My open let­ter to the Health Cab­i­net Sec­re­tary last week left me with a bet­ter appre­ci­a­tion of the chal­lenges that his min­istry faces as it seeks to entrench qual­i­ty world-class health­care into this coun­try. As such, I choose to sug­gest five view­points that may ener­gize our march towards bet­ter health in Kenya.

First, we all appre­ci­ate that Kenya is cur­rent­ly in dis­as­trous need of many more med­ical prac­ti­tion­ers. The World Health Organization’s doc­tor-patient ratio is one doc­tor for every 1,000 peo­ple. Accord­ing to the lat­est data from the World Bank, Kenya has a doc­tor patient ratio of one doc­tor for 6,400 peo­ple. Inter­est­ing­ly, a few years ago, when our Gov­ern­ment recruit­ed Cuban doc­tors, it was most report­ed that we have one doc­tor for every 16,000. Irre­spec­tive of the actu­al num­ber, it is clear that we need thou­sands more doc­tors in Kenya.

One sure way of increas­ing the num­ber of qual­i­fied med­ical prac­ti­tion­ers is through free or Gov­ern­ment-spon­sored post­grad­u­ate train­ing for med­ical stu­dents. Their tuition fees, accom­mo­da­tion, and stipend expens­es should be catered for by the Gov­ern­ment. Nowa­days, the cost of a post­grad­u­ate med­ical degree is so pro­hib­i­tive that only the rich or spon­sored stu­dents can afford it. In the first three decades of inde­pen­dence, post­grad­u­ate med­ical stu­dents used to study for free, receive a stipend and med­ical cov­er from the gov­ern­ment. Accord­ing­ly, let the law­mak­ers get up and go for rel­e­vant poli­cies so that the pro­fes­sion may attract pas­sion­ate stu­dents from poor back­grounds. This moral oblig­a­tion will dras­ti­cal­ly increase the qual­i­ty and quan­ti­ty of our physicians.

Sec­ond­ly, I sug­gest that we abol­ish pri­vate prac­tice from Gov­ern­ment hos­pi­tals. The exist­ing arrange­ment inevitably cre­ates dou­ble stan­dards in the deliv­ery of med­ical ser­vices. Pub­lic hos­pi­tals should cater exclu­sive­ly to the med­ical needs of patients and not the busi­ness needs of doctors.

Third­ly, pri­vate hos­pi­tals play a crit­i­cal role in the health­care ecosys­tem and no won­der half of all health facil­i­ties in the coun­try are pri­vate­ly owned. Since mil­lions of Kenyans depend on them, the gov­ern­ment should ensure their afford­abil­i­ty. One of the steps the gov­ern­ment can take is to revise the tax regime on med­ical equip­ment. In July this year, a new med­ical oxy­gen plant that Kakamega Coun­ty had import­ed from France was stuck at the port, await­ing tax pay­ment of Shs 8million. 

Kakamega Coun­ty Gov­er­nor frus­trat­ing­ly stat­ed that ‘it is a shame that at this time of the Covid-19 pan­dem­ic we are being taxed on machines that are meant to save many lives.’

Indeed, every med­ical appli­ance exists to save lives. All these machines should be import­ed into the coun­try either tax-free or at very min­i­mal tax rates. That way, investors will not have to pass on the cost of import­ing them to help­less Kenyans. 

Fourth­ly, our Nation­al Hos­pi­tal Insur­ance Fund Uni­ver­sal Health­care pro­gram is the best idea ever to hap­pen to Kenyans. How­ev­er, you may agree with me that NHIF has become a cash cow for some play­ers both local­ly and inter­na­tion­al­ly. Upset­ting­ly, NHIF Chief Exec­u­tive Offi­cer Peter Kamun­yo recent­ly revealed that cor­rup­tion robs them of Sh10 bil­lion annu­al­ly. I sug­gest sup­port to the min­istry of Health from rel­e­vant inves­tiga­tive agen­cies to ana­lyze who the con­sis­tent recip­i­ents of the fund are. By fol­low­ing the mon­ey, we may find a well-guid­ed solu­tion to seal the dodges.

Final­ly, Kenyans are dis­tressed by the high cost of pre­scrip­tion drugs. Time is ripe for price con­trol in this sec­tor. Gov­ern­ment can also scheme to invest and pro­duce drugs local­ly devoid of cor­rup­tion. In India, the Nation­al Phar­ma­ceu­ti­cal Pric­ing Author­i­ty ensures fair pric­ing of phar­ma­ceu­ti­cal prod­ucts. It’s no won­der that India has some of the low­est drug prices in the world. Kenya needs to fol­low suit even as it learns from Indi­a’s experience. 

To crown it all, I sug­gest that CS Mutahi Kag­we attracts the pow­er of think­ing and act­ing green by call­ing for a broad-mind­ed meet­ing to syn­the­size exper­tise, tal­ent, and life expe­ri­ences for com­mon good. In this meet­ing, please invite the most expe­ri­enced prac­ti­tion­ers, Young Doc­tors, Tra­di­tion­al med­i­cine prac­ti­tion­ers togeth­er with your able offi­cials and rel­e­vant sec­tor rep­re­sen­ta­tives. The result shall be most transformative.

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