Nairobi, Kenya — September 25, 2025 (EAT).

Kenya has reaffirmed its longstanding health partnership with the United States, with renewed emphasis on sustainability and reducing dependence on donor funding. On the sidelines of the 80th United Nations General Assembly (UNGA) in New York, Health Cabinet Secretary Aden Duale led a Kenyan delegation to meet with Jeffrey Graham, the Acting Global AIDS Coordinator, to discuss the future direction of collaboration in HIV and malaria control.

The Latest

During their bilateral meeting, Duale and Graham reviewed nearly two decades of cooperation under the President’s Emergency Plan for AIDS Relief (PEPFAR) and the President’s Malaria Initiative (PMI). These programmes have cumulatively enabled over 1.4 million Kenyans to access life-saving HIV treatment and contributed to significant declines in new infections and related deaths.

In a statement posted on social media, Duale said:

“I underscored the need to safeguard these gains while embracing the next phase under the America First Global Health Strategy, with a focus on sustainability, country ownership and reduced donor dependency.”

The discussions come at a delicate moment, as the U.S. looks to recalibrate its health funding priorities and Kenya works to integrate HIV, TB, and malaria services into its mainstream healthcare systems.

Context in Brief

• PEPFAR evolution: Launched in 2003, PEPFAR has long been a backbone of global HIV efforts. Kenya has benefited significantly, leveraging U.S. support to build capacity, expand service access, and strengthen systems. 

• Health integration: Kenya is already in the process of integrating HIV, TB, and malaria treatment into its broader public health framework, shifting away from highly vertical, donor-dependent programmes. 

• Changing U.S. strategy: The U.S. has introduced a new America First Global Health Strategy, which emphasizes durability, self-reliance, and country-led health systems. 

Law, Policy & Process

• Under Kenya’s Public Health Act and relevant health policy frameworks, the Ministry of Health is mandated to coordinate national response to communicable diseases, including HIV, TB, and malaria.

• Implementation requires alignment across counties, national financing, supply chains, and monitoring & evaluation systems.

• Transition to sustainability will depend on domestic budget allocations and the ability to absorb functions currently supported by U.S. funds.

Voices & Stakeholders

• Health CS Aden Duale: Emphasised safeguarding past gains while pushing for new models that reduce donor reliance.

• U.S. side: While details were not disclosed publicly, the presence of Acting Global AIDS Coordinator Graham signals continued commitment to dialogue on future funding modalities.

• Health advocates & civil society: Many will closely monitor whether Kenya’s domestic resource mobilization can compensate for potential declines in external support without disrupting essential services.

Evidence & Data

• Coverage impact: Over 1.4 million Kenyans currently receiving HIV treatment under programmes supported by PEPFAR and U.S. health partnerships.

• Integration push: Kenya’s health authorities have already begun merging HIV, TB, and malaria services into the primary health care system to improve efficiency and sustainability. 

• Strategic shift: UNAIDS notes the U.S. strategy now emphasizes national self-reliance and resilient health systems. 

Risks & Implications

• Funding cliffs: If U.S. funding recedes without smooth transition, there is risk of service gaps and reversal of gains in HIV control.

• Financial burden: The shift toward domestic funding may strain Kenya’s health budget, especially under fiscal pressure and competing demands.

• Equity challenge: Ensuring vulnerable populations (e.g. rural, marginalized groups) continue receiving services during transitions will be critical.

• Donor trust: How well Kenya can manage this transition may influence future donor partnerships and credibility.

What We Don’t Know Yet

• The specific funding commitments (amounts, timelines) from both U.S. and Kenya in this new phase.

• Whether Kenya will commit to matching or scaling domestic health financing for HIV and malaria.

• How counties will respond and whether capacity exists at local levels to absorb more responsibilities.

• Whether new service disruptions may occur during the transition to reduced donor dependence.

Timeline

• 2003–present: PEPFAR and PMI establish long-term U.S.–Kenya health cooperation.

• 2024–2025: Kenya begins integrating HIV, TB, and malaria services into mainstream health systems. 

• September 25, 2025: Duale and Graham meet during UNGA, reaffirming future cooperation with emphasis on sustainability.

What to Watch

• Release of a joint statement or roadmap setting out how Kenya and U.S. will manage the transition.

• Kenya’s 2026 health budget and how much is earmarked for HIV, TB, and malaria programmes.

• Emerging county-level plans to absorb functions currently donor-supported.

• Civil society monitoring for any service disruptions or declines in access among key populations.