Faith based, private medical facilities hit by US health deal

Health PS Dr Ouma Oluga interacts with US Secretary of State Marco Rubio before the signing of the landmark health deal in Washington, DC, on Thursday, December 4, 2025. [PCS]

Faith-based medical facilities directly funded by the United States of America will feel the hit if the Sh207 billion deal between Kenya and USA will be implemented.

High Court Judge Chacha Mwita directed the Kenyan government not to implement the 37-page framework.

Nevertheless, the document indicates that as of March 31 this year, USA intends to stop funding health programs it directly runs such institutions and instead have the Kenyan government shoulder the headache of ensuring their continuity.

Data indicates that at least 15 percent of all health facilities- from stand-alone labs; the churches run clinics, dispensaries to main or referral hospitals.

Those ran by Catholic Church alone provide at least 21 per cent of health services in Kenya.

The document filed before the court also indicates that USA also intends to within 90 days do a review of all the health programs it funds through private facilities with an intent of either terminating them or modifying them.

Those entities that will be retained, the documents indicate, will have to go through the Kenya Kwanza government in order to get the funding.

The overall intent of the framework is to finally have USA completely stop funding of the Kenyan health programs.

“Within 90 days of signing of this Framework, the Participants intend to conduct an in-depth portfolio review of programs funded by the U.S. Government and identify implementing partners for termination or discontinuation, modification, or continuation of their contracts by the U.S. Government.

“Notwithstanding the above, the Government of Kenya intends to ensure continuity of services in faith-based health facilities currently being supported by the U.S. Government,” the document reads in part.

President William Ruto had alleged that the opposition against the implementation of the framework was from the USA’s decision to shift from private sector players to a government-to-government arrangement.

Nevertheless, the deal has more casualties than institutions or non-governmental organizations.

The document indicates that USA will also stop financing medical staff working in Kenyan hospitals.

In addition, the government has to re-adjust its plan, based on the deal, on the elimination of HIV, malaria and TB.

In the framework filed by the High Court, the Principal Secretary of the State Department for Medical Services at the Ministry of Health, Dr Ouma Oluga, said the idea is for the two countries to collaborate in surveillance and outbreak response, with the Kenya National Public Health Institute (KNPH) being at the heart of it.

However, the document reads that it is not an international agreement and does not give rise to rights or obligations under international or domestic laws.

This means, USA can walk away with the yam it offers to share with Kenya if and when it deems fit.

It indicates copyright to any research or product or service developed jointly pursuant to the framework will be determined on a case-by-case basis.

However, there is a caveat that either Kenya or USA may use, reproduce, adapt, modify, publish, license or transfer such intellectual property when the other party consents.

From a reading of the document,  there is an agreement between Kenya and USA on how to resolve the intellectual property rights.

“Where either participant intends to use the intellectual property rights developed in sub paragraph 18.2 above, for purposes other than envisaged by this Framework, the participants plan to resolve any matter in relation to such use, in a separate agreement,” it continues to read.

The document was expected to be a secret between the President Donald Trump and Dr. William Ruto-led administrations.

On confidentiality, the two were required not to make available any information exchanged under the framework with any third party or use the same for any other purposes without a prior consent from each other.

However, they had put an exception of participants’ contractor support personnel.

The first commitment by the USA was to train 30 field epidemiologists and 371 other staff in the public health emergency responsibilities in 2026, culminating to 1791 personnel by 2030.

“The U.S. Government intends to support an integrated approach to strengthening the Government of Kenya's surveillance capacity through comprehensive training across One Health sectors and programs, including empowering academic institutions to deliver in-person and virtual training for current and future surveillance officers within an integrated surveillance framework,” the 37 page document reads in part.

On the other hand, United States Food and Drug Administration (FDA) will not have access or be involved in fight against outbreaks until the case is heard and determined.

Kenya had committed to keep FDA on the loop as part of the commitment to the multibillion deal.

If the case filed by Busia Senator Okiya Omtatah before High Court Judge Chacha Mwita drags on next year or if allowed, Kenya will miss out on Sh580 million promised by the USA.

The deal indicated that in 2026, USA would give USD 4.5 million.

Further, it indicates that it would give an equal amount of money from 2027 to 2030 for outbreak response.

The other agreement was on the laboratory systems. The deal envisioned that the health sector should have at a network of 4542 labs, which would consist of 12 national public health surveillance, four for research, another four for level six referrals, one national quality control lab among others.

It indicated that USA currently gives Kenya Sh1.9 billion for laboratory commodities and around 515 frontline lab workers in Kenya.

The document reads that USA intended to fund all lab commodities in 2026, but this would be determined by the availability of money after which it would gradually reduce the amount by the end of the framework.

“The U.S. Government intends to support 3,500 county laboratories in 2026 for an estimated USD 3.3 million The support includes integrated specimen referral:multi-disease quality assurance, laboratory commodity management, biosafety/biosecurity, and laboratory decentralisation. This is expected to decline gradually, with the Government of Kenya funding 100 percent of these laboratories and related services by 2030,” it continues to read.

At the same time, US stated in the document that it intended to transition procurement, warehousing and distribution of its lab commodities to Kenya Medical Supplies Authority (KEMSA) by December 31, 2026.

The USA had historically kept off the authority due to corruption and mismanagement concerns.

On the flip side, Kenya indicated that it intended to use Kemsa as its hub for national pool procurement, warehousing and distribution vehicle for both public and private hospitals.

Trump land provides Kenya with drugs including HIV treatment, HIV rapid tests, HIV opportunistic infection treatment, tuberculosis preventive therapy, malaria rapid tests, malaria treatment, and insecticide-treated net.

It stated that it would fund the same 100 percent next year but would also reduce the amount overtime.

On its end, Kenya is to ensure that there is no monkey business at Kemsa.

“The Government of Kenya intends to strengthen national systems for the timely detection, investigation of cases of loss or diversion and falsification of health commodities. This includes enhancing KEMSA's internal safeguards comprising its existing and dedicated Security Department, real-time geo-fenced c-locks, c-POD systems, and oversight by thedistribution Monitoring and Evaluation unit. This is in addition to reinforcing the Pharmacy and Poisons Board's (PPB) role in identifying and addressing falsified health products,” the deal reads.

The two countries were to within 90 days, from the date of signing the framework, develop a transition mechanism and Kemsa institutional readiness assessment and structure how the commodities would be moved from US agents to the authority.

The other segment of the deal is the frontline health workers.

USA intended to fund 28668 health workers in 2026, then 21407 in 2027.

They were to also before April 1, 2026, develop a transition plan of Kenya EMR and other data systems currently supported by the U.S. Government to the Digital Health Agency.

The deal signed by the Prime Cabinet Secretary was to proceed for five years, after which Kenya and USA would sit and review its implementation.

In the meantime, Kenya agreed to have USA continue specimen testing, including genetic sequencing and sharing data on detected pathogens.

In the meantime, Kenya gave USA a seat in its budget-making process by agreeing that they will jointly agree on how much is allocated or spent on the health sector. This includes the 2025 budget.