Kenya: Score Justification Summary

1.1.1a National plan for AMR priority pathogens

Score: 100

There is evidence that Kenya has a national Antimicrobial Resistance (AMR) plan for the surveillance, detecting and reporting of priority AMR. The National Policy on Prevention and Containment of Antimicrobial Resistance published in 2017 by the Republic of Kenya includes sections on surveillance, detection, and reporting. Section 3.2 states that the national government will "[d]evelop and support the implementation of a National integrated AMR surveillance system". Section 3.2 also states that there is a lack "of an integrated surveillance system and weak laboratory capacity for detection and reporting antimicrobial resistance limits the availability of evidence to support decision making", and that guidelines for compulsory reporting will be developed. ¹ According to pages 13-14 the National Action Plan on Prevention and Containment of Antimicrobial Resistance 2023-2027 produced by the Kenyan government in 2023, there are strategies for surveillance and reporting of AMR. ² According to the Global Database for Tracking Antimicrobial Resistance, Kenya has demonstrated the development of a national action plan on AMR and also conducts surveillance. ³

1.1.1b Capacity of national lab/lab system to test for AMR priority pathogens

Score: 50

There is evidence to conclude that Kenya's national laboratory system can test for priority AMR pathogens. The National Public Health Laboratory and Zoonotic Disease Unit do not have a locatable websites. According to page 10 of the Kenya national action plan on antimicrobial resistance: Review of progress in the human health sector produced by the WHO in 2022, Kenya does test for 8 pathogens specifically, including Escherichia coli, Staphylococcus aureus, Salmonella spp., Shigella spp., Streptococcus pneumoniae, Pseudomonas aeruginosa, Acinetobacter spp., and Klebsiella spp. Page ten of the report also states that Kenya has "12 human health care facilities serving as AMR surveillance sites are connected to the national AMR database". ⁴

1.1.1c National environmental surveillance for AMR residues/organisms

Score: 0

There is insufficient evidence that the government conducts environmental detection or surveillance activities for antimicrobial residues or AMR organisms. According to section 3.3 of the National Policy on Prevention and Containment of Antimicrobial Resistance published in 2017 by the Republic of Kenya, the government will review and develop guidelines for "infection prevention and control (IPC); hygiene & sanitation; good agricultural and animal husbandry practices; preventive vaccinations; farm biosecurity; food and water safety; & prudent antimicrobial use", but makes no mention of whether these are being implemented. ⁵ There is evidence that detection of antibiotic resistance genes and pathogens in sewage in Kenya has been conducted by non-governmental Organizations, but there is no reference to the Ministry of Health or Ministry of Agriculture and Livestock Development. ⁶ There is no information on the Kenya National Public Health Institute, Ministry of Health, or Ministry of Agriculture and Livestock Development websites. ⁷⁸⁹ The National Public Health Laboratory and Zoonotic Disease Unit do not have a locatable websites.

1.1.2a National law(s) requiring prescription for antibiotic use (humans)

Score: 100

There is evidence of legislation to cover provision of prescriptions in Kenya, and evidence that use of antibiotics without prescriptions is low in Kenya. According to section 29(2)(a) of Kenya’s Pharmacy and Poisons Act 2012 (Cap 244), one of the conditions for receiving "poisons" [medicines] is "possession of the prescription of a duly qualified medical practitioner, dentist or veterinary surgeon, in accordance with such prescription". The act makes no specific mention of antibiotics, however. ¹⁰ According to academic research published in 2023, Kenya has one of the lowest rates of antibiotic use without prescription in Africa. ¹¹

1.1.2b National law(s) requiring prescription for antibiotic use (animals)

Score: 50

There is evidence of legislation to cover provision of prescriptions in Kenya. According to section 29(2)(a) of Kenya’s Pharmacy and Poisons Act 2012 (Cap 244), one of the conditions for receiving "poisons" [medicines] is "possession of the prescription of a duly qualified medical practitioner, dentist or veterinary surgeon, in accordance with such prescription". The act makes no mention of antibiotics, however. ¹² According to academic research published in 2024, the "vast majority of farmers buy antibiotics without a prescription". ¹³

1.2.1a Laws/plans on zoonotic disease

Score: 100

There is evidence of guidelines and a strategy for zoonotic disease prioritization, detection and reporting in Kenya. The One Health Strategic Plan for the Prevention and Control of Zoonotic Diseases in Kenya (2021-2025) produced by the Zoonotic Disease Unit in 2022, contains strategies and plans for zoonotic disease prioritization, detection and reporting. Sections 2.2, 2.2.1 and 2.2.2 specifically address surveillance in animals and humans. ¹⁴

1.2.1b Laws/plans on zoonotic disease spillover from animals to humans

Score: 100

There is evidence of a strategy for risk identification and reduction for zoonotic disease spillover events from animals to humans in Kenya. Strategic objective 2.1 of the One Health Strategic Plan for the Prevention and Control of Zoonotic Diseases in Kenya (2021-2025) produced by the Zoonotic Disease Unit in 2022 states that strengthening of surveillance of zoonotic diseases at a national and county level will "involve reviewing and updating the list of priority zoonotic diseases and the associated risk maps" and "conducting risk assessment for priority zoonotic diseases". ¹⁵

1.2.1c Laws/plans for surveillance & control of multiple zoonotic pathogens

Score: 100

There is evidence of guidelines and a strategy that account for the surveillance and control of multiple zoonotic pathogens of public health concern. According to page 11 of the One Health Strategic Plan for the Prevention and Control of Zoonotic Diseases in Kenya (2021-2025) produced by the Zoonotic Disease Unit in 2022, one strength of employing the One Health strategic approach in Kenya is that it can respond to "[m]multiple zoonotic disease challenges". According to page 3 of the document, disease surveillance is conducted through Integrated Disease Surveillance and Response System, (IDSR) and the District Health Information System 2 (DHIS 2), which allow for local district health centres to input data that is then transferred to sub-counties to be entered into a web-based database. Reporting is conducted weekly for outbreak prone diseases, and monthly for other diseases. ¹⁶

1.2.1d Cross-ministerial department/agency/unit for zoonotic disease

Score: 100

There is evidence of a department that functions as a multi-sectoral co-ordinating mechanism dedicated to zoonotic disease that functions across ministries in Kenya. According to the One Health Strategic Plan for the Prevention and Control of Zoonotic Diseases in Kenya (2021-2025) produced by the Zoonotic Disease Unit in 2022, the Zoonotic Disease Unit was established in 2011 as a "collaborative platform shared between the ministries responsible for human and animal health". ¹⁷ The Zoonotic Disease Unit does not have a website, and no information is available on the Ministry of Health, Ministry of Agriculture and Livestock Development, or National Environment Management Authority websites. ¹⁸¹⁹²⁰

1.2.1e Presence of One Health strategic plan

Score: 100

Kenya has a One Health strategic plan in place. The One Health Strategic Plan 2021–2025 is led by the Zoonotic Disease Unit. ²¹

1.2.2a Surveillance/reporting mechanism for zoonotic disease for livestock owners

Score: 100

There is evidence that Kenya has a national mechanism for owners of livestock to conduct and report on disease surveillance to a central government agency. According to section four of the Animal Diseases Act revised in 2012, "[e]very person having in his possession or charge an animal infected with a notifiable disease or suspected of being infected with a notifiable disease shall…give notice of that fact to the nearest administrative officer or inspector". ²² Livestock owners can report disease surveillance to practitioners, who then report through the Kenya Animal Bio-surveillance System (KABS). ²³

1.2.2b Laws/regulations on data confidentiality to protect livestock owners

Score: 0

There is insufficient evidence that there are safeguards for the confidentiality of information generated through surveillance activities for animals in Kenya within any existing regulations or guidelines. The Animal Diseases Act, revised in 2012, makes no mention of confidentiality when reporting disease outbreak. ²⁴ The Zoonotic Disease Unit does not have a locatable website. The Data Protection Act (CAP. 411C) does include health data, but only references data of the subject, which may not include an owner in the case of their livestock. ²⁵ The Joint External Evaluation for Kenya conducted in 2017 by the World Health Organization, makes no mention of confidentiality safeguards. ²⁶ There is no information available on the Ministry of Health or Kenya National Public Health Institute websites. ²⁷²⁸

