Kenya’s Universal Health Coverage Initiative: Progress Amidst Challenges

On May 22, 2025, Health Cabinet Secretary Aden Duale met with Dr. Tedros Adhanom Ghebreyesus, the Director-General of the World Health Organisation (WHO), amidst the poignant backdrop of the ongoing Universal Health Coverage (UHC) program in Kenya. The program, envisioned to ensure that every citizen has access to quality and affordable healthcare without the burden of financial strain, has found itself in turbulent waters, facing both skepticism and enthusiasm from the medical community.

In a striking display of commitment, Duale reached out to the WHO for enhanced financial support to help scale the implementation of UHC. “During our meeting on the sidelines of the 78th World Health Assembly, themed ‘One World for Health,’ I sought to deepen our collaboration with WHO to advance our national health priorities,” he shared in a statement. It could be argued that this kind of international dialogue is not merely a formality; it represents a lifeline for UHC in Kenya, especially given its historical complexities.

A Call for Financial Support

During the discussions, Duale emphasized the increasing financial challenges the Health Ministry has faced over the years, particularly since the launch of UHC in 2018 under former President Uhuru Kenyatta. Although the initiative was buoyed by substantial allocations in previous fiscal years—Ksh130.4 billion in 2021/2022 and Ksh146.8 billion in 2022/2023— the current financial climate tells a starkly different story. The latest health budget plummeted to Ksh127 billion, with merely Ksh4.2 billion allocated to UHC coordination and management.

One can’t help but ponder: how do we prioritize health amidst dwindling resources? Duale’s urgent call for increased contributions to WHO highlights a pressing question we all face: what are the sustainable pathways to ensure healthcare access for all, especially in low-income settings?

Challenges and Implications

As it stands, the Ministry of Health is grappling not only with budget cuts but also with the pressing issue of employment for UHC workers. Protests have erupted, with dedicated healthcare professionals camped outside the Ministry demanding permanent employment. Here lies the intersection of policy and human experience; healthcare workers deserve job security, yet budgetary constraints loom large. This seemingly endless cycle of funding gaps often leads us to ask: in a country rich with potential, why is healthcare often the first victim of financial austerity?

The projected cost for fully implementing UHC is staggering, estimated at Ksh550 billion annually, while the current health expenditure stands at Ksh247 billion. This colossal discrepancy raises eyebrows and advocates for innovative health financing solutions. During his meeting with Dr. Tedros, Duale referenced the necessity for sustainable financing mechanisms. “We discussed the need for sustainable WHO financing, including increased assessed contributions, to support the goals of the Fourteenth General Programme of Work (GPW14) for 2025–2028,” he noted. Sustainability is essential, but how achievable is it amidst global financial instabilities?

A Reflection on Healthcare Evolution

The journey towards UHC in Kenya has been anything but linear. While significant strides have been made since the program’s pilot in 2018, each step forward seems countered by a step back in terms of budgetary allocations. The story of UHC today speaks volumes about the evolving dynamics of healthcare funding and policy. As healthcare professionals navigate the complexities of their responsibilities, let us reflect: what would ideal healthcare access look like to us? And how do we get there?

Moreover, Kenya’s UHC initiative serves as a microcosm of broader global health challenges. As governments worldwide adjust policies in response to changing economic realities, Dr. Tedros emphasized the importance of international cooperation: “Health is a global public good. We are in this together.” It is a sentiment worth remembering as we strive for innovative, holistic solutions that connect local and global health agendas.

Conclusion

The essential task ahead is not simply to revive the budgetary allocations for UHC but to advocate for a fundamentally reimagined approach to healthcare funding that guarantees equitable access. The recent dialogues between Kenya and WHO could pave the way for transformative changes, but only if we commit collectively to overcoming the challenges that lie ahead.

In the face of uncertainty, one truth remains clear: investing in health is investing in humanity. Are we ready to make this investment? As we continue to ask difficult questions and seek constructive dialogues, the hope is that Kenya will emerge stronger, with a healthcare system that reflects the aspirations of its people.

Edited By Ali Musa

Axadle Times International–Monitoring