NAIROBI — Kenya’s public health system is staring into a deep funding crisis, with a Sh46 billion shortfall threatening vital services ranging from HIV treatment to the hiring of essential health workers.
The budget gap was laid bare this week in a briefing by Parliament’s Health Committee to the Budget and Appropriations Committee. The warning comes as key donor support particularly from the United States has been put on hold.
“If we don’t secure this funding, we’ll incur even higher costs later,” said Dr James Nyikal, the Seme MP who chairs the Health Committee. “This is not a crisis we can afford to ignore.”
The figures paint a stark picture. At least Sh33.9 billion is urgently needed to keep HIV and TB programmes alive. These services have long relied on foreign aid, which has now slowed significantly. Another Sh8.8 billion is required to recruit and support 8,500 health workers under the government’s Universal Health Coverage (UHC) push.
That initiative, seen as the cornerstone of Kenya’s ambition for equitable healthcare, is already in peril. Thousands of UHC workers have been on strike for over three months, demanding permanent contracts and back pay. Their contracts are set to expire in May 2026.
While Treasury has allocated Sh4 billion for their stipends, it’s not enough. An estimated Sh5 billion is needed to settle dues at the end of their term, and Sh3.8 billion more to make them permanent and pensionable.
“These workers are critical for achieving universal healthcare across all 47 counties,” Dr Nyikal warned. “If we don’t resolve their concerns, they’ll remain on the streets protesting.”
Kiharu MP Ndindi Nyoro called the extra funding “a small price” to pay for long-term healthcare stability and to reduce youth unemployment.
But that small price may come with political complications. The payroll for UHC workers is set to move from national to county governments on 1 July 2025. The Council of Governors (CoG), however, has said it will not accept the transfer without a guarantee of funds and policy clarity.
“We have not officially received the UHC payroll and will not absorb it without the necessary support,” CoG Chair Ahmed Abdullahi said.
Health Cabinet Secretary Aden Duale announced the payroll shift earlier this month, but many counties have expressed concern about being forced to inherit liabilities without resources.
The sector’s troubles don’t end there. The Ministry of Health also needs Sh4.2 billion to buy HIV drugs, contraceptives and vaccines. These commodities are partly funded through agreements with global partners like GAVI and UNICEF. Without the government’s share, those deals may fall through.
And while Parliament scrambles to close the funding gap, time is running out.
With HIV drug stocks under strain and health workers on the picket line, the crisis is no longer looming it’s already begun.