1.2.2c Wildlife zoonotic disease surveillance

Score: 100

There is evidence that surveillance of zoonotic disease in wildlife and animals within slaughterhouses in Kenya, but it does not specifically mention poultry. Section 2.2.2 of the One Health Strategic Plan for the Prevention and Control of Zoonotic Diseases in Kenya (2021-2025) produced by the Zoonotic Disease Unit in 2022, states that the Directorate of Veterinary Services (DVS) conducts national surveillance for notifiable diseases among animals in Kenya. Subdepartments report into the DVS, such as meat inspectors carrying out food-borne disease surveillance at slaughterhouses and the Kenya Wildlife Services (KWS) conducting surveillance of wildlife. There is no specific mention of poultry. ²⁹ There is no information available on the website of the Directorate of Veterinary Services. ³⁰

1.2.3a Annual reporting to OIE on zoonotic disease incidence

Score: 100

There is evidence of a mechanism for reporting notifiable diseases to The World Organization for Animal Health (WOAH) in Kenya. According to section 2.2.2 of the One Health Strategic Plan for the Prevention and Control of Zoonotic Diseases in Kenya (2021-2025) produced by the Zoonotic Disease Unit in 2022, the Directorate of Veterinary Services (DVS) reports notifiable diseases WOAH through the World Animal Health Information System (WAHIS). ³¹

1.2.4a Number of veterinarians per 100,000 people

Score: 0

1.2.4b Number of veterinary para-professionals per 100,000 people

Score: 11.13

1.2.5a Inclusion of private sector in national plan/law on zoonotic disease

Score: 100

There is evidence that the plans for zoonotic disease control in Kenya include mechanisms for working with the private sector in controlling or responding to zoonoses. According to section 2.5 of the One Health Strategic Plan for the Prevention and Control of Zoonotic Diseases in Kenya (2021-2025) produced by the Zoonotic Disease Unit in 2022 on institutional framework, the National Zoonoses Technical Committee (NZTC) will provide technical guidance to representatives of the private sector. Page 34 of the document lists one of the partners of the plan as the Kenya Private Sector Alliance. ³²

1.3.1a Updated national records of especially dangerous pathogen/toxin inventories

Score: 0

There is no evidence of a record, updated within the past five years, of the facilities in which especially dangerous pathogens and toxins are stored or processed in Kenya. According to page 21 of the Joint External Evaluation for Kenya conducted in 2017 by the World Health Organization, "[a] process of monitoring and developing an inventory of pathogens within facilities that store or process dangerous pathogens and toxins is not yet in place". ³³ There is no evidence of an inventory on the Kenya National Public Health Institute website. ³⁴ There is no evidence of an inventory mentioned on the Verification Research, Training and Information Centre database website. ³⁵ There is no evidence of an inventory on the Ministry of Health website. ³⁶ The National Public Health Laboratory does not have a working website.

1.3.1b Biosecurity laws on facility security for especially dangerous pathogens

Score: 0

There is insufficient evidence of biosecurity legislation or regulations in Kenya that specifically discuss containment of dangerous pathogens, but there are guidelines. Chapter four of the Laboratory Biosafety and Biosecurity Policy Guidelines produced by the Ministry of Health and Sanitation and Ministry of Medical Services (the previous name for the Ministry of Health) clearly states different regulations for dangerous pathogens regarding containment, although it is unclear when these guidelines were published. Categorization of pathogens falls into four different risk groupings which are then matched with four different levels of containment requirements. The factors that affect the level of risk given to a pathogen include pathogenicity, infectious dose, mode of transmission, host range, availability of effective preventive measures, and availability of effective treatment. Page 2 of the document states that the document is a template for laboratories to develop their own biosafety and biosecurity manuals. ³⁷ The document is not available from the website of either the Ministry of Health or the Kenya National Public Health Institute. ³⁸³⁹ Page 20 of the Joint External Evaluation (JEE) for Kenya, conducted in 2017 by the World Health Organization, states that a "Bioscience Bill, which includes a biosafety and biosecurity component, is currently being considered in Parliament", but there is no evidence that this has been ratified or made law. ⁴⁰ A Joint External Evaluation was conducted for Kenya in 2024, but the report is yet to be published. There is no evidence on the Verification Research, Training and Information Centre database. ⁴¹ There is also the Biosafety Act, 2009, but this is predominantly focussed on GMOs rather than containment of dangerous pathogens. ⁴²

1.3.1c Agency for enforcement of biosecurity laws/regulations

Score: 0

There is no evidence of a specific agency responsible for the enforcement of biosecurity legislation and regulations in Kenya. According to the Verification Research, Training and Information Centre database, the National Commission for Science, Technology and Innovation (NACOSTI) is the seat of the Biological Weapons Convention National Focal Point, but there is no evidence on the NACOSTI website. ⁴³⁴⁴ According to the Verification Research, Training and Information Centre database, there are no specific measures relating to biosecurity for dangerous biological agents and toxins in Kenya. ⁴⁵ No information was found on the Ministry of Health. ⁴⁶ According to the website of the National National Public Health Institute, the Biosafety and Biosecurity Unit within the Division of National Public Health Laboratory (NPHL) is responsible for strengthening of biosafety and biosecurity systems. ⁴⁷ The Biosafety and Biosecurity Unit does not have its own website, nor does the National Public Health Laboratory (NPHL).

1.3.1d Consolidation of especially dangerous pathogens into minimum # of facilities

Score: 0

There is no public evidence that Kenya has taken action to consolidate its inventories of especially dangerous pathogens and toxins into a minimum number of facilities. According to page 21 of the Joint External Evaluation for Kenya conducted in 2017 by the World Health Organization, "[d]angerous pathogens and toxins have not been consolidated into a minimum number of facilities". ⁴⁸ The Biosafety and Biosecurity Unit does not have its own website and there is no mention of consolidation on the websites of the Ministry of Health or the National National Public Health Institute. ⁴⁹⁵⁰ According to the Verification Research, Training and Information Centre database, there are no specific measures relating to biosecurity for dangerous biological agents and toxins in Kenya. ⁵¹

1.3.1e Capacity to conduct tests for anthrax/Ebola without culturing live pathogens

Score: 0

There is evidence that Kenya has capacity for conducting PCR testing of ebola and anthrax, but there is insufficient evidence to show that this does not preclude culturing a live pathogen. The National Strategy for the Prevention and Control of Anthrax in Humans and Animals in Kenya (2021-2036) produced by the Zoonotic Disease Unit in 2022, lists PCR testing and culture for humans as a method of anthrax diagnosis, but it unclear from the strategy whether Kenya currently has the capacity to perform these tests. Section 3.5.2 on animal confirmatory diagnostic capacity using molecular techniques (PCR) states that PCR testing and utilisation of culture using gamma phage is not yet established in regional veterinary investigation laboratories due to lack of biosafety and biosecurity infrastructure. ⁵² According to academic research published in 2021, Kenya is a member of the East African Community (EAC) which established a regional network of nine mobile BSL3/4 rapid deployment laboratories with the capacity for PCR testing including of ebola. ⁵³ The Joint External Evaluation for Kenya conducted in 2017 by the World Health Organization makes no mention of PCR testing. ⁵⁴ A Joint External Evaluation was conducted for Kenya in 2024, but the report is yet to be published. ⁵⁵

1.3.2a Biosecurity training using a standardised, required approach

Score: 33.33

There is evidence of a national curriculum for biosafety and biosecurity, and evidence that training should be conducted, however this appears to be more on an ad-hoc basis. The Kenya Laboratory Biorisk Management Curriculum 2nd Edition was published by the Republic of Kenya in 2019, but does not state that training is mandatory in Kenya. ⁵⁶ According to page 21 of the Joint External Evaluation for Kenya conducted in 2017 by the World Health Organization, the Ministry of Health "has developed a biosafety and biosecurity curriculum for training health care workers (particularly medical laboratory personnel) and provides an annual refresher training guide for use at the health facility level. With funding from CDC through the United States President’s Emergency Plan for AIDS Relief, and using the locally designed curriculum, over 3000 medical laboratory personnel have been trained on basic biosafety by local implementing partners and NPHL’s biosafety and biosecurity office. In addition, 100 biosafety/biosecurity trainers-of-trainers have been trained". ⁵⁷ A Joint External Evaluation was conducted for Kenya in 2024, but the report is yet to be published. ⁵⁸ Section 5.2 of the Laboratory Biosafety and Biosecurity Policy Guidelines produced by the Ministry of Health and Sanitation and Ministry of Medical Services states that induction training "shall be given within 30 days of initial employment or assignment to a new job" and that this training will include laboratory safety guidelines. According to section 5.2.2., occupational health training shall be conducted annually. ⁵⁹ There is no further information on the Verification Research, Training and Information Centre, Ministry of Health or Kenya National Public Health Institute websites. ⁶⁰⁶¹⁶²

