The question many have asked me — is the Kenya-U.S. health deal good or bad? My answer is that it’s neither good nor bad — it’s pragmatic at best; more complex than black or white, and this is why.
At face value, a U.S. commitment of $1.6 billion over five years looks like an unequivocal win for Kenya’s health system: cutting-edge laboratories, digital health systems, better-trained health workers. To put this in context, a contribution of $320 million annually in a country where total general government expenditure on health is just slightly above $2 billion means America’s “gift” is almost 15% of Kenya’s total general public expenditure. Simply put, America is “gifting” Kenya about $5 per capita in a country where the government spends $43 per capita.
It is understandable why many see this as a generosity that Kenya should simply accept. But should Kenya look a gift horse in the mouth? If Kenya did look the gift horse in the proverbial mouth, the teeth would reveal a fundamental decay in how wealthy nations now conduct global health partnerships and Kenya’s constrained position in negotiating them.
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About the author
Githinji Gitahi
Dr. Githinji Gitahi is group chief executive officer of Amref Health Africa, the largest Africa-led international organization, reaching more than 11 million people each year through 150 health-focused projects across 35 countries. Previously, Dr. Githinji was vice president and Africa regional director for Smile Train International; managing director for Monitor Publications in Uganda; and general manager for marketing and circulation in East Africa for the Nation Media Group. Dr. Githinji also sits on the boards of the Africa Centres for Disease Control and Prevention and The Coalition for Epidemic Preparedness Innovations.
