When the Covid-19 pandemic struck in 2020, African countries, including Kenya, initially received less than 5% of the global supply of vaccine despite the fact that they carried a significant share of the world’s disease burden.
Then came the global retrenchment of aid.
The African continent and the health sector were hit the hardest. Indeed, external health aid to the continent has dropped by nearly 70% since 2021, and by 30% to Kenya since 2023.
Official development aid, specifically the support provided by the United States’ Agency for International Development (USAID) has always played a key role in healthcare provision, specifically in the most underserved areas like Kibera where government health infrastructure is lacking and where people, often living on less than 3 dollars per day, have little access to healthcare.
In addition to increasing access to treatment and reducing infection rates, USAID also contributed to improving maternal and child health and family planning. Recent aid cuts and the retreat of the US from the WHO have not hit all sectors of health equally. Indeed, maternal and child care have been hit particularly hard, affecting the delivery of critical services like prenatal care and skilled birth attendance.
Towards health sovereignty
In response to aid cuts, African countries called to seize this opportunity to break away from aid dependence, not just temporarily patch the funding gap.
Africa CDC, the African Union’s public health agency, has been central in achieving this role. Namely, Africa CDC’s New Public Health Order serves to strengthen health systems and calls for greater mobilisation of national budgets towards health, education and innovation, and less reliance on external donors.
On the other hand, Kenya cannot move forward without aid. But this aid must inscribe itself in a framework of health sovereignty and cooperation. One important element to achieving this are sunset clauses : global health program deadlines and exit plans that ensure aid doesn’t fuel parallel systems forever. Sunset clauses also allow for gradual ownership transfers of programs funded by development banks and philanthropies (like the Global Fund, Gavi, etc.) to national governments. This type of structured transition is far less damaging than abrupt aid cuts.
Kenya has increasingly made them a baseline expectation for international health initiatives operating on its territory.
The future of maternal and child care in Kenya
Despite this difficult backdrop of traditional donors like the US, there are real reasons for hope. Alternative models of cooperation point toward a different future.
This year, Kenya, China, and UNICEF launched an initiative aimed at reducing maternal and newborn deaths in the counties of Garissa, Mandera, and Wajir in northeastern Kenya where maternal and newborn mortality rates are well above the national average as skilled birth attendance is critically low. The two-year programme, through expanded maternal, newborn, and emergency healthcare services, is expected to benefit more than 652,000 people.
More importantly, NGOs like Child Destiny Foundation matter more than ever.
When USAID programs were shut down in 2025, the consequences were immediate. Health programs that had taken years to build were terminated in a matter of weeks. Medical and humanitarian NGOs were the first to experience these cuts. In Kenya, NGOs play a critical role in delivering health services. Many of them lost their funding overnight, with no transition period and no alternative source of support. Programs focused on maternal health, child nutrition, and disability support were among those that simply stopped.
Before the cuts, USAID had been channeling over $400 million per year into Kenya's health sector. A large share of that money reached communities through NGOs, the actors closest to the most vulnerable people. When that funding disappeared, so did many of the services that the most vulnerable populations depended on. The scale of the impact of aid cuts is hard to measure.
It is in this context of program closures, shrinking budgets, and rising inflation that Child Destiny and organizations like it continue their work, every single day, with the same commitment as before.
But this work cannot wait for geopolitics to resolve itself.
It depends on continual, regular support.
We count on your help to keep our services running and to develop our ambitious projects.
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