1.3.3a Personnel checks for permission to access to especially dangerous pathogens

Score: 0

There is no evidence that security and other personnel with access to especially dangerous pathogens, toxins, or biological materials with pandemic potential are subject to drug testing, background checks, and psychological or mental fitness checks. The Kenya Laboratory Biorisk Management Curriculum 2nd Edition was published by the Republic of Kenya in 2019, but does not state that any checks are mandatory in Kenya. ⁶³ The Joint External Evaluation for Kenya conducted in 2017 by the World Health Organization makes no mention of background checks being needed in Kenya. ⁶⁴ A Joint External Evaluation was conducted for Kenya in 2024, but the report is yet to be published. ⁶⁵ There is no information on the Ministry of Health website. ⁶⁶ The Laboratory Biosafety and Biosecurity Policy Guidelines produced by the Ministry of Health and Sanitation and Ministry of Medical Services makes no mention of background checks. ⁶⁷ The National Public Health Laboratory does not have a locatable website.

1.3.4a National transport regulations for Category A and B infectious substances

Score: 0

There is evidence of publicly available information on national regulations on the safe and secure transport of infectious substances, but it does not reference category A and B materials specifically. Chapter eight of the Laboratory Biosafety and Biosecurity Policy Guidelines produced by the Ministry of Health and Sanitation and Ministry of Medical Services, for which it is unclear when it was published, covers transportation of biological specimens and agents, including infectious materials. There is no specific reference to category A and B materials, but the guidelines do state that at least "two members of staff should be trained on IATA guidelines and regulations and certified". ⁶⁸ Section D.1.2 of the Joint External Evaluation for Kenya conducted in 2017 by the World Health Organization states that there is a system in place to transport specimens, but does not reference any regulations. ⁶⁹ A Joint External Evaluation was conducted for Kenya in 2024, but the report is yet to be published. ⁷⁰ There is no information on the Ministry of Health or the Kenya National Public Health Institute websites. ⁷¹⁷² The National Public Health Laboratories do not have a specific locatable website.

1.3.5a Laws/regulations on cross-border transfer and end-user screening

Score: 0

There is insufficient evidence of legislation or regulations in place to oversee the cross-border transfer and end-user screening of especially dangerous pathogens, toxins, and pathogens with pandemic potential. The Biosafety (Import, Export and Transit) Regulations, 2011 make no reference to toxins or pathogens. ⁷³ The Laboratory Biosafety and Biosecurity Policy Guidelines produced by the Ministry of Health and Sanitation and Ministry of Medical Services makes no mention of cross-border transfer or screening. ⁷⁴ There is no information on the Ministry of Health or the Kenya National Public Health Institute websites. ⁷⁵⁷⁶ The Ministry of Health does have a section on cross-border transportation for truck drivers, but there is no information available. ⁷⁷ Page one of the Joint External Evaluation for Kenya conducted in 2017 by the World Health Organization does state that "cross-border protocols for cooperation and a regional laboratory network exists", but does not state that these refer to transfer of dangerous pathogens. ⁷⁸ A Joint External Evaluation was conducted for Kenya in 2024, but the report is yet to be published. ⁷⁹

1.4.1a Biosafety laws/regulations

Score: 0

There is evidence of legislation for biosafety in Kenya, but this is primarily in regards to genetically modified organisms (GMOs). According to the website of the National Biosafety Authority, Kenya has several pieces of legislation covering biosafety, including the Biosafety Act, 2009, which regulate all activities involving GMOs, the Biosafety (Environmental Release) Regulations, 2011, the Biosafety (Import, Export and Transit) Regulations, 2011, the Biosafety (Contained Use) Regulations, 2011, and the Biosafety (Labeling) Regulations, 2012. ^808182838485

1.4.1b Agency for enforcement of biosafety laws/regulations

Score: 0

There is evidence of an agency responsible for the enforcement of biosafety legislation and regulations, but it is primarily focussed on genetically modified organisms. According to the website of the National Biosafety Authority, the National Biosafety Authority is "mandated to ensure safety of human and animal health and provide adequate protection of the environment from harmful effects that may result from genetically modified organisms". ⁸⁶

1.4.2a Biosafety training using a standardised, required approach

Score: 33.33

There is evidence of a national curriculum for biosafety, and evidence that training should be given. The Kenya Laboratory Biorisk Management Curriculum 2nd Edition was published by the Republic of Kenya in 2019, but does not state that training is mandatory in Kenya. ⁸⁷ According to page 21 of the Joint External Evaluation for Kenya conducted in 2017 by the World Health Organization, the Ministry of Health "has developed a biosafety and biosecurity curriculum for training health care workers (particularly medical laboratory personnel) and provides an annual refresher training guide for use at the health facility level. With funding from CDC through the United States President’s Emergency Plan for AIDS Relief, and using the locally designed curriculum, over 3000 medical laboratory personnel have been trained on basic biosafety by local implementing partners and NPHL’s biosafety and biosecurity office. In addition, 100 biosafety/biosecurity trainers-of-trainers have been trained". ⁸⁸ A Joint External Evaluation was conducted for Kenya in 2024, but the report is yet to be published. ⁸⁹ Section 5.2 of the Laboratory Biosafety and Biosecurity Policy Guidelines produced by the Ministry of Health and Sanitation and Ministry of Medical Services states that induction training "shall be given within 30 days of initial employment or assignment to a new job" and that this training will include laboratory safety guidelines. According to section 5.2.2., occupational health training shall be conducted annually. ⁹⁰ There is no relevant information on the Verification Research, Training and Information Centre database website. ⁹¹

1.5.1a Evidence of national assessment of dual-use research

Score: 0

There is no evidence that Kenya has conducted an assessment to determine whether ongoing research is occurring on especially dangerous pathogens, toxins, pathogens with pandemic potential or other dual-use research. Dual-use is covered within chapter 15 of the Laboratory Biosafety and Biosecurity Policy Guidelines produced by the Ministry of Health and Sanitation and Ministry of Medical Services, for which it is unclear when it was published, but does not state whether ongoing research is occurring. ⁹² The Joint External Evaluation for Kenya conducted in 2017 by the World Health Organization makes no reference of an assessment of on-going research. ⁹³ A Joint External Evaluation was conducted for Kenya in 2024, but the report is yet to be published. ⁹⁴ There is no specific, locatable website for the National Public Health Laboratories. There is no information on the websites of the Ministry of Health or Kenya National Public Health Institute. ⁹⁵⁹⁶

1.5.1b National law/regulation on oversight of dual-use research

Score: 0

There is insufficient evidence of regulations or legislation requiring oversight of research with especially dangerous pathogens, toxins, pathogens with pandemic potential and other dual-use research. There are guidelines that cover dual-use research. Dual-use is covered within chapter 15 of the Laboratory Biosafety and Biosecurity Policy Guidelines produced by the Ministry of Health and Sanitation and Ministry of Medical Services, for which it is unclear when it was published. There is no evidence that these are based on regulations or legislation. ⁹⁷ There is no relevant information on the Ministry of Health, Kenya National Public Health Institute or Verification Research, Training and Information Centre database websites. ^9899100 According to page 21 of the Joint External Evaluation (JEE) for Kenya, conducted in 2017 by the World Health Organization, "Kenya has not adopted a list of selected hazards and pathogens". ¹⁰¹ A Joint External Evaluation was conducted for Kenya in 2024, but the report is yet to be published. ¹⁰²

