Kenya's fight against HIV/Aids, tuberculosis, and malaria faces a double blow that threatens to undo decades of progress —a sharp domestic budget cut to Global Fund-supported programmes and increased uncertainty in international donor support.
In the financial year starting in July, the government reduced its budget allocation for these programmes by almost 40 percent, from Sh28.7 billion in the financial year ending June 30,2025 to Sh17.3 billion for the new fiscal year.
This drastic reduction comes at a time when Kenya is struggling with one of the highest disease burdens in sub-Saharan Africa, while also facing mounting pressure to finance its health systems amid global donor fatigue.
"To lower the number of HIV/Aids, malaria, and tuberculosis cases, I have proposed Sh17.3 billion for the Global Fund," announced John Mbadi, the Cabinet Secretary for Treasury, during the budget reading last Thursday.
The Global Fund to Fight AIDS, Tuberculosis and Malaria is one of the largest and most reliable sources of external health financing for Kenya. Since its establishment in 2002, it has disbursed over $2 billion to Kenya, supporting the purchase of antiretrovirals (ARVs), TB and malaria medications, mosquito nets, diagnostics, training for healthcare workers, and outreach to vulnerable populations.
The budget cut comes at a time when Kenya continues to rank among the top 15 high-burden countries globally for both HIV and tuberculosis. Over 1.3 million Kenyans rely on free ARV treatment, and more than 36,000 new HIV infections are reported annually.
According to the 2022 Kenya HIV Estimates Report, HIV prevalence stands at four percent among adults aged 15 to 49, with certain counties such as Homa Bay, Kisumu, and Siaya reporting rates exceeding 15 percent.
Meanwhile, the incidence rate of TB is 251 per 100,000 people, resulting in over 80,000 new cases each year, many of which go undiagnosed. While malaria is more regional, it impacts millions, with a national prevalence of six percent and rates exceeding 19 percent in high-transmission areas around Lake Victoria.
These challenges have been worsened by an executive order issued by US President Donald Trump in early 2025, which froze USAid disbursements, including the President's Emergency Plan for AIDS Relief, Kenya’s largest HIV support programme, leading to ARV therapy shortages.
"Consistent with President Trump’s Executive Order on Reevaluating and Realigning United States Foreign Aid, Secretary Rubio has paused all US foreign assistance funded by or through the State Department and the US Agency for International Development (Usaid ) for review. He is initiating a review of all foreign assistance programmes to ensure they are efficient and consistent with US foreign policy under the America First agenda," the order read in part.
In addition to funding cuts, Kenya is under pressure to meet its co-financing obligations to the Global Fund. As a lower-middle-income country, it must contribute at least 20 percent of the value of its Global Fund grants, amounting to over Sh106 billion for the current funding cycle.
Failure to meet this requirement could result in the withholding of up to 15 percent of the grant, delayed disbursements, increased oversight, or even disqualification from future funding rounds. With over 60 percent of HIV commodities funded by donors, non-compliance could have dire consequences for public health.
"Any delay at any point in the process, whether at the beginning, during quantification, during the tendering process, or at the end, during logistics, may result in delivery being pushed into the following year. This would mean that the current year's funding would be lost for the disease programme, and the following year's budget may be lower," said the Global Fund.
Kenya’s health sector has been allocated Sh138.1 billion, representing just 3.29 percent of the national government budget which is below the Abuja Declaration which requires governments to allocate at least 15 percent of their national budget to the health sector.
