Nairobi: A wave of uncertainty continues to grip Kenya’s healthcare sector following a recent freeze on U.S. foreign aid, a move that has led to mass retrenchments across health facilities in Kiambu County and beyond. The funding suspension, initiated by the U.S. Agency for International Development (USAID), has put thousands of healthcare workers at risk and threatens critical HIV treatment and prevention programmes.
According to Kenya News Agency, for five years, Mary Muthoni, an HIV testing and counselling provider at Kangemi Health Centre, a health facility supported by USAID for several critical services, has worked tirelessly to support patients in need. Today, she finds herself among the many healthcare workers facing an uncertain future. “Over 20 of my colleagues have already been retrenched in the past week, and we have received no clear communication about what happens next,” she says.
Similar layoffs have been reported at other health facilities across Kiambu County, including Akshar Health and Life Care Hospital, where clinicians, pharmacy technicians, and HIV service providers have also been affected. The crisis stems from an executive order issued in January 2025 by U.S. President Donald Trump. Executive Order 14169, titled ‘Reevaluating and Realigning United States Foreign Aid,’ imposed a 90-day pause on all U.S. foreign development assistance programmes to allow for a comprehensive review.
This broad suspension affected key health initiatives, including those funded by USAID and the President’s Emergency Plan for AIDS Relief (PEPFAR). Programmes supporting HIV and AIDS, malaria, and other critical diseases were left in limbo, raising fears of devastating health impacts worldwide. Subsequently, the U.S. State Department announced a complete freeze on new funding for most foreign aid programmes, with exceptions only for emergency food assistance and military aid to Israel and Egypt. This decision disrupted billions of dollars earmarked for health, education, and development, leaving no exemptions for essential health programs like PEPFAR.
On January 28, 2025, the U.S. administration issued a waiver exempting ‘life-saving humanitarian assistance,’ including core life-saving medicines. However, many health programmes, particularly those related to HIV and AIDS prevention and treatment, continue to struggle with funding uncertainties. Kenya, ranked as the fifth-largest health beneficiary of USAID, has received over Sh1.26 trillion in U.S. health aid between 2001 and 2024. The sudden funding freeze has left health workers in limbo, with thousands facing forced unpaid leave or retrenchment.
Speaking in a live interview on a local broadcasting station on Sunday, February 9, 2025, Dr. Ruth Laibon, CEO of the National Syndemic Diseases Control Council (NSDCC), underscored USAID’s long-standing contributions to Kenya’s health system. “For 60 years, USAID has played a crucial role in funding HIV care and treatment programmes in Kenya. PEPFAR alone employs approximately 41,500 healthcare workers, many of whom are now facing layoffs,” she explained.
The retrenchments have had immediate consequences on healthcare services. Programmes offering HIV counselling and testing, antiretroviral therapy (ART), and maternal health support have slowed down or halted entirely. Patients who depend on these services now fear for their health and well-being. In an attempt to mitigate the crisis, the U.S. government issued a 90-day waiver allowing some humanitarian aid to proceed. Under this provision, USAID will continue supplying essential medical equipment, including HIV test kits, laboratory tools for clinical monitoring, opportunistic infection medicines, and antiretroviral drugs, with each dose covering three months; HIV testing for tuberculosis patients; retesting services for pregnant and breastfeeding women; and counselling and nutritional support.
While this waiver provides temporary relief, it does not guarantee long-term stability for Kenya’s health programmes. Health experts warn that if the funding freeze becomes permanent, it could lead to the collapse of essential services, leaving thousands without access to treatment. As uncertainty looms, the Kenyan government is exploring domestic solutions-alternative funding strategies to sustain critical health programmes. Cabinet Secretary for Finance, John Mbadi, has emphasized the urgent need for Kenya to shift towards domestic funding mechanisms. “If the U.S. withdraws foreign aid for Kenya’s health sector, we must find ways to sustain these crucial services through local funding,” he stated.
For now, thousands of healthcare workers remain in distress, and millions of Kenyans who rely on USAID-supported programmes face an uncertain future. Dr. Salome Kimani of Gikambura Hospital in Kikuyu sums up the prevailing mood: “Our future remains a mystery. We have received no official communication about when-or if-we will return to work. Healthcare providers across the country are deeply concerned, but it is the patients who will suffer the most.”
