NAIROBI, Kenya – Kenya’s health sector is grappling with a looming Sh47 billion budget shortfall that threatens to derail critical services and plunge ongoing reforms under the Universal Health Coverage (UHC) plan into crisis.
The Ministry of Health, in submissions to the National Assembly’s Budget and Appropriations Committee, painted a grim picture of stalled HIV and TB programmes, stalled hiring of healthcare workers, and urgent vaccine needs — all in the wake of suspended donor support, particularly from the United States.
According to the documents, at least Sh33.9 billion is urgently required to keep HIV and TB interventions afloat.
This comes amid an ongoing freeze in donor aid — a major blow, as the US government has historically bankrolled much of Kenya’s HIV response.
In addition, the ministry needs Sh8.8 billion to hire 8,500 UHC staff across the 47 counties — a cohort that has already been on a 96-day strike demanding permanent and pensionable terms, salary equalisation, and payment of outstanding gratuities.
Another Sh4.2 billion is needed immediately to procure essential medical supplies, including HIV commodities, family planning materials, and vaccines.
This amount represents Kenya’s counterpart contribution under global funding partnerships with Gavi and UNICEF.
“It is counterpart funding — if we don’t pay our share, we risk losing even more support,” warned Health Committee Chair James Nyikal (Seme), urging the budget team to prioritise the allocation.
The looming crisis is compounded by a looming deadline: the UHC workers’ contracts are set to expire in May 2026, with the Treasury only allocating Sh4 billion in the upcoming financial year to cover stipends.
Transitioning these workers to permanent roles will cost an additional Sh3.8 billion, and Sh5 billion will be needed to settle their end-of-contract payments.
Nyikal pressed MPs to prioritise the Sh8.8 billion needed to stabilise the workforce.
“If we don’t sort this out, I assure you they’ll be back on the streets protesting,” he said.
Kiharu MP Ndindi Nyoro backed the proposal, framing the funding as an investment in both youth employment and service delivery.
“Sh3.8 billion is not much — it goes straight into healthcare and job creation,” he said.
Meanwhile, a governance standoff is brewing over who should ultimately foot the bill for UHC workers.
Health Cabinet Secretary Aden Duale recently announced that their payroll would be transferred to county governments from July 2025. However, the Council of Governors (CoG) is pushing back.
“We haven’t received the payroll officially and we won’t accept it unless it comes with full funding,” said CoG chair Ahmed Abdullahi, citing unfair hiring practices, lack of clarity, and insufficient financial support.
With the national healthcare system already under pressure, the fate of tens of thousands of patients and health workers may now rest in the hands of Parliament — and how it chooses to allocate funds in the 2025/26 budget cycle.
