Civil society calls for self-reliance as foreign aid dwindles

Civil society organisations in the health sector are now calling for the strengthening of domestic resources following a steady decline of funds from developed countries.

Resilience Action Network Africa, AIDS Healthcare Foundation Kenya, Pandemic Action Network, and leaders and practitioners from civil society and research institutions called for the eradication of corruption.

 “There is a need to strengthen domestic revenue mobilisation through progressive taxation, budget transparency, and public investment in people-centred systems,” the organisations said in a statement.

 They spoke last week in Nairobi following deliberations titled, ‘Charting a pathway for sustainable financing of Africa’s resilience’.

 Governments are grappling with how to contain ballooning debt and increase spending on development while at the same time managing citizen resistance to increased taxation.

 Official development assistance in areas such as health, sanitation, education, and infrastructure from developed countries has been dwindling.

Kenya ranks seventh among countries most affected by US foreign aid cuts, indicating the country’s heavy dependence on donor money, especially in the health sector.

 The country has received about $1.7 billion (Sh220.15 billion) in aid from the United States in the last three years, a large part of it going to health services.

 This is according to official data from the US Agency for International Development.

 The pattern of aid distribution in Kenya reveals most of the money goes to HIV/Aids programmes, economic development, agriculture, other health programmes, water supply and sanitation, humanitarian assistance; operating expenses, programme support, general environmental protection, and democracy, human rights, and governance, respectively.

 US President Donald Trump announced the freeze on some of the funding on his first day in office in January as part of a review into government spending.

Civil society organisations said the termination of thousands of USAID awards this year has sharply reduced funding for global health programmes targeting malaria, TB, and HIV and other primary services.

The organisations said while aid has contributed to development, it is a misconception that foreign aid solely funds national budgets and health systems.

 They said available evidence shows that domestic resources finance nearly 40 per cent of health services, while donors finance about 20 per cent, and households cover the rest.

 They noted that sectors like malaria, HIV, and TB remain overly donor-dependent, distorting priorities and limiting policy autonomy.

 “UNAIDS warns of life-threatening consequences from the recent dramatic reductions: up to 1 million people may soon face treatment disruptions. In Kenya alone, over 54,000 health workers have lost their jobs due to halted projects. This exposes the fragility of over-reliance on foreign aid.”

 The civil society organisations warned that the shrinking fiscal space will see 34 out of 54 African countries spend more on debt servicing than on healthcare.

 “Coupled with corruption, inefficient spending, and low civic accountability, this is not just an economic crisis — it's a governance and accountability crisis.”

The civil society organisations said in order to break the cycle of dependency, there is a need to build resilient, self-reliant economies by investing in our greatest asset, the people.

 They urged the government to enhance accountability, improve efficiency, and build self-reliance.

 “Corruption and inefficiency can no longer be business as usual. We must strengthen our institutions and enforce real accountability at every level of leadership. The sources and uses of funds should be made public with robust, intentional citizens' involvement at all levels of decision-making.”

The organisations said there is a need for governments to allocate at least 15 per cent of national budgets to health, as pledged in the Abuja Declaration.

They said it is time to close funding gaps, prioritise domestic resource mobilisation, and invest in people and systems for long-term resilience — not just one-off fixes.

The organisations said there is a need to renegotiate debt and reduce the cost of capital as the global finance system is stacked against Africa.

 “Governments must renegotiate debt and support South Africa’s G20 push for fairer interest rates.”

They said Kenya’s ability to achieve universal health coverage is being undermined by a debt burden shaped by unfair global financing terms and shrinking external aid.