Bill Gates Pledges Sh26 Billion to Kenya’s Health Sector as Trump Cuts Foreign Aid

American billionaire Bill Gates has committed Sh26 billion in direct budget support to Kenya’s health sector, offering a lifeline as the Trump administration slashes foreign aid programmes across Africa.

The Gates Foundation grant, alongside Sh4 billion from the Susan Thompson Buffett Foundation, brings total philanthropic support to Sh30 billion for the current fiscal year ending in June, according to data from the University of Nairobi’s Centre for Epidemiological Modelling.

The funding comes at a critical time for Kenya’s healthcare system, which has seen total external support plummet from Sh126 billion last year to just Sh54 billion in the 2025/26 financial year. Off-budget support alone dropped from Sh87 billion to Sh26 billion, following President Donald Trump’s decision to cut major US-funded health contracts.

Gates Foundation has announced plans to invest tens of billions of dollars in women’s health globally, focusing on conditions that have historically been neglected. The investment will target five key areas including obstetric care and maternal immunisation, maternal health and nutrition, gynaecological and menstrual health, contraceptive innovation, and sexually transmitted infections.

Warren Buffett’s foundation, named after his first wife and managed by his children, is providing direct financing to the Kenyan government for the first time. The organisation supports reproductive health initiatives, including access to contraception and safe abortion services.

The aid cuts have created a critical shortage of essential medicines worth Sh34.7 billion, with HIV treatments facing the largest gap at Sh14.47 billion, followed by tuberculosis drugs at Sh13.81 billion. Vaccines, nutrition supplements, and malaria treatments also face significant shortfalls.

The Global Fund, which fights HIV/AIDS, tuberculosis and malaria, has contributed Sh14 billion in direct budget support, making it one of the top three external funders alongside the Gates and Buffett foundations.

The shift in funding sources has also changed Kenya’s debt structure for health financing. The share of grants in on-budget external funding has risen to 67.9 percent in 2025/26, up from 46.2 percent the previous year, as the proportion of loans dropped to just 32.1 percent.

Gates, ranked as the world’s 14th richest person, and Buffett, the 11th richest, have long collaborated on global health philanthropy. Melinda French Gates, Bill’s ex-wife, has separately invested in women’s health since leaving the Gates Foundation last year.

The American government’s retreat from global health funding has created what observers describe as an urgent gap, challenging wealthy philanthropists and international charities to fill the void left by cuts to US aid programmes that have supported health initiatives across the continent for decades.​​​​​​​​​​​​​​​​