WASHINGTON — The United States has pledged over $1.6 billion to bolster Kenya’s health system through a landmark five-year bilateral compact, marking the first accord under the Trump administration’s revamped foreign aid framework.
Signed Thursday by Secretary of State Marco Rubio and Kenyan President William Ruto, the agreement reflects the administration’s “America First Global Health Strategy,” unveiled in September. This strategy emphasizes increasing recipient countries’ responsibility in combating major health issues, HIV/AIDS, malaria, tuberculosis and polio, aiming for a gradual transition from aid dependence to self-reliance.
As part of the compact, Kenya has committed to raise its own health budget by $850 million over the next five years. U.S. officials anticipate similar deals with other African nations in the near future.
The agreement also signals a strategic shift in aid delivery. Following the disbanding of the U.S. Agency for International Development earlier this year, funding will increasingly flow directly to Kenyan government channels, moving away from non-governmental organizations (NGOs) and what Rubio referred to as the “NGO industrial complex.” This redistribution aims to enhance efficiency by empowering local government systems and integrating faith-based health providers on equal footing with private entities for government reimbursements.
In 2024, before the aid cuts under the new administration, the U.S. contributed $440 million to Kenya’s health and population programs, with $310 million targeting HIV/AIDS. Under the new model, U.S.-supported health workers will gradually become the responsibility of the Kenyan government.
At the signing ceremony, Rubio expressed appreciation for Kenya’s leadership in a gang suppression force in Haiti and urged more countries to contribute toward stabilizing the Caribbean nation. President Ruto lauded the health initiative and recognized the lifesaving impact of prior U.S. support, assuring strict accountability for all funds received.
“I assure you that every shilling and every dollar will be spent efficiently, effectively, and accountably,” Ruto stated, underscoring Kenya’s commitment to maximizing aid effectiveness.
This agreement marks a significant pivot in U.S. foreign health aid policy, focusing on sustainability and recipient accountability amidst broader changes in international assistance frameworks.