1.5.1c Existence of agency responsible for oversight of dual-use research

Score: 0

There is insufficient evidence that there is an agency specifically responsible for oversight of research with especially dangerous pathogens, toxins, pathogens with pandemic potential or other dual-use research. The National Biosafety Authority primarily deal with genetically modified organism usage in Kenya and does not mention toxins, pathogens, or pathogens with pandemic potential or other dual-use research. ¹⁰³ There is no evidence on the website of the Ministry of Health. ¹⁰⁴ According to the Verification Research, Training and Information Centre database website, the National Commission for Science, Technology and Innovation (NACOSTI) creates guidance for the management of biological materials. ¹⁰⁵ According to the website of the National Commission for Science, Technology and Innovation, one of its mandates is to "[u]undertake…regular inspections, monitoring and evaluation of research institutions to ensure compliance with set standards and guidelines", but it is not specifically stated that this includes research with especially dangerous pathogens, toxins, pathogens with pandemic potential or other dual-use research. ¹⁰⁶ There is no available evidence on the website of the Kenya National Public Health Institute. ¹⁰⁷

1.5.2a Requirement to screen synthesised DNA against list prior to sale

Score: 0

There is no evidence of national legislation or regulations that require the screening of synthesized DNA against lists of known pathogens and toxins before it is sold in Kenya. There is legislation concerning biosafety and genetically modified organisms made from a novel combination of genetic material by use of DNA covered by the Biosafety Act 2009, but it makes no mention of screening for synthesized DNA. ¹⁰⁸ The 2022 Guidelines for Determining the Regulatory Process of Genome Edited Organism and Products in Kenya produced by the National Biosafety Authority, also makes no mention of screening for synthesized DNA. ¹⁰⁹ The Joint External Evaluation for Kenya conducted in 2017 by the World Health Organization makes no mention of DNA screening. ¹¹⁰ A Joint External Evaluation was conducted for Kenya in 2024, but the report is yet to be published. ¹¹¹ The Verification Research, Training and Information Centre database makes no mention of DNA screening. ¹¹² There is no evidence on the Ministry of Health or Kenya National Public Health Institute websites. ¹¹³¹¹⁴

1.6.1a Immunization rate for humans (measles/MCV2)

Score: 0

1.6.1b Availability of vaccination figures for livestock (FMD) through OIE database

Score: 100

There is evidence of vaccinations of livestock data for foot-and-mouth disease (FMD) publicly available through the OIE database. According to the terrestrial data for Kenya for the first semester of 2024, 200 animals were vaccinated in response to foot-and-mouth disease. ¹¹⁵

1.6.1c Equitablenature of national immunization strategy/plan

Score: 100

There is evidence that Kenya has a national immunization strategy that is equitable. The Kenya National Immunization Policy Guidelines 2023 were produced by the Ministry of Health in 2023. The second impact goal of the guidelines listed on page 1 is to "[l]eave no one behind, by increasing equitable access and use of new and existing vaccines". Section 3.4 states includes overcoming socioeconomic barriers for under-immunized population groups in Kenya, "including in urban informal settlements, remote rural areas, insecurity-affected settings, refugees, and marginalized groups that face social, cultural, economic and gender barriers to vaccination". ¹¹⁶

1.6.1d Vaccine hesitancy and build public trust coverage in vaccines in national immunization strategy/plans

Score: 0

There is evidence that the national immunization strategy in Kenya includes discussion of measures to address vaccine hesitancy and build public trust in vaccines, but no actual measures are listed. The Kenya National Immunization Policy Guidelines 2023, produced by the Ministry of Health in 2023, states as policy objective 4 of its programme on page 8, that it aims to "[d]evelop policies on interventions aimed at increased acceptance, reduced vaccine hesitancy and refusals". ¹¹⁷ It does not state what these measures are. There is no other information available on the Ministry of Health or Kenya National Public Health Institute. ¹¹⁸¹¹⁹

1.6.1e National advisory group for immunization strategy/plan

Score: 100

There is a national advisory group that provides technical guidance and advice on immunization to government in Kenya. According to the website of the Global NITAG Network, the Kenya National Immunization Technical Advisory Group (KENITAG) was established in 2014. ¹²⁰ According to page 18 of the National Policy Guidelines on Immunization 2012 produced by the Ministry of Health, the Kenya National Immunization Technical Advisory Group "will serve as a scientific and technical advisory body to the Ministry of Health on matters relating to vaccines and immunization policy". ¹²¹

1.6.1f Presence of an immunization programme for influenza

Score: 100

There is evidence that Kenya has a national immunization programme for influenza, but this is only evidenced by the WHO and there is no evidence for a programme among domestic sources. According to the WHO, Kenya introduced a seasonal vaccine in 2024, which covers private and public usage, with 50,000 doses distributed in 2024. ¹²²¹²³ There is no evidence of an influenza policy document or strategy on the websites of the Ministry of Health of Kenya National Public Health Institute. ¹²⁴¹²⁵

1.7.1a Strategy/plan for resilience of health system

Score: 100

There is evidence that Kenya has a strategy to develop a health system that is resilient to the challenges that climate change and changing seasonal weather patterns pose, that includes the threat of infectious diseases. Section 5.5 of the National Climate Change and Health Strategy (KCCHS) 2023–2027 addresses health concerns arising from climate change and "sets out an integrated approach to climate actions that address sustainable health, human settlements, and sanitation services". This includes strategies to combat infectious diseases, including "[h]ealth programmes, protocols, and guidance to identify and manage new climate change-related diseases and risks are developed and implemented". This includes responding to extreme weather events such as "[h]eat stress, drought, and floods [that] can alter disease transmission
patterns". ¹²⁶

2.1.1a Capacity of national lab system to conduct 5 or more WHO core tests

Score: 100

There is evidence that the Kenya National Public Health Institute has the capacity to conduct diagnostic tests for at least 5 of the 10 WHO-defined core tests. According to the Laboratory Services page of the Kenya National Public Health Institute website, the Kenya National Public Health Institute has the capacity to test for Malaria, Dengue virus, influenza, HIV, tuberculosis, as well as other neglected tropical diseases. ¹²⁷

2.1.1b Plan to conduct testing during a public health emergency

Score: 0

There is insufficient evidence of a plan for conducting testing during a public health emergency in Kenya. There is no mention of testing in a public health emergency in the Joint External Evaluation for Kenya conducted in 2017 by the World Health Organization. ¹²⁸ A Joint External Evaluation was conducted for Kenya in 2024, but the report is yet to be published.¹²⁹ There is no mention of testing in the Kenya Public Health Emergency Operations Center (KPHEOC) Handbook or the Kenya Public Health Emergency Operations Centre National Strategic Plan 2021-2026, both published by the Ministry of Health. ¹³⁰ There is no evidence on the Ministry of Health or Kenya National Public Health Institute websites. ¹³¹¹³² The National Public Health Laboratories do not have a specific, locatable website.

2.1.2a Existence of an accredited national lab serving as a reference facility

Score: 100

There is evidence of a national laboratory in Kenya that serves as a reference facility which is accredited. According to the website of the Kenya National Public Health Institute, the National HIV Reference Lab was "the first government laboratory to be accredited in the country in 2012 under ISO 15189:2012 for three scopes: Viral Load (VL), Early infant diagnosis (EID) and serology and ISO 17043:2010 for two scopes: VL, EID". In 2021, the National HIV Reference Lab also attained WHO HIV DR Accreditation. ¹³³

2.1.2b External quality assurance of a national lab serving as a reference facility

Score: 100

There is evidence of a national laboratory in Kenya receiving external quality assurance. According to the website of the Kenya National Public Health Institute, the National HIV Reference Lab has received both ISO 15189:2012 and WHO HIV DR accreditations. ¹³⁴

2.2.1a Nationwide specimen transport system

Score: 0

There is insufficient evidence of a nationwide specimen transport system in Kenya. According to section D.1.2. of the Joint External Evaluation for Kenya conducted in 2017 by the World Health Organization, there is a system in place to transport specimens to national laboratories, but this is only from "less than 50% of intermediate level districts in country for advanced diagnostics". ¹³⁵ A Joint External Evaluation was conducted for Kenya in 2024, but the report is yet to be published. ¹³⁶ There is no information on the Ministry of Health or Kenya National Public Health Institute websites. ¹³⁷¹³⁸ There is no relevant information on the Verification Research, Training and Information Centre database website. ¹³⁹ Chapter 8 of the Laboratory Biosafety and Biosecurity Policy Guidelines produced by the Ministry of Health and Sanitation and Ministry of Medical Services, for which it is unclear when it was published, does discuss transportation, but gives to evidence for a national transport system. ¹⁴⁰

