Washington, D.C. – December 5, 2025 – The United States and Kenya signed a groundbreaking five-year Health Cooperation Framework on Thursday under which Washington will provide up to $1.6 billion in direct funding to strengthen Kenya’s public health system. The historic agreement — the first government-to-government health compact of its kind in Africa — was signed by U.S. Secretary of State Marco Rubio and Kenya’s Prime Cabinet Secretary Musalia Mudavadi in the presence of President William Ruto.
The deal marks a deliberate departure from decades of aid channeled through international NGOs and multilateral agencies. Instead, American resources will flow directly into Kenya’s national treasury and county health budgets, giving Nairobi full control over planning, procurement, and implementation while maintaining strict accountability and performance benchmarks.
President Ruto described the framework as a decisive milestone in Kenya’s journey toward universal health coverage (UHC), one of the four pillars of his administration’s Bottom-Up Economic Transformation Agenda. “This partnership eliminates third-party intermediaries and guarantees that every dollar reaches the intended beneficiaries with maximum impact and transparency,” he said. He added that the funds will be used to purchase modern medical equipment, ensure reliable supply of essential medicines and commodities to all facilities, expand the health workforce, and extend insurance coverage to millions of currently uninsured Kenyans.
Secretary Rubio explained why Kenya was chosen as the inaugural partner: “We selected Kenya first because of our deep strategic partnership and because Kenya has demonstrated political stability, strong institutions, and genuine commitment to health-sector reform.” He described the agreement as the flagship of President Trump’s America First Global Health Strategy, which prioritizes direct bilateral deals with reliable partners over the traditional “NGO industrial complex.”
The $1.6 billion U.S. commitment will be complemented by at least $850 million in new domestic spending by Kenya, bringing the total five-year investment to $2.5 billion. Key focus areas include:
Sustaining and expanding HIV/AIDS treatment and prevention (currently supporting over 1.4 million Kenyans on antiretroviral therapy)
- Malaria control and elimination
- Tuberculosis detection and treatment
- Maternal, newborn, and child health
- Immunization and polio eradication
- Disease surveillance and pandemic preparedness
- Laboratory strengthening and digital health systems
The partnership builds on more than 25 years of collaboration during which the United States has invested over $7 billion in Kenya’s health sector — primarily through PEPFAR, the President’s Malaria Initiative, and other flagship programs — helping reduce new HIV infections by more than 70 percent and malaria mortality by 75 percent in targeted areas since the early 2000s.
Kenya has pledged to progressively increase its own health budget from approximately KSh 10 billion in the coming fiscal year to KSh 50 billion by 2029/30, with the goal of fully assuming financial responsibility for these programs by 2031. The agreement also encourages participation of faith-based health providers — which operate nearly 40 percent of rural facilities in Kenya — provided they are accredited and enrolled in the national insurance scheme.
Health Cabinet Secretary Dr. Aden Duale addressed domestic concerns about data privacy by confirming that any information shared with U.S. partners will be fully de-identified and aggregated, in strict compliance with Kenya’s Data Protection Act, Health Act, and Digital Health Act. “No individual patient records will ever leave Kenya,” he stressed.
The signing took place on the margins of President Ruto’s working visit to Washington, during which he also witnessed the U.S.-brokered peace agreement between the Democratic Republic of Congo and Rwanda. The health compact further cements Kenya’s position as one of America’s closest allies in Africa, alongside existing cooperation in security, counter-terrorism, trade under the Strategic Trade and Investment Partnership (STIP), and Kenya’s leadership of the Multinational Security Support mission in Haiti.
For ordinary Kenyans, the agreement promises tangible improvements: shorter waiting times at public hospitals, consistent availability of medicines, more community health workers, and — over time — the removal of financial barriers that currently force millions to pay out-of-pocket or forgo care altogether.
As the first concrete outcome of the Trump administration’s restructured global health architecture, the Kenya framework is expected to serve as a template for similar direct-financing agreements with other stable and reform-minded partners across Africa and beyond. For a continent long accustomed to donor-driven programs, the deal represents a quiet but profound shift: from aid dependency toward genuine health sovereignty, backed by one of the world’s largest bilateral commitments in recent history.
