PREVIEW
$1.7 billion of health assistance announced as replacement for USAID funding
Kenya will get US$1.7 billion of United States funding in the first of a series of bilateral health spending pacts that will replace assistance from the United States Agency for International Development (USAID).
The deal, announced on 4 December to coincide with President William Ruto’s presence in Washington DC as a guarantor of the peace agreement between Congo-Kinshasa and Rwanda, is part of the Trump administration’s ‘America First Global Health Strategy’ launched in September.
Kenya’s health budget was a big loser from the Trump administration’s decision to shutter USAID and freeze most aid spending in January (AC Vol 66 No 5, Western aid cuts reshape the geopolitical landscape & Vol 66 No 6, Targeted by Trump – Africa and Europe draw closer). Nairobi estimated that the loss of US aid left a $220 million hole in the health budget this year. In February, the Ruto government moved to reclassify HIV/AIDS and TB drugs so that patients were no longer be able to receive them for free.
Treatment and prevention of HIV/AIDS, TB and malaria, as well as maternal care, polio eradication and infectious disease outbreak response and preparedness are the priorities of the agreement, which is yet to be published, say officials.
Funding delivered under the five-year deal is designed to go straight to the Ruto government. ‘We are not going to spend billions of dollars funding the NGO industrial complex while close and important partners like Kenya either have no role to play or have very little influence over how health care money is being spent,’ said US Secretary of State Marco Rubio at the signing ceremony in Washington.
The deal looks, at least in part, like a reward for Kenya’s deployment of police to tackle gang warfare in Haiti, which Rubio referred to at the ceremony.
Copyright © Africa Confidential 2026
https://www.africa-confidential.com
Prepared for Free Article on 22/01/2026 at 04:00. Authorized users may download, save, and print articles for their own use, but may not further disseminate these articles in their electronic form without express written permission from Africa Confidential / Asempa Limited. Contact subscriptions@africa-confidential.com.