2.2.2a Plan to rapidly authorize/license laboratories to scale-up testing during an outbreak

Score: 50

There is evidence of legislation to rapidly authorize or license laboratories to supplement the capacity of the national public health laboratory system to scale-up testing during an outbreak. According to section 5(b) and 5(c) of the 2022 Kenya National Public Health Institute Order, the Kenya National Public Health Institute shall "build appropriate response capacity to outbreaks and emergencies at the national, county, sub-county and community levels" and "facilitate appropriate laboratory capacity to detect and confirm conditions of concern for each level of the public health system". ¹⁴¹ There is no evidence of its implementation on the Ministry of Health or Kenya National Public Health Institute websites. ¹⁴²¹⁴³

2.3.1a Evidence of ongoing event-based and indicator-based surveillance and analysis

Score: 100

There is evidence that Kenya is conducting ongoing event-based and indicator-based surveillance and analysis for notifiable and novel infectious diseases, and evidence that this is done daily. According to page three of the One Health Strategic Plan for the Prevention and Control of Zoonotic Diseases in Kenya (2021-2025) produced by the Zoonotic Disease Unit in 2022, disease surveillance is conducted through the Integrated Disease Surveillance and Response System, (IDSR) and the District Health Information System 2 (DHIS 2). For health facilities, reporting is done weekly for outbreak prone diseases, but is conducted monthly for other diseases. ¹⁴⁴ According to page 31 of the Joint External Evaluation for Kenya conducted in 2017 by the World Health Organization, "[e]vent-based surveillance reports are generated on a daily basis and submitted to the Disease Surveillance and Response Unit". ¹⁴⁵ A Joint External Evaluation was conducted for Kenya in 2024, but the report is yet to be published. ¹⁴⁶

2.3.1b Evidence of a mechanism (such as IHR focal point) for reporting notifiable diseases to the WHO within the set timeline

Score: 100

There is publicly available evidence of a mechanism for reporting notifiable diseases to the WHO within the set timeline. According to the 2021 IHR (2005) State Party Self Assessment Annual Report for Kenya produced by the World Health Organization, the office of the Director General of Health is the designated IHR focal point for urgent communication with the World Health Organization, and is accessible 24/7 for communication. According to the report, Kenya uses the generic World Health Organization terms of reference for IHR focal point, but is yet to put the terms of references into national policies and legislation. ¹⁴⁷

2.3.2a Electronic national and sub-national reporting surveillance system

Score: 100

There is evidence that Kenya operates an electronic reporting surveillance system at both the national and the sub-national level. According to academic research published in 2020, Kenya uses a surveillance system called District Health Information System 2 (DHIS2) that operates at both a national and subnational level. According to the research, data flows electronically from the community, to health facilities, to sub-county surveillance officers who would then enter the data into DHIS2, allowing the data to be transferred to the national level. ¹⁴⁸

2.3.2b Collection of ongoing/real-time lab data by electronic surveillance system

Score: 100

There is evidence that the electronic reporting surveillance system in Kenya can collect ongoing laboratory data, and that this data be disaggregated and analysed by age. According to academic research published in 2020, the District Health Information Software 2 (DHIS2) is used for feeding in of routine diagnostic testing data, which is reported monthly. ¹⁴⁹ There is no evidence in the Kenya National eHealth Policy (2016-2030). ¹⁵⁰ According to academic research from 2017, data from the District Health Information Software 2 (DHIS2) could be disaggregated by age. ¹⁵¹

2.3.3a National wastewater surveillance programme or initiative

Score: 100

Kenya is actively engaged in wastewater and environmental surveillance initiatives at a national level.

Kenya became the second African country after Nigeria to establish environmental surveillance for polio in 2013, starting with just two sampling sites that have since expanded to 24 locations nationwide. ¹⁵² Kenya has 24 environmental sampling sites in Kibera, where wastewater is collected monthly and transported to KEMRI's laboratory for analysis.¹⁵³

A pilot system was implemented in Nairobi using Moore swabs at two sites (Mathare and Kamukunji), with samples collected three times a week between January 2022 and October 2023. Swabs were processed at the National Public Health Laboratories, sequenced for SARS‑CoV‑2 variants. ¹⁵⁴ Another study in Kisumu (March 2022 – March 2023) sampled both centralized and decentralized wastewater (e.g., hospitals, public toilets, markets). SARS‑CoV‑2 detection in wastewater was strongly associated with subsequent COVID‑19 cases – wastewater positivity indicated a drastically elevated probability of cases occurring 4-7 days later. ¹⁵⁵

Moreover, Kenya is among six African countries participating in Project Stellar, a pilot initiative funded by the Global Fund and implemented via the Association of Public Health Laboratories (APHL). The project tests the feasibility of wastewater-based surveillance (WWBS) for molecular detection and whole-genome sequencing of SARS‑CoV‑2, and leaves room for future expansion to include other pathogens. ¹⁵⁶

Moreover, on 20-22 May 2025, Nairobi hosted the Eastern Africa Regional Workshop (part of UNEP's Wastewater Surveillance for Africa Initiative), along with WHO and ILRI. This event brought together officials and experts from 11 Eastern African countries to explore ways to develop national surveillance systems, harmonized monitoring methods, and regional infrastructure.¹⁵⁷

2.4.1a Common usage of electronic health records

Score: 100

There is evidence that electronic health records commonly in use. According to a 2024 Exemplars in Global Health report, Kenya's electronic community health information system (eCHIS) is used by 106,000 community health workers across the country. ¹⁵⁸ This is furthered by a Ministry of Health press release from March 2025, which states that 8,572,860 households have been registered on eCHIS. ¹⁵⁹ According to academic research, Kenya also uses KenyaEMR, an open source EHR system, which as of 2018, had been implemented in 300 facilities in 4 geographic regions in Kenya. ¹⁶⁰ According to the Exemplars in Global Health website, eCHIS was first piloted in 2022, and released in 2023. ¹⁶¹

2.4.1b Public health system access to individual electronic health records

Score: 100

There is evidence that the national public health system has access to electronic health records of individuals in Kenya. According to Centre for Health Solutions – Kenya website, health informatics officer and administrators can access files on the KenyaEMR health records system, which is part of the electronic community health information system (eCHIS) and has been deployed across Kenya. ¹⁶² According to section 4.4 of the electronic community health information system privacy policy listed on the Ministry of Health website, the Ministry of Health may use personal data of patients within the electronic community health information system for a variety of reasons, including research, communication, maintenance, and legal requirements, among others. ¹⁶³

2.4.1c Existence of data standards for health record data comparability

Score: 100

There is evidence of data standards to ensure data is comparable within Kenya's electronic health systems. According to page 15 of the National Community Health Digitization Strategy 2020-2025 produced by the Ministry of Health in 2021, which discusses interoperability of electronic health systems in Kenya, the electronic community health information system (eCHIS) includes integration of the National Integrated Identity Management System (NIIMS), used for client identity resolution; the Electronic Health Record (EHR) systems used for client referral coordination;
the Shared Health Record (SHR) system, designed for collating patient level data; the Kenya
Health Information System (KHIS), used for aggregating statistics of services; and the Master Community
Health Unit List (MCHUL), designed for managing community health data. ¹⁶⁴

2.4.2a Data sharing mechanisms

Score: 0

There is insufficient evidence of established mechanisms at the relevant ministries responsible for animal, human, and wildlife surveillance to share data. The Zoonotic Disease Unit does not have a working website. According to academic research, data collected through the Kenya Animal Bio-surveillance System (KABS) is backed up on the Kenya Ministry of Agriculture, Livestock, and Fisheries central database, but it is unclear if this is then shareable with other ministries. ¹⁶⁵ There is no information on the Ministry of Health or Kenya National Public Health Institute websites. ¹⁶⁶¹⁶⁷ According to page 16 of the Joint External Evaluation for Kenya conducted in 2017 by the World Health Organization, "[n]o formal infrastructure exists for sharing data across human health and animal health sectors". ¹⁶⁸ A Joint External Evaluation was conducted for Kenya in 2024, but the report is yet to be published. ¹⁶⁹

2.4.3a Availability of de-identified health surveillance data on disease outbreaks

Score: 0

There is no evidence that Kenya makes de-identified health surveillance data on infectious diseases publicly available via reports on government websites. There is no such data available on the websites of the Ministry of Health, the Kenya National Public Health Institute, or the Agriculture and Livestock Development. ^170171172 The National Public Health Laboratory does not have a working website.

