Thousands of employees of United States government-funded health projects and programmes in Kenya are staring at forced unpaid leave, and possible layoff following President Donald Trump’s order freezing aid for at least three months.
Hours after occupying the White House on January 20, President Trump ordered a sweeping review of almost all US foreign aid and tasked billionaire Elon Musk, who has termed the United States Agency for International Development (USAID) a “criminal” organisation, with scaling down the agency.
They include 1,952 doctors and clinical officers, 1,234 nurses and midwives, 578 laboratory staff, more than 340 pharmacists and more than 24,577 community health workers, according to the assessment done by The Andelson Office of Public Policy.
The Andelson Office is a division of amfAR, the Foundation for Aids Research, focused on advocating public policy changes related to HIV/Aids research, prevention and treatment at the international level.
Globally, Pepfar directly supports 271,229 individual health care workers delivering direct client services, amounting to 190,693 full-time equivalent positions.
These workers are now receiving orders to stop all clinical services and cease reporting to health clinics.
HIV testing booth at Homa Bay County Teaching and Referral Hospital on February 4, 2025. HIV testing and counseling services have been disrupted at the health facility following withdrawal of support from USAID.
Photo credit: George Odiwuor| Nation Media Group
The reality of President Trump’s order has started hitting home, with more than 2,000 employees of the US government-funded Academic Model Providing Access to Healthcare (Ampath)-Uzima project in Kenya being sent on unpaid leave.
The move has sent shockwaves through Kenya’s healthcare system, particularly affecting HIV/Aid patients who depend on the programme’s services.
Ampath, which operates through its Eldoret office and serves the Rift Valley, Nyanza and Western regions, implemented the directive on February 1. Prof. Sylvester Kimaiyo, chief of party of the Ampath-Plus programme, issued the notice.
“All affected staff members are requested to proceed for unpaid leave with effect from February 1, 2025,” stated Professor Kimaiyo in an internal memo dated January 31.
The Ampath project has more than 2,000 permanent and casual employees. Prof Kimaiyo told affected staff members to remain accessible during the leave period.
“The employees are requested to remain accessible via email or phone for any urgent communication from the management for further updates about the resumption of work or other instructions,” he said in the memo.
Ampath-Kenya is a partnership between Moi University, Moi Teaching and Referral Hospital and a group of universities headed by Indiana University, that serves HIV patients by providing free drugs, counselling and related services.
Prof Kimaiyo assured the affected staff that all measures have been put in place to ensure that their rights are honoured in relation to the order by President Trump.
“As Ampath, we sincerely appreciate your cooperation and understanding during this period that you have been serving our clients,” he said.
At least three other non-governmental organisations in Kisumu have been affected, though specific numbers of affected employees remain undisclosed as organisations maintain silence about the full extent of the disruption.
The situation threatens to unravel decades of progress in Kenya’s health sector, where USAID has been a crucial partner. Last year, the agency allocated Sh19.2 billion ($149.4 million) to its Kenya projects, though this was a significant decrease from the previous year’s Sh32.4 billion ($251.5 million).
Moi Teaching and Referral Hospital (MTRH) Chief Executive Officer Philip Kirwa attempted to calm fears among patients, assuring them that the hospital will maintain services with reduced staff.
“As MTRH together with the remaining staff of Ampath, we will continue offering services to clients and we hope for the best in the future,” he stated.
In light of the funding crisis, National Treasury Cabinet Secretary John Mbadi announced plans to reallocate development budget funds to critical health programmes.
“We will have no alternative but to slash part of the development budget and use the funds to finance critical programmes that will be starved of cash if the US stops foreign aid,” Mr Mbadi explained, emphasising the government’s commitment to ensuring continuity of vital health services.
The crisis extends beyond healthcare into environmental conservation, with Kenyan conservation organisations warning of severe impacts on biodiversity protection efforts.
USAID has historically played a crucial role in supporting African conservation initiatives, particularly those empowering local groups to manage and protect wildlife and natural resources.
The aid freeze has triggered international concern and protests in Washington, DC, where Democratic lawmakers gathered outside USAID offices to oppose the Trump administration’s actions.
The situation has been further complicated by the appointment of Secretary of State Marco Rubio as acting director of the agency, with plans to potentially merge it with the State Department.
Democratic Senator Chris Van Hollen of Maryland criticised the move, suggesting it benefits US adversaries.
“This has nothing to do with making the US government more efficient and everything to do with aiding and abetting our adversaries around the world,” he stated, citing praise from former Russian President Dmitry Medvedev.
The crisis has sparked debate about the sustainability of aid-dependent health programmes and the need for robust domestic funding. While Kenya’s government has pledged to step in, the scale of programmes like Ampath and their extensive reach across multiple regions presents significant challenges for domestic funding alone.
The situation raises broader questions about global health security and the stability of international aid systems.
As affected countries grapple with the immediate impacts, the long-term implications for global health initiatives, environmental conservation, the move potentially marks a significant shift in the landscape of international aid and development cooperation.
