President William Ruto, on Thursday, witnessed the signing of a landmark agreement with the United States, securing a $1.6 billion (Sh208bn) investment in Kenya’s health sector over the next five years.
The deal makes Kenya the first country in Africa to enter a government-to-government (G2G) health funding arrangement with the US.
The agreement provides direct funding to key government systems, including the Social Health Authority (SHA), the Directorate of Health Accounts (DHA), Kenya Medical Supplies Authority (KEMSA), Integrated Financial Management Information System (IFMIS), Ministry of Health (MoH), and the National Public Health Institute (NPHI).
Speaking at the signing ceremony, US Secretary of State Marco Rubio praised Kenya’s Universal Health Coverage (UHC) system, describing it as “a model for emulation across the continent.”
The new Cooperation Framework builds on a strategic health partnership between Kenya and the US that spans more than 25 years, during which the US has invested over $70 billion (Sh9.1 trillion), the single largest bilateral health contribution to Kenya.
In his remarks, Ruto thanked US for the support, assuring that every shilling and every dollar will be spent efficiently, effectively, and accountably.
"On behalf of the government and people of Kenya, I express profound gratitude to the United States, to President Donald Trump, and to you, Marco," Ruto said.
This gesture of goodwill by President Trump on behalf of the American taxpayers, he said, reinforces our ongoing mobilisation of domestic resources by Kenyans and actors and stakeholders in Kenya to the health sector.
He stated that the framework signed adds momentum to my administration’s universal health coverage focused on supply of modern equipment to our hospitals, efficient and timely delivery of commodities to our facilities, and health insurance on living no Kenyan behind.
Historically, much of this funding was delivered through donor-led programs like PEPFAR and the Global Fund, often executed by non-state partners.
While impactful, this approach created dependency, inefficiencies, and high administrative overheads, with only 40% of funds reaching frontline health workers and commodities.
The new G2G model is designed to address these challenges by promoting sustainability, accountability, and Kenyan ownership.
Under the agreement, the US will support the progressive transition of procurement and distribution of commodities to KEMSA by December 2026 and fund the absorption of 515 laboratory workers and 13,293 health workers by 2028.
The funding will also strengthen outbreak detection and response infrastructure, following the 7-1-7 model of epidemic preparedness.
“The United States’ contributions are conditional upon an annual increase in both the national and county health budgets as follows-Sh10 billion in FY 2026/27, Sh20 billion in FY 2027/28, Sh35 billion in FY 2028/29, and Sh50 billion in FY 2029/30,” reads a statement from the MOH.
These specific co-financing commitments are required for human resources for health and strategic health commodities currently funded by the US.
Under the agreement, Kenya will progressively increase its contribution to the health sector over the coming years.
By 2027/28, the contribution rises to $35.3 million (Sh4.6 billion), followed by $70.7 million (Sh9.2 billion) in 2028/29.
The upward trend continues with $106 million (Sh13.8 billion) in 2029/30, $124 million (Sh16.1 billion) in 2030/31, and finally reaching $142 million (Sh18.5 billion) in 2031/32.
By 2031, the government of Kenya is expected to fully take over funding for health commodities and human resources currently supported by the US, totalling $141 million (Sh18.5 billion).
The Cooperation Framework also establishes a data sharing agreement recognising Kenyan health data as a strategic national asset.
All data shared under the program will adhere to the Data Protection Act 2019, Digital Health Act 2023, and other applicable Kenyan laws.
Among the benefits to Kenya, the framework is expected to strengthen national health sovereignty, ensure sustainable domestic financing, integrate digital health and surveillance systems, and enhance the country’s workforce and supply chain systems.
The deal also deepens diplomatic ties, boosts investor confidence, and positions Kenya as a regional health hub.
Under the framework, the Government of Kenya will absorb healthcare workers, strengthen digital and surveillance infrastructure, and implement data security standards to prevent fraud, waste, and loss.
The partnership aligns with Kenya’s Vision 2030, UHC goals, and the Ruto administration’s Bottom-Up Economic Transformation Agenda (BETA).
"If we're trying to help countries, help the country. Don't help the NGO go in and find a new line of business. Bottom line is, if you want to help a country, work with that country, not work with a third party that imposes things on that country. And so for us, the first, we hope to sign many of these in the days to come," said Rubio.
