The United States government continues to run robust health programs across all 47 counties in Kenya, even as the current administration redefines the long-term vision for American foreign health assistance globally.
That is the word from Heidi O’Bray, Health Lead for the Office of Foreign Assistance at the U.S. Embassy in Nairobi, who says Kenya stands out as a high priority partner for Washington in the health sector.
“When the administration first came in January last year, there was a review of our programs, and it was determined to look at the programs that were really having life-saving impact,” O’Bray said.
Heidi O’Bray added: “In Kenya, we’re fortunate to have a number of those that were prioritized across HIV, TB, malaria, maternal child health, and global health security.”
The review, she explained, was not a retreat from health commitments but rather a deliberate effort to concentrate resources where they matter most.
Health and humanitarian programs emerged from that process as clear priorities for continuity, and Kenya’s programming came through largely intact.
In September of last year, the administration released its America First Global Health Strategy, a document that O’Bray says sets a new course for how the United States engages with partner countries on public health.
Central to that strategy is a framework Kenya has come to call the Health Cooperation Framework, a memorandum of understanding built around three pillars; ensuring no disruption to life-saving service delivery, maximizing the impact of joint programming, and gradually shifting leadership and financial responsibility to the Kenyan government itself.
“The shift with the framework is really to making sure that the Kenyan government is really in the lead and designing a program that meets the needs of the Kenyan population and in line with the five-year vision that relies less on external support and more on domestic resources,” O’Bray said.
At the heart of the framework is what O’Bray describes as the co-investment model.
As U.S. funding gradually steps back over the five-year period, Kenya is expected to progressively increase its own domestic resource mobilization to fill the gap and sustain the services that American assistance currently supports.
The transition, she insists, is being planned carefully and collaboratively with the Kenyan government to ensure no patients are left behind.
“We’re doing this in a very deliberate, responsible way so that no patients are left behind as we transition in a responsible way to Kenyan government domestic resources,” O’Bray said.
Part of that deliberateness involves making services more efficient and more affordable before the handover, so that what Kenya inherits is a leaner, more sustainable health system rather than a costly dependency.
O’Bray emphasizes that the U.S.–Kenya relationship in the health sector remains close, with both governments working in lockstep throughout the planning process.
“We really see Kenya as a strong partner for the United States government,” she said. “We are fortunate to have continued health programming in Kenya, again, across all 47 counties.”
For O’Bray, the bottom line is that every dollar spent must now demonstrate clear, measurable impact.
The era of expansive foreign health funding without rigorous accountability is giving way to one where efficiency, sustainability, and country ownership define success.
Kenya, she suggests, is well positioned to meet that moment.
