By Lenah Bosibori
Kenya's healthcare system stands at a critical juncture. With donor support gradually decreasing, medical professionals are sounding the alarm about the deterioration of data systems that previously served as the foundation for monitoring diseases, managing patients, and distributing medications.
During a thought leadership forum focused on the decline in Official Development Assistance (ODA), organized by the Kenya Editors’ Guild (KEG) in Nairobi, Dr. Willis Akhwale, a special advisor with the End Malaria Council and former head of Kenya's COVID-19 Taskforce, cautioned that the data systems used for decision-making are deteriorating, impacting areas such as medication distribution and patient monitoring.
"Without strong data systems, we can expect an increase in mother-to-child HIV transmission, along with a surge in malaria, TB, and other infectious diseases," he cautioned, emphasizing that data should determine which medications are available in each area.
If a community is vulnerable to malaria, provide anti-malarial medication. If high blood pressure is prevalent, ensure those medications are available. Without data, we will constantly face mismatches.
Dr. Akhwale noted that global funding has traditionally focused on particular vertical initiatives such as HIV, tuberculosis, malaria, and vaccination efforts. Although these programs were costly, they significantly lowered mortality rates and enhanced quality of life. However, as donor support withdraws, the systems responsible for monitoring treatment, tracking medicines, and identifying high-risk individuals are being reduced or completely discontinued.
Without strong data systems, healthcare professionals are operating in the dark," he cautioned. "We could witness an increase in avoidable conditions such as mother-to-child HIV transmission and multidrug-resistant TB.
Dr. Akhwale mentioned that among the most immediate impacts are the loss of jobs for highly trained health professionals who oversaw these initiatives, along with broader effects on sectors such as travel and hospitality, which supported donor-related health events.
He further stated, 'The decline in donor support didn't start today. It has been ongoing for some time. The situation has only become more severe due to substantial reductions, especially from the U.S. government.'
Why Data Systems Matter
Reliable health information is crucial for preparation and action. Programs funded by donors enabled monitoring of individuals on treatment, those who had stopped taking their medication, and those at risk of experiencing issues.
“Without this data, it's challenging to stock the correct medications, forecast outbreaks, or act promptly,” stated Dr. Akhwale. “If we aren't aware of how many TB patients are following their treatment or which areas are experiencing rises in malaria, we remain unaware of the upcoming health crisis.”
As stated by Dr. Githinji Gitahi, the CEO of Amref Health Africa, Kenya allocates approximately KES 650 billion ($5 billion) each year for healthcare. Out of this amount, KES 129.2 billion ($1 billion) is provided by external donors, while the remaining KES 516 billion ($4 billion) is covered through local taxes and individuals' direct payments.
Eighty percent of our health budget is already funded by Kenyans through taxes or by families selling land to cover hospital expenses," stated Dr. Gitahi. "Therefore, this is not about charity. It's about questioning: how can we rearrange the funds we already possess to safeguard the most vulnerable?
He mentioned that initiatives aiding HIV treatment, TB management, and family planning, which were previously supported by external donors, now need to be given priority in national and local budgets.
Medical professionals suggest that Kenya and the African continent as a whole should concentrate more on affordable health promotion rather than costly treatment: by funding access to clean water, hygiene, proper diet, pedestrian-friendly areas, and measures to stop diseases.
"Addressing illness is expensive and not viable in the long term. However, promoting wellness enables people to stay healthy and reduces costs as well as saves lives," stated Dr. Gitahi.
He highlighted that non-communicable diseases (NCDs), including cancer, high blood pressure, and diabetes, now make up 50% of hospital admissions, exceeding the numbers for HIV, tuberculosis, and malaria. A significant number of these conditions can be avoided with improved control over food, safer urban environments, and more physically active routines.
Although many Kenyans think private hospitals provide superior care, Dr. Gitahi noted that top specialists, laboratories, and resources are frequently found in public hospitals. The issue is not related to the quality of medical treatment but rather to service, empathy, and overall patient experience.
We should focus on ensuring that public hospitals are the preferred option for every citizen, not only those who cannot afford private treatment," he stated. "Let private hospitals support, rather than take the place of, public healthcare services.
To make the most of scarce resources, Kenya needs to adopt precise public health strategies, leveraging local data for informed local choices.
KEG's CEO Rosalia Omungo stated again, "We need to change the story about African initiative. We support promoting a concept of shared responsibility that clearly defines the roles that African governments, the business community, and donors must take in funding long-term healthcare systems."