Kenya’s TB Crisis: Tension as the country faces a Sh4.5 billion funding gap

Tuberculosis is not a new problem in Kenya.

What has changed is the financial environment around the fight against it.

Kenya is now facing a Sh4.5 billion funding deficit for its TB response, with donors still financing the majority of the programme while the government contributes about 10 per cent of the required funding, according to stakeholders in the National TB Programme, Parliament and Stop TB Partnership-Kenya.

The warning comes as two of the country's biggest external health financiers - the Global Fund and the US government - prepare to reduce their support, raising questions about who will finance TB screening, diagnostics, treatment and the health workers behind the programme.

How big is Kenya’s TB problem?

Kenya remains among the world's high-TB-burden countries.

In 2025, the Ministry of Health reported that 90,900 people were diagnosed with TB and started treatment, equivalent to about 81 per cent of the country's estimated TB burden.

That means thousands of cases were still estimated to be missing from the formal diagnosis and treatment system.

Stakeholders appearing before Parliament this week put the number of TB infections detected in the previous year at about 117,000, with approximately 16,000 deaths.

They also said roughly one in five cases remains undiagnosed.

The burden is not evenly distributed.

Nairobi, Mombasa, Nakuru, Kitui, Machakos, Makueni, Siaya, Kericho, Embu, Migori and West Pokot are among the counties identified as having particularly high numbers of TB cases.

The Sh4.5 billion funding gap

TB control requires considerably more than buying medicines.

The programme has to find people with symptoms, screen communities, transport samples, run laboratory tests, maintain diagnostic equipment, trace contacts, train and pay health workers and ensure patients complete treatment.

The funding picture explains the concern.

Kenya's annual TB programme requirement is about Sh7.5 billion, while only around KSh2.7 billion is currently being raised - leaving a gap approaching Sh5 billion.

Its breakdown showed the Global Fund providing about 64 per cent of the money raised, the US government about 25 per cent and the Kenyan government roughly 10 per cent.

The exact deficit varies slightly depending on the budget period and components counted, which explains the Sh4.5 billion figure now being highlighted by the National TB Programme and Stop TB Partnership-Kenya.

The big issue is that the programme is substantially dependent on external financing.

Ill-timed donor cuts

Kenya has benefited from years of international investment in TB, HIV and malaria programmes.

The Global Fund and Kenya launched a new US$407 million package covering 2024–2026, supporting HIV, TB and malaria programmes as well as laboratories, community systems and health infrastructure.

The Global Fund says its cumulative investment in Kenya since 2003 has reached about US$2 billion.

But the funding environment has changed.

The Global Fund's 2026 results report says funding disruptions in 2025 affected TB programmes in several countries, including interruptions to case finding, diagnosis and treatment.

The organisation has warned that protecting previous gains will require greater country ownership as international financing comes under pressure.

Kenya's own Ministry of Health has also acknowledged the need to move towards stronger national systems and sustainable domestic financing as the country's long-standing US health partnership enters a new phase.

What could the funding gap affect?

The immediate concern is not necessarily that TB drugs will suddenly disappear.

A funding squeeze can hit the less visible parts of the programme first - screening, laboratory diagnostics, sample transportation, community tracing, health-worker support and detection of drug-resistant TB.

TB is highly infectious.

Missing a case means the person may remain untreated while potentially transmitting the disease to others.

Stakeholders told Parliament that the disruption of US-funded health programmes had already resulted in major workforce losses and service reductions, including reported declines in TB services in some counties and shortages of first-line TB medicines in several facilities.

Can SHA close the gap?

One proposal now being pushed is to incorporate basic TB services into the Social Health Authority (SHA) benefit package.

Advocates argue that covering diagnostics such as X-rays and sputum testing could reduce what patients pay from their own pockets while encouraging earlier screening and treatment.

Parliament's Health Committee has indicated support for pursuing inclusion of TB services under the new benefit tariffs.

But insurance coverage alone does not replace the public-health financing required to detect cases in communities, transport samples, maintain laboratories and support TB surveillance.