U.S. and Kenya Sign $2.5 Billion Health Cooperation Framework

On December 4, 2025, the United States and Kenya signed a five-year, $2.5 billion Health Cooperation Framework in Washington, D.C., marking a significant shift in U.S. global health policy towards direct government-to-government partnerships. The agreement was signed by U.S. Secretary of State Marco Rubio and Kenyan President William Ruto.

Under the framework, the U.S. commits to providing $1.6 billion, while Kenya will contribute $850 million. The funds aim to combat diseases such as HIV/AIDS, malaria, tuberculosis, and polio, with a focus on strengthening Kenya's health systems and promoting self-reliance. This partnership represents a departure from previous models that primarily channeled aid through non-governmental organizations (NGOs).

Secretary Rubio emphasized the need for a more direct and accountable approach, stating that the agreement "aims to strengthen U.S. leadership and excellence in global health while eliminating dependency, ideology, inefficiency, and waste from our foreign assistance architecture." He also praised Kenya for its role in leading and contributing to the international stabilization force working to combat powerful gangs in Haiti.

President Ruto expressed confidence in the transparent use of funds and credited U.S. assistance for saving millions of lives. He highlighted that the agreement reflects growing confidence in the strength, sustainability, and reform momentum of Kenya's healthcare systems.

The Health Cooperation Framework is the first under the Trump administration's "America First Global Health Strategy," which seeks to align health funding with U.S. foreign policy objectives and encourage recipient countries to take greater responsibility for their health programs. This strategy marks a shift from previous health programs historically managed by the U.S. Agency for International Development (USAID), which was dismantled earlier in the year.

The agreement directs investments into core Kenyan government institutions, including the Social Health Authority (SHA), the Digital Health Agency, and the Kenya Medical Supplies Agency (KEMSA). This approach aims to enhance the country's healthcare infrastructure, improve service delivery, and promote self-reliance.

Kenya has stipulated conditions to ensure data security, including limiting the sharing of personally identifiable information and restricting data use to agreed-upon purposes. The data sharing provisions have raised concerns about data security and privacy, but Kenya has implemented measures to protect sensitive information.

The shift from funding NGOs to direct government partnerships may affect the operations and funding of NGOs previously involved in health programs in Kenya. The agreement also includes provisions for data sharing between the two nations, with safeguards to protect sensitive information.

The U.S.-Kenya Health Cooperation Framework signifies a pivotal shift in international health partnerships, emphasizing direct government collaboration and self-reliance. While it offers opportunities for strengthening health systems, it also raises questions about data security, the role of NGOs, and the future of global health aid.