2.4.4a Confidentiality legislation/regulations for identifiable health information

Score: 100

There is evidence of legislation and regulations that safeguard the confidentiality of identifiable health information for individuals, such as that generated through health surveillance activities. Part six of the 2023 Digital Health Act specifically addresses confidentiality and security of data. Section 3(e) states that the purpose of the act is to "provide for privacy, confidentiality, and security of health data". Section 26 states that health data shall be governed by the principles of "privacy and confidentiality".¹⁷³

2.4.4b Inclusion of cyber protections in health data confidentiality law/regulation

Score: 100

There is mention of legislation concerning cyber security within the Kenya National eHealth Policy 2016-2030 regulations. Section 1.3 states that the draft Cyber Security and Protection Bill, 2016 and the revised Kenya Information and Communications Act both have provisions for cyber security. ¹⁷⁴ The 2023 Digital Health Act makes no mention of cyber security or ransomware. ¹⁷⁵

2.4.5a Cooperative commitments or agreements within regions

Score: 100

There is evidence that the government of Kenya has made a commitment via a cooperative agreement to share surveillance data during a public health emergency with other countries. According to section 72(2) of the Public Health Act 2012, the government of Kenya may enter into agreements with foreign countries for "providing for the reciprocal notification of outbreaks of any formidable epidemic or other disease of any other matter affecting the public health relations of Kenya with other countries". ¹⁷⁶ According to the Africa Centres for Diseases Control and Prevention, Kenya is one of 12 countries that have joined together in collaboration to respond, prevent and control disease outbreaks, especially the recent monkeypox outbreaks, which includes "data-sharing mechanisms". It is unclear whether this is just for one or multiple diseases, and there is no evidence of any implementation of mechanisms yet. ¹⁷⁷ Kenya is party to the 2005 International Health Regulations (IHR) through the World Health Organization. This requires Kenya to notify WHO within 24 hours of detecting any event that may constitute a Public Health Emergency of International Concern (PHEIC), and to share surveillance information promptly. According to article 10(4), the WHO may then share this information with other parties. ¹⁷⁸ Kenya is a member of East African Community (EAC) One Stop Border Posts Act, 2016, created by several East African countries, section 22 of which states that participating countries shall "develop and implement comprehensive mandatory information and communications technology requirements at their common borders to enable seamless, reliable and effective data exchange of high integrity and appropriate format within and between the various agencies of the adjoining Partner States". ¹⁷⁹ Kenya is also a member of the East Africa Public Health Laboratory Network Project, a World Bank funded project whose aim is to "to establish a network of efficient, high quality, accessible public health laboratories for the diagnosis and surveillance of Tuberculosis and other communicable diseases". This includes the East African Integrated Disease Surveillance Network, which aims to harmonize "integrated disease surveillance systems in the region". ¹⁸⁰¹⁸¹

2.5.1a National support to conduct contact tracing in the event of a public health emergency

Score: 50

There is evidence of a national system in place to provide support at the sub-national level to conduct contact tracing, but only in the event of an active public health emergency. According to the World Health Organization, there is evidence that contact tracing was scaled up during the COVID-19 pandemic, but no evidence of a specific local plan. ¹⁸² The Joint External Evaluation for Kenya conducted in 2017 by the World Health Organization makes no mention of contact tracing. ¹⁸³ A Joint External Evaluation was conducted for Kenya in 2024, but the report is yet to be published. ¹⁸⁴ There is no of mention training for contact tracing in the Kenya Public Health Emergency Operations Center (KPHEOC) Handbook or the Kenya Public Health Emergency Operations Centre National Strategic Plan 2021-2026, both published by the Ministry of Health in 2021. ¹⁸⁵ There is no specific plan for contact tracing on the Ministry of Health website. ¹⁸⁶

2.5.1b Provision of wraparound services to enable self-isolation/quarantine as recommended

Score: 0

There is insufficient evidence that Kenya provides wraparound services to enable infected people and their contacts to self-isolate or quarantine as recommended, particularly economic support (paycheck, job security) and medical attention. There is no evidence on the Ministry of Health or Kenya National Public Health Institute websites. ¹⁸⁷¹⁸⁸ According to academic research, there were cash transfer programs available during the COVID-19 pandemic in Kenya, but no evidence that these were for isolation. ¹⁸⁹ There is no evidence on the National Treasury of Kenya website. ¹⁹⁰

2.5.2a Strategy for tracing and quarantining international travelers

Score: 50

There is evidence of a specific joint plan or cooperative agreement between the public health system and border control authorities to identify suspected and potential cases in international travelers and trace and quarantine their contacts in the event of a public health emergency in Kenya. According to the Ministry of Health website, port health services is a division of the health services that is responsible for prevention of disease through points of entry and exit. The port health services are regulated by a variety of agreements including International Health Regulation (IHR 2005), the Public Health Act CAP 242, and the Food Drugs and Chemical Substances Act CAP 254. ¹⁹¹ The section 71 of the Public Health Act gives specific powers to the Minister of Health to regulate the borders "for the purpose of preventing the introduction of infectious disease into Kenya". ¹⁹²

2.6.1a Access to field epidemiology training program in country and/or abroad

Score: 100

There is evidence that applied epidemiology training programs (such as FETP) is available in Kenya. According to the Kenya Field Epidemiology and Laboratory Training Program website, the Kenya Field Epidemiology and Laboratory Training Program (K-FELTP) was established in 2004 and is part of the Ministry of Health. ¹⁹³

2.6.1b Existence of field epidemiology training for animal health professionals

Score: 100

There is evidence of field epidemiology training programs explicitly inclusive of animal health professionals in Kenya. According to academic research, an In-Service Applied Veterinary Epidemiology Training (ISAVET) program has been running since 2021 in conjunction with the Directorate of Veterinary Services. ¹⁹⁴

2.6.2a Evidence of at least 1 trained field epidemiologist per 200,000 people

Score: 0

There is insufficient evidence that Kenya has at least 1 trained field epidemiologist per 200,000 people. According to the Kenya Field Epidemiology and Laboratory Training Program website, Kenya is still "working towards attaining the Global Health Security Agenda (GHSA) target of one trained Field Epidemiologist per 200,000 populations". ¹⁹⁵ According to the Joint External Evaluation for Kenya conducted in 2017 by the World Health Organization, there are 423 health workers that have been trained in basic FELTP, but it is unclear whether these still work in Kenya. ¹⁹⁶ A Joint External Evaluation was conducted for Kenya in 2024, but the report is yet to be published. ¹⁹⁷

3.1.1a National emergency response plan for diseases with pandemic potential

Score: 100

There is evidence that Kenya has an overarching national public health emergency response plan in place which addresses planning for multiple communicable diseases with epidemic or pandemic potential. The 2021 Kenya Public Health Emergency Operation Centre Standard Operating Procedures produced by the Ministry of Health sets out procedures for "activating, operating, and deactivating the KPHEOC [Kenya Public Health Emergency Operation Centre]". ¹⁹⁸ According to page viii of the Kenya Public Health Emergency Operation Centre Strategic Plan (2021-2026), "[the Public Health Emergency Operation Centre] is fully costed and prioritized, based on the anticipated funding." Page 21 of the plan states that this funding comes from primarily the World Health Organization, the US Centers for Disease Control and Prevention, and United States Agency for International Development. ¹⁹⁹ The Kenya Public Health Emergency Operations Center (KPHEOC) Handbook and the Kenya Public Health Emergency Operations Centre National Strategic Plan 2021-2026, both published by the Ministry of Health also outline Kenyas response to a public health emergency. ²⁰⁰²⁰¹

3.1.1b National public health emergency response plan published in past 3 years

Score: 0

There is insufficient evidence that the 2021 Kenya Public Health Emergency Operation Centre Standard Operating Procedures, the Kenya Public Health Emergency Operations Center (KPHEOC) Handbook or the Kenya Public Health Emergency Operations Centre National Strategic Plan 2021-2026, all published by the Ministry of Health have been updated in the last three years. There are no updates listed in the documents themselves, on the Ministry of Health website, or on the Kenya National Public Health Institute website, where they are listed as primary documents. ^{202203204205206}

