A joint session of Parliament’s Health Committee has raised concerns about attempts by donor partners in the health sector to economically disadvantage Kenya through practices that foster overdependence on their support for financing programs related to HIV/AIDS, malaria, and vaccine procurement.
The National Assembly Health Committee and the Senate Standing Committee on Health allege that these agencies have developed a habit of creating algorithms designed to advance their interests at the expense of the Kenyan people.
The lawmakers pointed an accusing finger at the Global Fund and the Global Alliance for Vaccines and Immunization (GAVI), describing them as the most notorious for advancing such practices, despite their support in financing critical programs in the health sector.
They spoke during the approval hearing of the nominee for the Director General of Health position Dr. Patrick Amoth.
“We faced many challenges with procurement, particularly concerning items like cancer medications and malaria mosquito nets. In your opinion, what steps should we take to become independent and ensure that our cooperation with these agencies does not lead to the development of an algorithm designed to advance their interests at the expense of our people? Posed Narok Senator Ledama Ole Kina.
“Is there plan to have the country self-reliant in matters related to procurement of vaccines, HIV/AIDS, malaria, and support for TB programs,” asked Ndhiwa MP Martin Peters Owino.
In his response, Dr. Amoth stated that the Ministry of Health has begun developing a sustainability plan to give Kenya greater leverage in managing and running its programs.
He stated that, by assessing the fiscal space, available resources, human resources for health, and existing infrastructure, the country can finance all programs currently funded by donors through the national budget within the next five years.
“Sometimes it’s tough, especially when you’re in a situation where this type of support is only available from a specific partner. These are the conditions and the price you sometimes have to pay for being part of the underdeveloped world,” he said.
“But going forward to your support to this committee and the rest of the country. We need especially for her we need to plan for her as a country. That is when we can be able to talk about independence,” he stated.
“Moving forward, your support is crucial not only to this Ministry but to the entire country. We need to plan strategically for health as a nation. Only then can we begin to discuss true independence,” he added.
Endebess MP Robert Pukose, who chairs the National Assembly Departmental Committee on Health, sought to know from Dr. Amoth what his plans would be once he is approved and confirmed as Director General of Health under the Ministry of Health.
“What is the one thing you will do once approved by Parliament and confirmed by the Cabinet Secretary of Health?” Dr. Pukose asked, a question that was echoed by Nominated Senator Omar Mariam Sheikh, who is also the vice-chairperson of the Senate Committee on Health.
Dr. Amoth, who has been acting the Director General for Health in the Ministry of Health, for the past 4 years pledged to address the longstanding human resource conflicts affecting various departments within the Ministry of Health, including resolving issues related to industrial strikes and the posting of medical interns.
This is even as he made a case for the Kenya Health Human Resource Advisory Council (KHHRAC) to be resourced properly to enable it deliver on its mandate.
Under the Health Act of 2017, KHHRAC is mandated to review policies and establish uniform norms and standards for the posting of interns to both National and County Government facilities, as well as for the inter-county transfer of healthcare professionals.
The Act also stipulates that KHHRAC shall manage the transfer of healthcare professionals between different levels of government, oversee the welfare and service schemes for health professionals, handle the management and rotation of specialists, and maintain a master register for all health practitioners in the counties.
“If approved by Parliament and confirmed to this position, I will be requesting your support in adequately resourcing this institution to help us address industrial strikes, such as the one concerning the posting of medical interns, and to manage the human resources within the Ministry of Health and the County governments,” said Dr. Amoth, who also the Vice President of the Executive Board of the World Health Organization (WHO), representing the African region.
“Currently, KHHRAC is underfunded as well as understaffed, it has only the Chief Executive Officer (CEO) and three other staff. Therefore, being unable to execute its mandate effectively,” he added.
He explained that if the institution had been in place and well-resourced, the industrial strikes by health professionals witnessed in the country could have been averted by addressing their welfare and the scheme of service.
On the critical debate whether Health function should be reverted back to the National government, Dr. Amoth emphasize the need for consultation, cooperation, and technical assistance to help counties deliver on their mandate.
He highlighted the importance of a more robust framework to support counties in their efforts to provide essential services to citizens.
“I cannot imagine at any given day that the health function which is a devolved function being taken back to the national government. If you look at the infrastructure as well as the equipment they have put in place as a ministry I can tell you that devolved is working but there are teething problems to make it better,” he stated.
“For example, if you look at the healthcare infrastructure, some counties buy up to 10 ambulances to support their services, really we cannot go back those days when things were centralized,” he held.
At the national level, he reiterated that counties need support to fulfill their mandate through technical assistance and by ensuring they have the resources necessary to continue delivering healthcare services.
