Mwai Kibaki: Champion of the 'economics' of healthcare for all
Health & ScienceBy Rosa Agutu | Sun,Apr 24 2022 02:00:00 UTC | 4 min read
There are no roads that were named after the late president Mwai Kibaki.
Apart from the Mwai Kibaki Library at the University of Nairobi, Lower Kabete Campus, the only other place that would have been named after him was Othaya Hospital, which would have become the Mwai Kibaki Teaching and Referral Hospital in 2018 had the plans sailed through.
Kibaki’s dalliance with health began after the ignoble ‘Mlolongo elections’ of 1988. His sole opponent was former Bahati MP Dr James Muriuki, the same constituency he once headed in Nairobi.
But when attempts to rig Kibaki from the Othaya Parliamentary seat failed, he was dropped as Kenya’s Vice President, replaced by Dr Josephat Karanja, and consigned to the less glamorous, but important, health docket.
It was the worst of times: A crumbling healthcare system due to a growing population, saw the Bretton Woods institutions force the government to introduce a cost-sharing health scheme in 1989. Kenya’s population then stood at 22 million.
Though healthcare was free in dispensaries, costs increased with the subsequent level of care sought. The scheme came to grief as it was not only untenable but also financially disastrous to the poor and vulnerable. Following a public outcry, it was discontinued after nine months.
The other challenge for Kibaki in between attempting to standardise hospital equipment, and negotiating salaries for nurses, was the vagaries of HIV.
It was a disease then so little understood doctors who first announced the earliest cases in 1984 were arrested as the news would “scare foreigners and affect tourism.”The government only ceased hushing the situation when statistics by 1990 indicated HIV was quietly killing 100,000 Kenyans daily with a huge social and financial burden.
Running an underfunded ministry and the introduction of multiparty politics saw Kibaki resigning from the government on December 25, 1991.
The government later reintroduced ‘facility-dependent outpatient fees’ in which new fees were to be charged after treatment. The ravages of HIV saw it declared a national disaster eight years later.
Time magazine had named Kibaki among 100 people in the world ‘likely to lead’ in 1974 and the prediction came to pass in the 2002 elections. Kenya’s population then stood at 33 million.
Kibaki never forgot health as President, declaring war against HIV during his first term and mandating the National AIDS Control Council (NACC) with the multi-sectoral management of the national HIV/AIDS programme.
He also chaired the Cabinet Committee on HIV/AIDS terming the scourge “one of the biggest single challenges to development in our nation” in 2003 when three people were dying of HIV-related causes every five minutes and about 700 people died daily, according to the Ministry of Health.
Kibaki said that “we must mobilise our people and make them play their rightful roles in strategies and interventions aimed at reducing HIV infections.”
Though antiretroviral (ARV) drugs were introduced in the world in 1996, they were only available in developed countries and it wasn’t until 2003 that Kibaki made ARV treatment free in public hospitals during that year’s World AIDS Day with a budgetary allocation to boot.
By 2004, his administration instituted guidelines for HIV testing in all clinics besides promising to waive heavy taxes levied on sanitary towels to enhance their reproductive health and reduce the costly burden of hygiene on poor women.
During the country’s first National Women’s Conference on HIV/AIDS in Nairobi, Kibaki told the 4,000 women delegates that “you shall not pay a cent more. I instruct manufacturing companies, traders, and all those concerned to immediately stop charging extra.”
By 2010, President Kibaki’s effort in healthcare had made impressive strides: national HIV prevalence dropped from 7.1 per cent in 2007 to 6.3 per cent in 2010, according to the Kenya Demographic and Health Survey (KDHS) 2008/9.
Access to life-saving treatment has also improved considerably. By December 2011, over 500 000 people living with HIV had been placed on antiretroviral therapy (representing 72 per cent coverage)—up from just 3,000 people in 2001.
By September 2005, an estimated 54,000 Kenyans were receiving ARVs compared to the 1.1 million today.
Recognising the importance of a healthy population in national development, the Kibaki regime began providing free distribution of treated mosquito nets and free anti-malaria treatment in all health facilities.
But attempts to introduce free maternity in 2003 never took off until the Jubilee administration succeeded in 2013.
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