3.1.1c One health principles by covering multiple threat types

Score: 100

There is evidence of a One Health approach to public health emergencies. According to page 19 of the Kenya Public Health Emergency Operations Center (KPHEOC) Handbook, "[t]hese plans provide guidance regarding preparing for, mitigating against, detecting and responding to public health emergencies in line with the One Health approach". ²⁰⁷ Alongside these documents, however, Kenya also has the One Health Strategic Plan for the Prevention and Control of Zoonotic Diseases in Kenya (2021-2025) produced by the Zoonotic Disease Unit in 2022, contains strategies and plans for zoonotic disease prioritization, detection and reporting, page 33 of which provides information on the management and response structure for zoonotic diseases. ²⁰⁸

3.1.1d Vulnerable populations in national public health emergency response plan

Score: 0

There is insufficient evidence that the overarching plan is equitable and recognises socioeconomic differences. Although according to page viii of the Kenya Public Health Emergency Operation Centre Strategic Plan (2021-2026), the National Strategic Plan "recognizes that all human beings have equal rights regardless of their nationality, ethnic origin, sex, race, religion, or any other status", there is no specific strategy to address inequities within the plan. ²⁰⁹

3.1.2a Mechanism to engage private sector in outbreak preparedness/response

Score: 0

There is insufficient evidence of a specific mechanism for engaging with the private sector to assist with outbreak emergency preparedness and response in Kenya. According to the website of the Kenya Healthcare Foundation, which is the Health Sector Board of the Kenya Private Sector Alliance (KEPSA), public private dialogue can help in cases of "[e]mergency Care and disaster response", but there is no information given on how this is done. ²¹⁰ According to the Connecting Business Initiative website, KEPSA was involved with emergency response during 2024 flooding in Kenya, and "joined the first meeting of the National Disaster Committee and was requested by their government partners to support with provisions of food and non-food items, dignity kits, and fundraising", but it is unclear whether this forms a specific mechanism of engagement. ²¹¹

3.1.3a Policy/plan/guidelines in place to implement non-pharmaceutical interventions (NPIs)

Score: 0

There is no evidence of a specific plan or strategy for implementation of non-pharmaceutical interventions (NPIs) during an epidemic or pandemic. No evidence is available on the websites of either the Ministry of Health or Kenya National Public Health Institutes. ²¹²²¹³ The National Public Health Laboratory does not have a locatable website. There is no information on the Verification Research, Training and Information Centre website. ²¹⁴ The Joint External Evaluation for Kenya conducted in 2017 by the World Health Organization makes no mention of non-pharmaceutical interventions. ²¹⁵ A Joint External Evaluation was conducted for Kenya in 2024, but the report is yet to be published. ²¹⁶ There is no information in the Kenya Public Health Emergency Operation Centre Standard Operating Procedures (2021-2026) produced by the Ministry of Health in 2021. ²¹⁷ There is no mention of related non-pharmaceutical interventions in the Kenya Public Health Emergency Operations Center (KPHEOC) Handbook or the Kenya Public Health Emergency Operations Centre National Strategic Plan 2021-2026, both published by the Ministry of Health. ²¹⁸²¹⁹

3.2.1a Completion of biological-focused IHR exercise with the WHO in past year

Score: 100

There is evidence that Kenya activated their national emergency response plan for an infectious disease outbreak in the past year. According to the World Health Organization, Kenya activated its Public Health Emergency Operations after confirmation of a Monkeypox outbreak in 2024. ²²⁰ Likewise, the U.S. Centers for Disease Control and Prevention also states that Kenya activated its Public Health Emergency Operations Center in response to Monkeypox. ²²¹

3.2.1b Evidence of bio-focused exercise to identify gaps/best practices

Score: 50

There is evidence that Kenya has identified a list of gaps and best practices in response to an infectious disease outbreak, and developed a plan to improve response capabilities in the past year. According to the World Health Organization, the Ministry of Health conducted an Intra-Action Review (IAR) to review Kenya's response to a Monkeypox outbreak in order to "identify best practices, challenges, practical areas for immediate remediation or continued improvement". It is unclear whether the plan has been published. ²²² There is no evidence of the plan, or a difference plan, on the Ministry of Health or Kenya National Public Health Institute websites. ²²³²²⁴ There is no evidence of a plan being published on the WHO website. ²²⁵

3.2.2a Evidence of national-level biological threat-focused exercise that includes private sector

Score: 0

There is insufficient evidence that Kenya has undergone a national-level biological threat-focused exercise that has included private sector representatives in the past year. No evidence is available on the websites of either the Ministry of Health or Kenya National Public Health Institutes. ²²⁶²²⁷ The National Public Health Laboratory does not have a locatable website. There is no information on the Verification Research, Training and Information Centre website. ²²⁸ There is no relevant information on the Kenya Private Sector Alliance website. ²²⁹ There is no evidence that Kenya has undergone a national-level biological threat-focused exercise in the last year without the participation of the private sector.

3.3.1a Existence of Emergency Operations Center (EOC)

Score: 100

Kenya does have an Emergency Operations Center (EOC). The 2021 Kenya Public Health Emergency Operation Centre Standard Operating Procedures produced by the Ministry of Health sets out procedures for "activating, operating, and deactivating the KPHEOC [Kenya Public Health Emergency Operation Centre]". ²³⁰ Aside from the regulations for Kenya Public Health Emergency Operation Centre, there is no evidence of the centre on the Ministry of Health website, although it has been referenced in recent tweets. ²³¹²³² Additionally, the National Disaster Operations Center was set up in 1998, and coordinates disaster management within Kenya, and lists the EOC as within its Organizational structure, but gives no further information. ²³³ There is no information regarding the centre on the Kenya National Public Health Institute. ²³⁴

3.3.1b Requirement for EOC to conduct/evidence EOC conducts at least annual drills

Score: 0

There is evidence that the Public Health Emergency Operation Centre has conducted drills and reviews, but it is not clear that this is once a year. According to page 5 of the Kenya Public Health Emergency Operation Centre Strategic Plan (2021-2026) produced by the Ministry of Health in 2021, the Public Health Emergency Operation Centre "has conducted drills, simulation, and tabletop exercises, and coordinated response to disease outbreaks and emergencies". ²³⁵ According to the core functions of the National Disaster Operations Center, it conducts an annual review, and drills and exercises in the country, but there is no publicly available evidence of this taking place. ²³⁶

3.3.1c EOC activation within 120 minutes of identification of emergency/scenario

Score: 0

There is no public evidence to show that the Emergency Operations Center (EOC) has conducted within the last year a coordinated emergency response or emergency response exercise activated within 120 minutes of the identification of the public health emergency or scenario. There is no available information on the websites of either the Ministry of Health or Kenya National Public Health Institutes. ²³⁷²³⁸ No information is available on the website of the National Disaster Operations Centre. ²³⁹ According to page 48 of the Kenya Public Health Emergency Operations Center (KPHEOC) Handbook published by the Ministry of Health in 2021, the "PHEOC should be capable of activation within 120 minutes as required by IHR 2005", but there is no evidence of this having taken place. ²⁴⁰

3.4.1a Joint exercise/procedures for potential deliberate biological events

Score: 0

There is no publicly accessible evidence that public health, animal health, the private sector and national security authorities have carried out an exercise to respond to a potential deliberate biological event, or that standard operating procedures, guidelines, memorandums of understanding, or other agreements between the public health, animal health, the private sector and security authorities to respond to a potential deliberate biological event exist. According to the National Commission for Science, Technology and Innovation, Kenya hosted a two day conference on countering the threats of biological weapons by malicious actors in 2022, but this did not include conducting an exercise. ²⁴¹ There is no further relevant information on the National Commission for Science, Technology and Innovation website. ²⁴² There is no evidence on the Ministry of Health or National Public Health Institute Websites. ²⁴³²⁴⁴ According to the Joint External Evaluation for Kenya conducted in 2017 by the World Health Organization, "[d]raft plans for an all-hazards emergency response and for CBRNE events also include clear roles and links for public health and security authorities. A number of these plans have been evaluated and tested through simulation exercises in recent years", but there is no evidence of such plans. ²⁴⁵ Kenya hosted a regional workshop in 2024 focussed on handling of biological materials and installations, but there is no evidence of a full exercise to respond to a biological event being conducted beyond use of the National Biological Risk Assessment tool. ²⁴⁶

