Push for domestic TB funding, with Kenya facing a shortfall of Sh5 billion

The Director, Stop TB, Evaline Kibuchi, is delivering remarks at the Health Financing Breakfast Meeting with members of the Parliamentary Health Committee and the Parliamentary TB Caucus on September 21, 2026.[Benard Orwongo, Standard]

Anti-TB lobby groups are pushing for an increased allocation of domestic resources to eliminate Tuberculosis (TB), while simultaneously demanding the inclusion of TB services in the Social Health Authority (SHA) package.

The lobby groups told the National Assembly Health Committee, chaired by Dr James Nyikal, that eliminating a disease that kills at least 44 Kenyans every single day has been an uphill battle due to severe underfunding.

Currently, Kenya faces a Sh4.9 billion shortfall in its TB program.

This push for local funding comes at a critical time. Dr Nkirote Mugambi, the Chief of Party at the Centre for Health Systems Strengthening (CHSS), warned lawmakers that the country's TB response, including screening, diagnosis, and treatment, has heavily depended on external donors who are now pulling back.

Additionally, Mugambi told the committee that drug-resistant TB is usually funded through foreign resources.

This entails training if health workforce,, collection and movement of samples from remote areas to laboratories for testing, including treatment of patients.

“We have been given a warning by donors that resources will shrink significantly over the next four to five years,” Mugambi told the committee.

Annually TB program requirement is Sh7.5 billion, but only Sh2.7 billion is raised.

Of the monies, the Kenyan government allocates only 10 percent of annual budget for TB programs, with support from Global Fund and the U.S. Government at 64 percent (Sh1.73 billion) and 25 percent (Sh680 million).

The proposal was acknowledged by Chairperson of the committee, Dr Nyikal who said TB program has been running well, but maintained that total elimination was key, as Kenya is still ranked among top TB burden counties globally.

“Most of the funding if from donors; we need to get to domestic funding,” said Nyikal.

However, the chairperson said TB is still in silos despite it being under the  Ministry of Health, and that some components of the program can be implemented at county level with a decline in funding.

“We need to integrate TB at at policy and county level. Counties should be involved,” said Nyikal, highlighting that integration will handle the issue of equipment, diagnostics, and services that are largely handled at the national level.

Additionally, Nyikal said inclusion will bring onboard the National Equipment Service Program (NESP), because a lot of money for TB program goes to diagnostics.

Kenya, stakeholders maintained risks loosing gains made in elimination of the disease, if no much resource is allocated to eliminate TB, a disease that remains a public health concern.

For example, Kenya suffered more during the stop-work order by the U.S. Government; Kenya’s TB program greatly suffered, with at least 41,000 health workers lost their jobs.

Delivery of TB services also dropped; for example, Siaya recorded a drop of between 20 to 30 percent in services.

At least five counties recorded a stock-out of first-line TB drugs, with patients turned away from facilities without care.

Nevertheless, national TB diagnosis fell by 3.2 percent, first reversal ever recorded in a decade.

Therefore, the official pleaded with the National Health Committee to establish and protect a dedicated domestic TB fund, while ring-fencing the budget within the Ministry of Health

Data shows at least 117,000 TB infections were reported last year, with 16,000 deaths whereas at least one in in five cases are still never diagnosed.

Nairobi leads with the highest number of TB cases, followed by Mombasa, Nakuru, Kitui, Machakos, Makueni, Siaya, Kericho, Embu, Migori, West Pokot, Kajiado, Kirinyaga and Nyeri.

“Today, when we go to sleep, at least 44 people will die because of TB,” said Director Stop TB, Evelyn Kibuchi.

“MPs, this number if your votes,” added Kibuchi.

Elimination of TB she said, requires zero infections, zero deaths and zero catastrophic cost in diagnostics and treatment.

Further, Kibuchi asked the National Health Committee to help restore Sh10 million funding for TB program that was slashed three years ago, have funding of Sh860 million for completion of Bio Safety Level 3 laboratory and employment of more human resource.

The laboratory, key for the diagnosis and management of TB samples  was allocated Sh200 million by Global Fund, but has since stalled.

On his part, Endebes MP Dr Robert Pukose said ring-fencing resources is not a solution to funding gaps, but rather, better utilisation of available resources.

Pukose said as the country heads to next General elections next year, priorities might change.

The 2027/28 budgetary process is ongoing; it will be tabled in November, ahead of its reading in April, 2027.

“Priorities might change because people are moving into elections.,” said Pukose.

Further, the MP explained that allocation under Primary Healthcare Fund (PHC) should also be utilised for TB care.

Pukose said tehre is more allocation of Sh19.1 billion for PHC, allocation made from exchequer.

“Level 2, 3, and 4 so long as you're registered, it means they will be able to see you, carry out diagnostics, and be treated and have SHA off set the bill. What happens for Social Health Insurance Fund (SHIF) is for inpatient. It’s more of a members club,” said Pukose.

But in a quick explainer, Anti-TB said TB services are not issued at lower level facilities, including Level 2 and some 4 hospitals.

The parliamentarians were also asked to help push for inclusion of the services under SHA benefit set to be officially gazetted in October.

“We are hoping basic TB services including screening, x-ray, all the diagnostics. If included in SHA package, it will really reduce out of pocket from patients,” said Kibuchi.

According to the official, the biggest burden of cost is on diagnostics.

“If SHA package would include the Xray, sputum, tests, we shall reduce the cost and will encourage people to go for screening and treatment,” added Kibuchi.

On his part Stephen Anguva, the national coordinator of the advocacy group Network of TB Champions, said currently, patients pay out of pocket to access SHA services.

The majority of TB patients, according to Anguva cannot afford SHA premiums.

“We are currently having patients pay for TB services. These services are not in primary hospitals, and when they get to high level facilities, they either pay out of pocket,” added Anguva.

In the current budgetary allocation TB services are clustered as a vertical funded program.

“Our key request is that we submitted key tests that TB should be included in SHA tariffs. We submitted our proposal, as National Health Committee, please help us realise this,” Anguva pleased with the committee.

In response, Pukose said the committee will push for inclusion of the services under new tariff benefit.

On human resource, Kibuchi said there is need to have more trained healthcare providers to handle TB. Most hospitals she said do not have medical officers, whereas some lack euipment for diagnostics.

But in response, Pukose proposed adoption of model used in Canada, where Community Health Promoters (CHPs) are key in prevention of diseases, including TB.

Under the model, he explained that CHPs use Artificial Intelligence (AI) to feed their gadgets with details collected from communities.

From collected details, action is taken, for example, have individuals linked to screening, testing and treatment preventing spread of the disease at community level.

“When you look at a model like Canada, they have CHPs similarly to ours and each is in certain people, they use AI to make diagnosis.  For example, night sweats, chronic coughs, if you feed to the AI it states it a suspected TB case,” said Pukose.

“Such a case is then referred to a hospital, with a medical officer for more review, tests and treatment. This can be used here,” he added, emphasising the need to utilise them, as they are paid Sh5,000 by both national government at a shared cost of SH2,500 each.

But according to Kibuchi, more expertise human resource is key, in diagnostic and treatment of the disease.

At the same time, Kibuchi asked the National Assembly Health Committee to help allocate a budget of Sh8 million for annual renewal of licensing of Digital xrays.

There is a total of 96 TB machines across the country.