The fight against HIV/Aids, implementation of Social Health Insurance Fund (SHIF), and procurement of Community Health Promoters (CHP) kits lies in limbo following budget cuts of the health sector by a whopping Sh161 billion. 

Also affected by the reduction are the Semi-Autonomous Government Agencies (SAGAs) under the medical services unit, human vaccines production and provisions of medical commodities, as well as facilitation of the Managed Equipment Services. 

Documents tabled before MPs who sit in the Health Committee, chaired by Seme MP James Nyikal, by Medical Services Principal Secretary Ouma Oluga show that the said reduction is part of a Sh321.4 billion additional allocation that the state department requires to implement its functions. 

While the department has a total requirement of Sh426.8 billion, comprising Sh350.6 billion in the recurrent expenditure and Sh76.2 billion in the 2025/2026 estimates, the department was only allocated Sh105.4 billion, which is a further reduction of Sh67.2 billion from Sh172.6 billion that had been allocated in the Budget Policy Statement (BPS). 

“The key areas not fully funded include the historical under-funding of salaries in SAGAs, the Presidential directive projects, Managed Equipment Services, Human Vaccines Production and provision of medical commodities for strategic health programmes such as HIV/Aids, family planning and vaccines,” Oluga said. 

Budget gaps 

With regards to implementation of SHIF, the documents reveal that the vote has a shortfall of Sh145 billion that had been earmarked for scaling up the fund in implementation of the Social Health Insurance Act, 2023, Primary Health Care Act, 2023, and Digital Health Act, 2023 which established the Primary Health Care Fund and The Emergency, Chronic and Critical Illness Fund. 

The Primary Health Care Fund has a budget gap of Sh48 billion, having only been allocated Sh13 billion despite a total requirement of Sh61 billion, while the Emergency, Chronic and Critical Illness Fund has a shortfall of Sh97 billion, having been allocated a paltry Sh10 billion despite a total requirement of Sh107 billion. 

With regards to the procurement for HIV programmes, family commodities, the documents show that the department has a shortfall of Sh4.27 billion out of which Sh2 billion is for the procurement of traditional vaccines, Sh1.69 billion as Gavi co-financing, which is mandatory under partner financing agreement and must be provided within the year, Sh585 million is for vaccine independence initiative (VII) replenishment to Unicef and Sh2.88billion is for the provision of family planning commodities.  

In relation to HIV commodities and following the United States government funding freezes, the program requires Sh33.9 billion. 

Service disruptions  

“The State Department further requests that these funds be ring-fenced in the FY 2025/24 and the Medium-Term Budget and further be exempted from any budgetary cuts in Supplementary Estimates,” reads the document, adding that the budget requirement for procurement of strategic commodities under HIV, Family Planning and Vaccines programmes has undergone a perpetual financial rationalisation over the years.  

“Further, there has been a steady reduction in donor funding for these programmes and therefore calls for the need to increase GoK counterpart funding,” it adds. 

With regards to funding for CHP kits, the vote has a gap of Sh3 billion to be able to procure the kits as well as pay CHP workers.   

The shortfall for personal emoluments is Sh500 million, which has occasionally caused disruptions in the provision of services, while the deficit of the health systems and process re-engineering is Sh2.5 billion.