Rising HIV Infections Push Kenya to Reform and Strengthen Health Services

In a pivotal move for public health, Kenya is turning financial pressure into an opportunity to safeguard gains made against HIV. With external funding volatile and a disturbing rebound in new infections, government health authorities and partners are now pushing to embed HIV services into the mainstream health system.

The goal is to ensure that care for people living with HIV (PLHIV) continues consistently, regardless of donor support. Advocates believe that domestic ownership, integration and efficiency can keep lifesaving antiretroviral treatment flowing to the hundreds of thousands of Kenyans who depend on it, and help steer the country back toward the global goal of ending AIDS as a public health threat.

Globally, according to the World Health Organization, HIV remains a major public health challenge. At the end of 2024, an estimated 40.8 million people were living with HIV worldwide, including 39.4 million adults (15+) and 1.4 million children (0–14 years). In the same year, about 1.3 million people acquired HIV and roughly 630,000 people died from HIV-related causes.

The bulk of the global burden remains in sub-Saharan Africa: The World Health Organization (WHO) estimates that about 26.3 million people living with HIV in 2024 were in the African Region, over two‑thirds of the global total.

These global numbers frame Kenya’s fight as part of a much larger, ongoing worldwide effort, underscoring that the stakes remain high everywhere, even as some countries make gains.

In Kenya, the urgency for transformation is evident in the most recent national data. According to the 2025 report by the National Syndemic Disease Control Council (NSDCC), the country registered 20,105 new HIV infections in 2024, a 20 percent increase from the previous year (when there were 16,752).

Meanwhile, the total number of people living with HIV in Kenya is estimated at 1,326,419. The national prevalence rate is reported at 3.03 percent.

The financing context adds urgency to the need for reform. Kenya’s HIV response has historically relied heavily on external donors for prevention, treatment drugs, and care commodities. With global funding pressures rising and donor priorities shifting, this model increasingly feels fragile.

That fragility drives the push for sustainable, domestically supported systems, including integration of HIV services into broader health platforms.

Under the new approach, instead of relying solely on stand-alone HIV clinics, HIV prevention, testing, treatment and long-term chronic care would be offered through routine primary health services and chronic-disease platforms.

The vision is to integrate HIV services with care for conditions such as tuberculosis, maternal and reproductive health, non‑communicable diseases and mental health, normalizing HIV as a chronic, manageable condition, reducing stigma, streamlining staffing, cutting operational costs, and strengthening continuity of care even in face of funding shocks.

Part of the reform includes a push for stronger data systems: a unified national health information infrastructure to track clinical outcomes and financial flows, support accountability, and guide efficient allocation of resources. This is seen as critical to sustaining care for PLHIV reliably over time.

Kenya is also scaling up modern prevention and treatment strategies. The national health authorities’ 2025–2026 operational plan calls for expanded rollout of pre‑exposure prophylaxis (PrEP) targeting high‑risk and key populations, along with phased introduction of longer‑acting treatment and prevention options. These interventions, if properly resourced, could significantly reduce new infections and improve long-term adherence and outcomes for those on treatment.

While national-level statistics matter, the epidemic’s burden is uneven across counties, which means responses must be tailored based on local epidemiology. 

According to NSDCC data, just ten Kenyan counties contributed 60 percent of all new HIV infections in 2024. These counties are: Nairobi, Migori, Kisumu, Homa Bay, Busia, Siaya, Kakamega, Nakuru, Mombasa and Bungoma.

At the top of that list, Nairobi County recorded 3,045 new infections in 2024.

This makes the capital the current hotspot of the epidemic, likely driven by urban population density, high mobility, concentrations of key populations, and social vulnerability.

The next highest counties were Migori County (1,572 new infections) and Kisumu County (1,341 new infections), followed by others in the Lake Victoria region and selected urban or peri‑urban centres.

Kakamega County is classified among the top-tier, high-burden counties driving Kenya's HIV epidemic, signaling the national urgency for integrated health solutions.

According to the National Syndemic Disease Control Council (NSDCC) estimates for 2024, Kakamega County recorded 835 new HIV infections, contributing significantly to the national total of 20,105 cases that reversed a three-year decline.

The county also carries a large existing burden, with an estimated 51,604 People Living with HIV (PLHIV), translating to a prevalence rate that historically has hovered around 4.5 percent, notably higher than the national average of 3.03 percent. 

Key drivers of the epidemic in Kakamega include Gender-Based Violence (GBV), high-risk sexual networks, and stigma, with adolescent girls and young women being identified as the most vulnerable population.

Global and regional context further underscores the stakes. According to WHO and other international agencies, disruption in funding or commodity supply can rapidly reverse gains made over decades.

Their global data and projections reinforce that maintaining and expanding treatment and prevention coverage, supported by robust health systems, is essential to avoid avoidable increases in infections and HIV‑related mortality.

Kenya’s pivot, embedding HIV services into routine health care, strengthening data systems, improving financial governance, and scaling up modern prevention and treatment tools, responds directly to both the fiscal fragility and the epidemiological warning signs.

With sustained political commitment, transparent financing, and effective implementation, this integrated model stands to protect countless lives, normalize HIV care as part of everyday health services, and help steer the nation toward the long‑term goal of ending AIDS as a public health threat.