Kenya has become the first country to operationalise a new government-to-government (G2G) health financing partnership with the United States after Treasury Cabinet Secretary John Mbadi signed a five-year $1.6 billion (about Sh207 billion) funding agreement aimed at strengthening the country's health system.
The deal marks a major shift in how US health assistance will be delivered, replacing the long-standing model of funding through implementing partners with direct government-to-government support.
Speaking after the signing ceremony on Wednesday, Health Cabinet Secretary Aden Duale described the agreement as a milestone in Kenya-US relations, saying the implementation phase had officially begun.
"I think this is a very great day in the Kenyan health sector in terms of the Kenya-U.S. health cooperation framework, and I am very happy because we have ticked all the boxes," Duale said.
He noted that Kenya was the first country globally to sign both the broader health cooperation framework and the accompanying financing agreement.
According to Duale, the Sh207 billion package will support key health priorities including HIV, tuberculosis, malaria, cancer care, the National Public Health Institute and the government's digital health programme.
"This agreement touches on our important institutions: cancer, the National Public Health Institute, our digitization health program, our malaria, HIV and TB programs," he said.
Duale said the agreement also introduces a new financing model where all US funding will pass through the National Treasury, allowing greater transparency and parliamentary oversight.
"For many years, the U.S.-Kenya health cooperation was done through partners implementing agencies, but now everything is government to government," he said. "Now, as a government, we have full visibility from the National Treasury, being captured in the budget and audited by Parliament."
He explained that while the US funding would begin immediately, it would gradually reduce over the five-year period as Kenya increases its own health financing.
"The whole concept is that in five years the U.S. will withdraw, and the Kenyan government will sustainably run the health sector," Duale said.
Treasury CS John Mbadi welcomed the agreement, saying it resolves long-standing challenges over tracking donor-funded health programmes.
"I want to thank the U.S. government for this gesture. Kenya being the first country to sign this kind of agreement," Mbadi said.
He recalled the uncertainty created when previous US-funded health programmes were frozen in 2025.
"I was asked how much are we likely to lose, and it was very difficult to come up with the figures," he said. "Now this money is completely different, and we have full visibility."
Mbadi assured development partners that the funds would be managed transparently.
"We have full visibility as National Treasury... the implementing ministry also has full visibility and accountability," he said. "The accountability and transparency around this funding will be guaranteed."
US Foreign Service Officer Susan M. Burns said the agreement reflected a new era of shared responsibility between the two countries.
"We are trying to transition to a new model of assistance. It's really about shared responsibility, and it's really about close collaboration," Burns said.
She said the agreement builds on decades of cooperation that has helped save more than one million lives through HIV programmes while supporting tuberculosis and malaria interventions.
"But I think it's time for a new model," she said. "We're working together and we're supporting the vision of the Government of Kenya in terms of digitization of the health sector, ways to improve efficiencies and, of course, to continue to provide patient care."