HIV advocates want disclosure on Kenya-US Sh323b health deal

President William Ruto and US President Donald Trump after witnessing the signing of a peace deal between DRC and Rwanda at the Donald J Trump United States Institute of Peace in Washington, DC. [PCS]

The National Empowerment Network of People Living with HIV/Aids in Kenya (Nephak) wants the government to make public the recently signed Kenya–US health partnership to dispel speculation and ensure transparency.

For now, the agreement remains under lock and key by both the Kenyan and US governments.

“The signed agreement should be made public,” said Nephak Executive Director Nelson Otwoma.

Under the agreement, the two countries signed a five-year, $2.5 billion (Sh323.4 billion) health cooperation framework outlining a comprehensive vision to save lives and strengthen Kenya’s health system.

The resources will reinforce Kenya’s efforts in combating HIV, TB, and malaria, as well as strengthen surveillance, laboratories, digital health, and emergency response.

Nephak said the deal offers stability and predictability.

“With a signed agreement, you do not wake up one morning and leave, like President Donald Trump did during the stop-work order,” said Otwoma.

When Trump assumed office on January 20, 2025, Kenya’s health sector, like many others globally, faced major policy shifts. One of the most disruptive was the stop-work order that halted operations of the US Agency for International Development (USAID), which heavily funded the Kenyan health system

The order created a funding gap of Sh30.9 billion meant for health products and technologies, human resources, health management information systems, and broader health system strengthening.
Of this, Sh140 million was allocated to health information systems.

The Ministry of Health has previously acknowledged that Kenya’s data systems rely heavily on donor funding for upgrades, maintenance, and technological improvements.

The stop-work order affected critical systems, including the electronic medical records platform, a key component of HIV care and treatment that enables clinicians to track patient histories and treatment outcomes.

The President’s Emergency Plan for Aids Relief (PEPFAR), the Presidential Malaria Initiative, and the Department of Defence and Centres for Disease Control and Prevention are some of the programmes the US has been supporting.

Apart from heavy support in HIV, the US government also supports the elimination of malaria and TB, the promotion of maternal and child health, and sanitation.

With 20 years of operations in Kenya, PEPFAR has been working to reach global targets of 95‑95‑95, ensuring at least 95 per cent of the population knows their HIV status, 95 per cent are put on ARVs, and 95 per cent have their viral load suppressed.

Additionally, through the current Country Operational Plan, running from 2023 to 2025, and prior to the stop-work order issued by the US, PEPFAR had planned to support Kenya in achieving a 50 per cent reduction in mother-to-child transmission to below five per cent by this year.

Since 2010, Kenya has gradually reduced new HIV infections by more than 67 per cent, decreasing from 101,000 cases in 2010 to approximately 16,752 infections in 2024. At least 1.3 million Kenyans are living with HIV, of whom 1.2 million are on treatment.

The Kenyan health care funding is allocated from the exchequer, donor support, out-of-pocket payments and insurance.