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January 21, 2019

Free healthcare more desperately needed than free education


Following the 2002 General Election, it was possible to believe that Kenya had advanced beyond the kind of confrontational tribal contests that initially marked the return to multiparty politics in 1991. 

For in the earlier elections — in 1992 and 1997 — we basically had various leaders of the “Five Big Tribes’ (the Kalenjin, the Kikuyu, the Luo, the Kamba and the Luhyia) all running for president with very little support outside their own regional base.  

And in these two elections, long-serving President Daniel Moi (a Kalenjin) won easily, as he faced a deeply divided opposition.  

But by 2002, we seemed to have put self-defeating, single-minded tribal voting patterns behind us, turning, instead, to broadly collaborative regional vote blocs, combining in highly fluid alliances.

Sadly, since then, rather than advance further, we have steadily lost all the democratic gains that led to that historic regime-change election in 2002. Not only in the democratic electoral processes, but even more as concerns the democratic values of tolerance and inclusiveness.

Last week’s crackdown on human rights and civil rights NGOs is but the most recent manifestation of a longstanding downward trend.

Basically, it is a regression towards the authoritarianism that preceded the 1988 General Election, which even now remains the gold standard for polls rigging in this country.

The principal objective of Moi and his inner circle at that time was the permanent marginalisation of the Kikuyu community, and the cutting down to size of its most prominent leaders. For Moi had all along seen them as the greatest threat to his dictatorial rule.

But instead of achieving such marginalisation, what Moi did was to set in motion the events which would lead to a return to political pluralism. And thus, ultimately to the presidency of Mwai Kibaki  — precisely the Kikuyu leader who Moi had been most determined to keep out of high office.

Moi was to learn the truth behind Arthur C Clarke’s view that “All human plans are subject to ruthless revision by Fate”

Or as Woody Allen put it, “If you want to make God laugh; tell Him your plans”.

President Kibaki’s greatest legacy was his free primary school education initiative. On his orders, no less than 1.5 million kids, who up to 2002 had been doomed to illiteracy, simply walked into the nearest primary school, and started on their lessons.

I used to think that no future Kenyan president could ever hope to top that achievement: For what could be more beneficial for the average poor Kenyan than free education?

But I now believe that it may be possible: I think it’s now time to aim for Universal Health Care.

Consider, for example, the ideas put forward on this subject, in the copious writings of Siddharth Chatterjee, who is the United Nations Resident Coordinator here in Nairobi.  

Previously, he was the United Nations Population Fund Representative in Kenya, and worked extensively with First Lady Margaret Kenyatta in her heroic efforts to reduce incidences of maternal and early childhood deaths.

In an analysis titled “Achieving Universal Health Coverage (UHC) in Kenya through Innovative Financing”, he had this to say:

“…M-Pesa was conceived to address the challenge of rural banking but it has also provided a platform for mHealth, the use of mobile devices to support the practice of medicine and public health.

Kenya can institute targeted taxation as an innovative financing policy to complement existing financing mechanisms. Partnering with mobile phone service providers and charging a small fee for targeted healthcare initiatives can generate the necessary resources to support UHC in the country.

An estimated US$122.5 million (Ksh 12.5 billion) is transacted daily in the form of mobile money transactions. By contributing roughly one percent on a graduated scale, Kenya can easily raise US$ 1.2 million (Ksh 125 million) daily to finance UHC.

For example UNITAID, an International Drug Purchase Facility for AIDS, tuberculosis, and malaria is supported mainly (70%) through the airline ticket tax...Kenya can do the same by charging a small tax at its international airports and border crossings for a ring fenced public health account.”

It is ideas and initiatives such as these that form the foundation for an enduring presidential legacy.


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