Kenya and the United States on Wednesday sealed a landmark $1.6 billion (Ksh 207 billion) health compact, the first bilateral health agreement under President Donald Trump’s “America First” foreign aid policy.
The five-year deal, valued at $2.5 billion when Kenya’s Ksh 110 billion contribution is added, marks the end of the old USAID-NGO model. For the first time, American funds will flow directly to Kenya’s Ministry of Health and county governments.
U.S. Secretary of State Marco Rubio and Kenya’s Prime Cabinet Secretary Musalia Mudavadi signed the agreement at the State Department in the presence of President William Ruto.
Speaking immediately after the signing, Secretary Rubio said: “This is not charity – this is a partnership between two sovereign nations. Kenya has proven itself a reliable strategic partner, from leading the mission in Haiti to standing firm on shared values. Today we reward that partnership by trusting Kenya to manage these resources directly.”
President William Ruto described the deal as a “game-changer” for Kenya’s healthcare system.
The agreement comes ten months after President Trump ordered the closure of USAID in early 2025 and redirected global health funding through direct government-to-government compacts.
White House officials confirmed Kenya was chosen as the first partner because of its leadership in the Multinational Security Support mission in Haiti and its commitment to increase domestic health spending.
Health Cabinet Secretary Aden Duale, who was part of the Kenyan delegation, told reporters the funds will be released in annual tranches starting January 2026 with strict performance benchmarks.
The deal is expected to create thousands of new healthcare jobs, equip county hospitals, and expand free HIV treatment and malaria prevention programmes across Kenya’s 47 counties.
As President Ruto left the State Department, he told the waiting press: “Kenya is open for more partnerships like this – direct, respectful, and results-driven.”
