Kenya’s new Health Cooperation Framework with the United States (U.S.) represents one of the most consequential restructurings of external health financing in recent years. This discussion emerges after several months of uncertainty linked to the recalibration of U.S. support to Kenya’s HIV, TB and malaria programmes. At the same time, the national conversation has shifted. Questions of sovereignty, privacy and data governance have become increasingly central.

For these reasons, the agreement has attracted both public scrutiny and persistent speculation, including unfounded claims that it grants the U.S. access to Kenya’s medical records. A factual, sober assessment paints a different picture; one that is less dramatic but far more significant for Kenya’s health governance.

Details of the New Framework

The agreement, announced this week, outlines a five-year partnership through which the U.S. government will provide approximately USD1.6–1.7 billion to support national HIV, malaria and tuberculosis programmes, strengthen laboratories, stabilise supply chains and enhance surveillance and digital health systems.

Historically, U.S. health financing flowed primarily through the United States Agency for International Development (USAID) and the President’s Emergency Plan for AIDS Relief (PEPFAR) implementing partners, creating parallel operational structures that relied heavily on non-governmental organisations (NGOs) for data management, procurement, and programme implementation. When elements of this support were paused or reconfigured in 2023–2024, when President Trump signed an executive order abolishing the USAID, Kenya experienced an abrupt period of uncertainty. The new Framework, therefore, marks a transition from donor-driven models to a government-to-government arrangement designed to restore predictability while strengthening national stewardship.

Understanding the Data Question: What Is Included and What Is Not

Much of the public anxiety has centred on data sharing, with assertions that the agreement permits the transfer of identifiable patient records to U.S. agencies. The evidence does not support this interpretation. What the Framework requires is the continuation of reporting mechanisms that have existed for two decades: aggregated epidemiological data, laboratory results, including genomic sequencing, and de-identified programmatic datasets used to evaluate public-health outcomes. These are standard forms of information exchanged in international disease-control efforts. They do not include names, ID numbers, contact details or clinical histories tied to individual identities.

The similarity with earlier USAID and PEPFAR arrangements is important. Those programmes required detailed reporting to track viral suppression, treatment adherence and outbreak trends. The current Framework does not introduce a new or expanded category of data sharing. It instead consolidates and localises it under the direct custodianship of the Kenyan government, which now becomes the central manager rather than an indirect participant in donor-driven ecosystems. 

Kenya’s Legal Safeguards on Healthcare Data

Kenya’s legal regime provides clear guardrails. The Data Protection Act defines health information as sensitive personal data, strictly regulating its processing and prohibiting cross-border transfer without appropriate safeguards, a lawful purpose, and oversight by the Office of the Data Protection Commissioner. The Digital Health Act sets out governance structures for custodianship, access, de-identification and system security.

These laws were fully operational during the USAID/PEPFAR reporting era and remain binding today. Nothing in the Framework supersedes or contradicts these statutory protections. Any data shared under the agreement must conform to them, and any breach would be subject to regulatory action.

Legitimate Risks and the Need for Transparency

Although claims of mass data transfer are unfounded, legitimate governance risks remain. Global practice shows that even de-identified datasets can be vulnerable to re-identification if handled poorly. Ambiguity in technical annexes can undermine public trust. These risks relate to implementation, not intent. The government should therefore commit to transparency in defining what datasets are shared, the technical protections applied, and the oversight mechanisms in place. Parliamentary scrutiny, public communication and regulatory involvement are essential to maintaining confidence.

Conclusion

The agreement holds significant implications for Kenya. Most immediately, it restores financial stability to critical programmes after the disruptions caused by changes in USAID and PEPFAR allocations. Millions of Kenyans rely on consistent access to HIV treatment, malaria prevention tools and TB diagnostics, services that depend on uninterrupted supply chains and robust laboratory capacity. The Framework secures this continuity.

It also marks an important step toward localisation. For the first time in two decades, Kenya is positioned as the primary steward of the systems, data platforms and procurement processes that underpin national health programmes. This enhances policy coherence, strengthens accountability to Parliament and embeds long-term capacity within state institutions.

Digital health stands to gain significantly. Investments in data interoperability, laboratory connectivity and county-level systems can advance Kenya’s ambition to build an integrated, sovereign digital-health architecture. If governed well, this shift strengthens rather than compromises national control.

However, greater control comes with heightened responsibility. The government must demonstrate improved financial discipline, transparent procurement and robust data governance. Donor intermediaries previously absorbed operational risks; those risks now sit squarely within government systems.

So far, a factual reading shows that the Kenya–U.S. Health Cooperation Framework does not grant the United States access to identifiable Kenyan health records. It reflects long-established global health practices and continues data-reporting structures that existed under USAID and PEPFAR, now under a model that strengthens Kenyan ownership. Its success will rest on transparency, compliance with Kenyan law and strong institutional oversight. If implemented prudently, the Framework can protect privacy while supporting a more resilient, more locally led and more sustainably financed health system for Kenya.