The battle against malaria remains a major public health challenge in Kenya and many African countries. While recent efforts have borne fruit, prevalence remains high. The Ministry of Health estimates there were about 5.5 million malaria cases in 2023 alone. According to the World Health Organisation, over 12,000 Kenyans died from malaria in 2022 alone, yet effective interventions exist.
We already know that the use of insecticide-treated nets, rapid diagnostic kits, community outreach and effective medicines, among other strategies, reduces malaria deaths and disease. Sadly, majority of these have been heavily reliant on donor funding. As donors continue pulling out, our ability to scale and sustain these interventions is running dry.
What this means is that we need a new way of thinking. A way of transitioning from donor reliance to self-sustenance. Lake region and coastal Kenyan counties have historically been the hardest hit by malaria. Innovative solutions are therefore expected to emanate from there.
Homa Bay County is proving that self-sustenance is possible through well-thought out public-private collaborations (PPCs). The county achieved a 15 per cent drop in malaria incidence between 2021 and 2023, with further declines in 2024 and 2025. In a sharp departure from the traditional donor-powered solutions, these gains have been largely driven by county-level innovations, backed by strategic partnerships with private sector healthcare actors, data providers, and civil society.
Homa Bay is making a strong case for co-investing in healthcare interventions to help meet health, social and economic development goals. We know from previous Global Fund analyses that every dollar invested in malaria control yields US$31 in economic and health returns through increased productivity, reduced treatment costs, and healthier communities overall.
The Zero Malaria Campaign Coalition underscores the importance of partnerships between public and private institutions as a transformative approach to fight malaria. Across Kenya, smart partnerships between public institutions and private innovators are quietly transforming the way we fight malaria. A standout example comes from the Kenya Medical Research Institute (Kemri), whose groundbreaking work in malaria diagnostics is bearing fruit. Tools like the locally developed Plasmocheck Malaria Rapid Diagnostic Kit are now being deployed in places like Busia and Siaya as part of the National Malaria Control Programme’s efforts.
But Kemri hasn’t walked this journey alone. Japan, through JICA, has long been a committed partner, supporting research and innovation in malaria testing. While public pilots linking startups to supply-chain platforms haven’t been fully rolled out—or documented—this collaboration is showing that when research meets resources, impact follows.
Under Kenya’s devolved system of governance, counties oversee about 70 per cent of public-sector health functions. On paper, this is a powerful mandate. In practice, it’s becoming harder to deliver on.
National budget constraints are biting. At the same time, donor support once the backbone of health sector funding is stagnating or falling off altogether as global attention shifts elsewhere. The result? Counties are left grappling with big responsibilities and very limited means.
Even when private-sector players are keen to invest in county-level health services through public-private community partnerships, progress stalls. Why? Counties often can’t provide the financial guarantees that make long-term private investment possible. Most don’t budget for feasibility studies, the early-stage groundwork needed to move ideas from ambition to execution. Add to that a thicket of policy complexities and unclear legal templates, and it’s no wonder that risk-averse investors hesitate. The system, as it stands, makes it hard for either side to move forward.
Worse still, mechanisms for rigorous evaluations and cross-county learning remain nascent. Lessons and success stories in counties rarely permeate to other regions, limiting potential for peer-learning, co-investing in larger ticket-size items, and scaling across the country. Yet there are strong examples of PPCs in the country to aid in the fight against malaria and other healthcare challenges.
Tharaka Nithi County, for instance, is implementing an innovative laboratory diagnostics PPC whose lessons could massively benefit other counties struggling to scale diagnostics. Nakuru and Trans Nzoia Counties are using unique partnership models to strengthen primary healthcare and improve social accountability. Kajiado, Makueni and Lake Region Economic Block counties are implementing initiatives aiming to scale innovations through public systems for better equity and impact.
To unlock the full potential of health PPCs, we need a coordinated push. This means fixing residual policy and institutional gaps that have long plagued Kenya’s public-private partnership (PPP) frameworks.
The National Treasury must lead from the front. Counties can’t shoulder the risk of these partnerships alone. A Devolution Health Guarantee Fund could be a game-changer. By offering partial sovereign backing—say, through letters of comfort or government support clauses, the Treasury can give counties the credibility they need to attract private investment.
Then there’s the matter of feasibility studies. Without them, no investor will commit. A modest annual allocation of Sh900 million to a Health Feasibility Grants Programme could fund 25–50 project assessments every year. Administered jointly by the Ministry of Health, Council of Governors and Treasury, this would bring Kenya in line with global best practice and build a solid pipeline of investment-ready projects.
Ms Wanga is Governor of Homa Bay County and Vice-Chair, COG Health Committee. Mr Wafula is an Associate Professor of Health Systems at Strathmore University and Open Phences Team Leader
