TB and Malaria response since 2003, has cut funding for HIV response by at least 18.2 per cent under its (GC8) grant cycle, which covers the 2026 to 2028 implementation period.
The reduction coincides with bilateral shifts from other major donors like PEPFAR, a move that health advocates warn causes acute financial shocks in national programs.
“When it's squeezed, what happens is acute services; their budgets are hardly touched because their impact is immediate. What really gets squeezed out is chronic care. Most of these services have over the years been donor-dependent, with over 80 per cent of the budgets required there from inputs like medicines and technologies that are necessary,” said Dr Kinyanjui.
Following the changes in the landscape of funding for global health, countries like Kenya were forced to integrate some of these services into primary healthcare as the Treasury slashed their funding by Sh11.7 billion.
Their budget allocation dropped from 28.7 billion shillings to 17.3 billion.
Experts argue that Kenya’s debt problem is not just a governance issue; it is also greatly impacted by the debt repayment mechanisms, which comprise high interest rates that force countries in Africa, Kenya included, into deep austerities.
“The system was built by creditors, for them by them, for their benefit,” Dr Kinyanjui
Kenya pays 10 times higher in interest than countries in Europe like Germany. They would borrow from Eurobond at 7 per cent, but Kenya is paying at 9.8 per cent. If that’s not apartheid, then what is it? The situation we are in is not just a verdict of our governance; we must look at the systems that are systematically designed to keep us poor. Maybe this is a neocolonialism system.”
It has also emerged that African governments paid approximately 89 billion USD, or Sh11.52 trillion, to service loans in 2025. In the same period, Kenya received at least 60 billion shillings in external development aid.
Similarly, at least Sh68 billion was also extracted from Africa through illegal financial flows during the same period, according to experts, a move that points to persistent exploitation of the continent.
The Controller of Budget in March this year had warned that Kenya risks sinking deeper into a debt trap - a cycle that is slowly being enabled by costly borrowing and poor coordination in project implementation.
But even as key sectors like healthcare continue to suffer the brunt of servicing these costly debts, experts advise the need for a shift towards concessional borrowing, stronger oversight mechanisms and debt transparency in order to help ensure that what is acquired is what the country really needs and that it serves the common good.
