Keypoints:
- $1.6bn US funding over five years
- Kenya commits $850m domestic spend
- Shift from NGO delivery to government
THE United States will channel more than $1.6bn into Kenya’s health system under a five-year compact signed on Thursday, marking the first agreement of its kind under President Donald Trump’s overhaul of foreign aid. The deal forms part of the administration’s ‘America First Global Health Strategy’, announced in September, which calls for developing nations to take greater responsibility for fighting HIV/AIDS, malaria, tuberculosis and polio in their own countries, Reuters reported.
The new strategy signals a significant shift in how Washington supports health systems overseas. Rather than funding programmes through international non-governmental organisations, the US plans to gradually transfer responsibility and resources to national governments, with the aim of building long-term self-reliance. It follows the dismantling of the US Agency for International Development earlier this year, ending decades of traditional aid structures.
Kenya raises domestic investment
US Secretary of State Marco Rubio and Kenyan President William Ruto signed the compact. Under the deal, Kenya pledged to raise its domestic health spending by $850 million over the five years. US officials told Reuters that similar agreements are expected with other African countries in the coming days.
Government data cited by Reuters shows the US provided $440 million to Kenyan health and population programmes in 2024, the year before aid cuts took effect. Of that total, $310 million was allocated to HIV/AIDS programmes, a central pillar in Kenya’s public health response.
At the signing, Rubio said the new approach would redirect funding away from what he described as the ‘NGO industrial complex’, arguing that too much of US assistance remained within international organisations rather than reaching frontline care. ‘We’re not doing this anymore,’ Rubio said. ‘This is about funding patients, not institutions.’
Funding shifts to government delivery
Under the compact, responsibility for health workers initially funded by the US will gradually shift to the Kenyan government. Faith-based providers will also be reimbursed on the same basis as private providers for health services delivered through the national system.
Both leaders framed the agreement as a path to stronger institutions and sustainable health services. Ruto praised the administration’s shift and credited earlier US investments with saving millions of Kenyan lives. ‘I assure you that every shilling and every dollar will be spent efficiently, effectively, and accountably,’ he said.
Haiti cooperation highlighted
Rubio also thanked Kenya for leading an international force focused on suppressing gangs in Haiti and called on more countries to support efforts to stabilise the Caribbean nation. Ruto echoed the appeal, emphasising that security in Haiti remains a shared responsibility.
The agreement underscores Kenya’s growing diplomatic role at a time when Washington is redesigning its engagement with the global South.
