NAIROBI, Kenya - African health leaders are sounding the alarm as the continent braces for a projected 30-40% plunge in external health aid in 2025 compared to 2023 levels, a development that threatens to reverse decades of public health gains. This drastic reduction in funding poses a severe risk to Kenya's health sector, which has long depended on international partners to finance essential programs combating HIV/AIDS, tuberculosis (TB), and malaria.

According to a March 2025 survey by the World Health Organization (WHO), the aid cuts have already slashed critical services like maternal care, immunization, and disease surveillance by as much as 70% in some of the 108 low- and middle-income countries surveyed. More than 50 of these nations have reported job losses among healthcare workers and significant disruptions to training programs. In Kenya, the consequences have been swift, with reports of suspended HIV prevention initiatives, clinic closures, and layoffs of thousands of health workers previously supported by U.S. funding.

A 2024 analysis by the African Institute for Development Policy revealed that over 60% of Kenya's health sector funding is donor-dependent. Key partners include the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight AIDS, Tuberculosis and Malaria, Gavi, the Vaccine Alliance, and the UK government. PEPFAR alone has historically funded nearly 60% of Kenya's HIV response, providing life-saving antiretroviral treatment to over a million people. The abrupt withdrawal of U.S. foreign assistance has created an estimated annual financing gap of over Ksh78 billion for Kenya's health programs, according to a Ministry of Health policy brief released in March 2025.

A Continental Push for Self-Reliance

In response to the escalating crisis, a powerful consensus is emerging among African leaders: the era of dependency must end. "Our reality today calls for urgent reflection and action. Africa must chart its own path, rooted in self-reliance, sustainability, and accountability,” stated Dr. Caesar Mwangi, Dean of Strathmore Business School, at a Regional Health Financing Forum in Nairobi on Friday, November 7, 2025.

This sentiment is echoed at the continental level. In April 2025, the Africa Centres for Disease Control and Prevention (Africa CDC) launched a transformative strategy to overhaul health financing. “Africa cannot continue outsourcing its health security,” declared Dr. Jean Kaseya, Director General of Africa CDC. The strategy aims to guide African Union (AU) Member States in revising national health financing plans, boosting domestic investment, and piloting innovative revenue-generation mechanisms.

The core of this push is the long-standing Abuja Declaration of 2001, in which AU countries pledged to allocate at least 15% of their national budgets to health. More than two decades later, only a handful of nations have consistently met this target. The Africa CDC's new plan includes novel ideas like solidarity levies on airline tickets and mobile services, and harnessing diaspora remittances, which amount to US$95 billion annually across the continent.

Kenya's Transition Plan

Recognizing its vulnerability, Kenya has begun taking steps to shore up its health financing. The Ministry of Health announced in March 2025 that it has developed a roadmap to strengthen domestic funding, prompted by the country's reclassification to a lower-middle-income country, which has accelerated the donor transition. According to the WHO, the Kenyan government has already allocated additional funds to the Ministry of Health to sustain key programs.

The transition plan prioritizes essential medical commodities, human resources, and strengthening health information systems. Furthermore, by bolstering mechanisms like the new Social Health Insurance Fund, Kenya aims to create a more sustainable, locally-driven response to public health challenges. However, the scale of the challenge is immense. The government's health spending has hovered between 6-8% of the total budget, well short of the 15% Abuja target. The immediate funding halt has already led to the suspension of community-based HIV monitoring and prevention centers and threatens the jobs of approximately 41,500 U.S.-funded health workers.

As WHO Director-General Dr. Tedros Adhanom Ghebreyesus noted, the crisis presents an opportunity. “Sudden and unplanned cuts to aid have hit many countries hard... But in the crisis lies an opportunity for countries to transition away from aid dependency towards sustainable self-reliance based on domestic resources.” For Kenya and the rest of the continent, turning this painful adversity into autonomy will be the defining challenge for public health in the years to come.