Health sector unions have urged the government and petitioners to pursue an out-of-court settlement after the Kenya–United States Health Cooperation Framework ran into legal headwinds, warning that prolonged litigation could disrupt essential services and deepen workforce uncertainty.
The Health Union Caucus said delays arising from the court challenge threaten a health system already grappling with staffing gaps, fragile supply chains and the transition toward Universal Health Coverage (UHC).
The call for an out-of-court settlement comes against the backdrop of High Court orders suspending implementation of the deal.
Justice Bahati Mwamuye issued temporary orders pending the hearing of two separate cases filed by the Consumers Federation of Kenya (COFEK) and Busia Senator Okiya Omtatah, who are seeking to quash the agreement because it violates several laws.
The caucus brings together major health unions, including the Kenya Union of Clinical Officers (KUCO), the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) and several allied cadres.
In a statement by KUCO Secretary-General George Gibore, the unions said the Sh2.5 trillion framework is primarily about patient welfare and system stability.
“The central beneficiary of this agreement is the patient,” the caucus said, arguing that continued court battles risk paralysing reforms meant to stabilise programmes historically dependent on donor-funded NGOs.
"It moves Kenya away from the unpredictable cycles of donor-led aid toward a sustainable, government-to-government partnership that prioritises the dignity of the Kenyan health worker and the security of the Kenyan patient," the statement reads.
A key pillar, the caucus notes, is the absorption of 13,800 frontline health workers into the public payroll by 2028.
These workers are critical to HIV, TB, and malaria programmes that employ more than 28,000 staff nationwide.
However, the unions warned that suspending implementation puts thousands of healthcare workers back into professional limbo, threatening continuity of care.
They called on the Ministry of Health and the Public Service Commission to urgently develop a transparent absorption framework for at least 15,000 health workers not currently accommodated under the deal.
According to the caucus, failure to address this gap risks entrenching a two-tier workforce—those with guaranteed public contracts and those left on uncertain terms—undermining morale and service delivery across public facilities.
They want clear timelines, funding sources and criteria to avoid future industrial unrest.
The unions are also pushing for strong financial safeguards should the deal proceed.
They have recommended the establishment of a robust, independent audit system to ring-fence the funds and prevent misappropriation, warning that the scale of financing heightens corruption risks.
“Every shilling must be protected to ensure it delivers tangible outcomes in workforce stability, medicine availability and patient care,” the statement said, adding that accountability will determine whether the framework succeeds or fails.
Another sensitive area highlighted is the planned transition of medical commodity procurement to the Kenya Medical Supplies Authority (KEMSA) by December 2026.
While welcoming the move as a step toward national sovereignty and reduced stock-outs, the caucus cautioned that past procurement failures must not be repeated under an expanded funding envelope.
As the case proceeds, the Health Union Caucus is urging all parties to weigh the legal questions against the immediate needs of patients and health workers.
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