The Health sector in Kenya is responsible for developing, implementing, and monitoring policies related to specialised medical services, including population health, research and innovation, public health, sanitation, preventive and promotive health services, professional standards, health education management, food quality, hygiene and nutrition, quarantine administration, radiation, control and management of tuberculosis and malaria. Additionally, the Sector provides strategic leadership and support to health professional bodies, aiming to maintain professional standards and promote excellence in healthcare practice.

Kenya’s health system was ranked second in Africa for quality services using top-notch equipment for diagnosis and treatment, as well as high-skilled medical personnel by the Numbeo Health Index Report 2024. However, despite having a robust healthcare sector, many patients across the country are increasingly facing a dire shortage of essential medicines, particularly for cancer treatment, while contending with the growing menace of counterfeit and substandard drugs. In low- and middle-income countries (LMICs) like Kenya, where 90 per cent of the global disease burden exists, an alarming 3.5 million deaths annually are linked to inadequate access to essential medicines.

On February 6, Health Cabinet Secretary Dr. Deborah Barasa said the situation, exacerbated by financial constraints, and inefficiencies in medicine procurement has put the country’s healthcare system under immense pressure. Speaking during the inaugural Axmed Access Summit, the CS admitted to this crisis but assured that the government, through her ministry, was putting measures in place to resolve the issues.

The cutting of USAID funding puts further strain on an already dicey situation. This development comes at a time when Kenya is already experiencing shortages of HIV drugs. According to the commodities dashboard managed by the National AIDS and STIs Control Programme (NASCOP), essential HIV medications were out of stock at the Kenya Medical Supplies Agency (KEMSA) as of the end of January.

Drug shortages in the country continue to be a pressing issue. However, a bigger crisis is looming, which is the proliferation of substandard and falsified (SF) medical products. Fake medicines, often containing harmful substances or incorrect dosages, have infiltrated Kenya’s pharmaceutical supply chain, leading to severe health complications, treatment failures, and even fatalities.

The World Health Organisation (WHO) estimates that one in 10 medical products in circulation globally is falsified. Industry associations estimate that up to 30 per cent of medicines in Kenya may be counterfeit, with a black market value of Ksh15 billion.

The exit of USAID has consequently left a vacuum in the health sector. A market shortfall creates a suitable environment for counterfeiters to flood the market. Desperate patients are more likely to turn to informal markets or unlicensed pharmacies, where counterfeit drugs are rampant. What makes fake drugs even more appealing is their relative affordability especially when booking at the current state of the economy where the cost of living is rising.

To safeguard public health, the country must move to strengthen the capacity of regulatory bodies, of which the government has promised to prioritise healthcare funding in the upcoming budget. The country must also enhance customs and border control, and fast-track the regulation of suppliers across the value chain. Furthermore, adopting technologies for drug authentication, increasing public awareness about the dangers of counterfeit drugs, and diversifying medicine procurement through new partnerships will be essential to stem the tide of fake medicines.

Without urgent intervention, the country risks trading one crisis for another. While medicine shortages are dire, their substitution with potentially lethal alternatives represents a far graver threat to Kenya’s health outcomes.