3.5.1a Risk communication plan for specific use during a public health emergency

Score: 0

There is insufficient evidence of a specific risk communication plan or strategy for use during a national public health emergency in Kenya. According to section 6.3 of the National Disaster Risk Management Strategy (2025-2030) produced by the Ministry of Interior and National Administration, "[r]isk information will be translated into languages and accessible formats tailored to diverse audiences, enhancing understanding and facilitating informed decision-making". No further information is provided and it is unclear when this document was produced. ²⁴⁷ There is no mention of risk communication in the Kenya National Emergency Response Plan produced in 2020 by the ACP-EU Natural Disaster Risk Reduction Program, listed on the website of the National Disaster Operations Centre website. ²⁴⁸ According to page 30 of the Kenya Public Health Emergency Operations Center (KPHEOC) Handbook, a public communications plan that "entails plans for risk communication to the public" is listed as a functional plan, but there is no evidence of this specific plan. ²⁴⁹

3.5.1b Inclusion of different population & sector needs in risk communication plan

Score: 100

There is evidence of a specific risk communication plan or strategy for use during a national public health emergency, that caters to different language groups in Kenya. According to section 6.3 of the National Disaster Risk Management Strategy (2025-2030) produced by the Ministry of Interior and National Administration, "[r]isk information will be translated into languages and accessible formats tailored to diverse audiences, enhancing understanding and facilitating informed decision-making". No further information is provided and it is unclear when this document was produced. ²⁵⁰ According to page 30 of the Kenya Public Health Emergency Operations Center (KPHEOC) Handbook, a public communications plan that "entails plans for risk communication to the public" is listed as a functional plan, but there is no evidence of this specific plan, or it has specific means of communication to have wide reach. ²⁵¹

3.5.1c Designation of a specific government spokesperson during a public health emergency

Score: 0

There is no evidence of a specific risk communication plan or strategy for that mentions a spokesperson for communication in the event of a public health emergency. Section 6.3 of the National Disaster Risk Management Strategy (2025-2030) produced by the Ministry of Interior and National Administration, makes no mention of a spokesperson when discussion communications. It is unclear when this document was produced. ²⁵² There is no mention of risk communication in the Kenya National Emergency Response Plan produced in 2020 by the ACP-EU (African, Caribbean and Pacific Group of States – European Union) Natural Disaster Risk Reduction Program, listed on the website of the National Disaster Operations Centre website. ²⁵³ According to page 30 of the Kenya Public Health Emergency Operations Center (KPHEOC) Handbook, a public communications plan that "entails plans for risk communication to the public" is listed as a functional plan, but there is no evidence of this specific plan. ²⁵⁴

3.5.2a Government use of media platforms to share info on public health emergencies

Score: 100

There is evidence that the public health system in Kenya has actively shared messages via online media platforms to dispel misinformation. According to a post on Facebook by the Ministry of Health in June 2025, Dr. Ouma Oluga, Principal Secretary of Medical Services at the Ministry of Health states that misinformation is hurting access to services. ²⁵⁵ It is unclear whether such messaging is a regular occurance. There is no evidence of specific messaging on the Ministry of Health or Kenya National Public Health Institute websites. ²⁵⁶²⁵⁷ There is regular posting on the Ministry of Health and Kenya National Public Health Institute Facebooks, but no mention of misinformation regularly. ²⁵⁸²⁵⁹

3.5.2b Evidence that senior leaders have shared mis/disinformation on infectious diseases

Score: 100

There is no evidence that senior leaders (president or ministers) have shared misinformation or disinformation on infectious diseases in the past two years in Kenya. There is no evidence in news reports, nor on the websites of the Ministry of Health or National Kenya Public Health Institute. ²⁶⁰²⁶¹ No evidence was found on the Africa Check fact checking website. ²⁶²

3.6.1a Percentage of households with Internet

Score: 36.3

3.6.2a Mobile-cellular telephone subscriptions per 100 inhabitants

Score: 65.23

3.6.3a Gender gap in access to a mobile phone (percentage points)

Score: 73.33

3.6.4a Gender gap in access to the Internet (percentage points)

Score: 20.83

3.7.1a Restrictions on export/import of medical goods due to an infectious disease outbreak

Score: 0

There is no evidence that Kenya has implemented restrictions on exports or imports of medical goods due to an infectious disease outbreak in the past year. No information was found on the websites of the Ministry of Foreign and Diaspora Affairs, Ministry of Health, Kenya National Public Health Institute or Ministry of Agriculture and Livestock Development websites. ^263264265266 No related news reports were found.

3.7.1b Restrictions on movement and/or exports/imports due to disease outbreak

Score: 100

There is no evidence that Kenya implemented restrictions on exports or imports of non-medical goods due to an infectious disease outbreak in the past year. No information was found on the websites of the Ministry of Foreign and Diaspora Affairs, Ministry of Health, Kenya National Public Health Institute or Ministry of Agriculture and Livestock Development websites. ^267268269270 No related news reports were found.

3.7.2a Evidence of travel ban due to an infectious disease outbreak

Score: 0

There is insufficient evidence that Kenya has implemented inbound travel restrictions due to an infectious disease outbreak. According to news reports, in response to rising numbers of Marburg, Mpox and Ebola cases in Uganda and Tanzania, travellers from those countries arriving at Jomo Kenyatta International Airport had to complete health declaration forms, but these do not represent inbound travel restrictions. These regulations were supported by the World Health Organization (WHO). WHO officials also support the measures included in the news report. ²⁷¹ According to a 2025 bulletin produced by the WHO, the WHO has assisted in helping Kenya put measures in place at Jomo Kenyatta International Airport to respond to rising numbers of Marburg, Mpox and Ebola, which according to page 9 of the July 2024 WHO Emergency Preparedness Response, included equipping "over 40 personnel with the skills needed to respond effectively to cross-border health threats including mpox". But there is no evidence these constitute restrictions on travel.²⁷²

3.7.2b Risk-based approach to international travel-related measures

Score: 100

There is evidence that Kenya uses a risk-based approach to international travel-related measures. According to news reports, regulations requiring COVID-19 vaccination certificate or proof of a negative COVID-19 test were dropped in 2023 on the basis of a review of COVID-19 travel restrictions conducted by the Ministry of Health alongside guidance from the World Health Organization, specifically citing a lower risk of COVID-19 transmission. ²⁷³

4.1.1a Doctors per 100,000 people

Score: 3.83

4.1.1b Nurses and midwives per 100,000 people

Score: 7.4

4.1.1c Updated health workforce strategy to address human resource shortfalls

Score: 100

There is evidence of a health workforce strategy in Kenya that has been updated in the last five years. Workforce is discussed within the State Department for Public Health and Professional Standards Strategic Plan 2023-2027 produced by the Ministry of Health, which discusses workforce planning for improved access to quality workforce and enhanced workforce training. It recognises weaknesses in workforce, such as low staffing levels and emigration (pages 30-31), and includes performance targets for workforce (page 129), including healthcare worker numbers (page 66). ²⁷⁴ According to a Ministry of Health press release, this document was released in 2023. ²⁷⁵ There is no workforce strategy available on the Ministry of Health or Kenya National Public Health Institute websites for the time period. ²⁷⁶²⁷⁷ Workforce is also mentioned in 1.4.3 of the National Health Quality Strategy produced by the Ministry of Health, but does not provide a full strategy. ²⁷⁸ According to the WHO, the WHO introduced the Kenyan Ministry of Health to the National Health Workforce Accounts, which provides a system for analysing workforce data. ²⁷⁹

4.1.1d Health system capacity for essential health services

Score: 100

There is evidence that Kenya has sufficient capacity within the health system to deliver essential health services.

Kenya's Joint external evaluation of the International Health Regulations (9–13 September 2024) gives the country a score of 4, the highest possible in this measure. It says that a package of EHS is well laid out and the country has developed plans/guidelines on continuity of EHS in emergencies, key ones being the COVID-19 plan for continuity of EHS, and a plan for continuity of non-communicable disease services during health emergencies, although large-scale public health emergencies disrupt the continuity of EHS, climate-induced emergencies, such as flooding and food insecurity during drought, create barriers to access, and risk perceptions deter the public from visiting health facilities during public health emergencies.²⁸⁰

According to academic research published in 2024, Kenya faces "significant challenges related to health worker shortages". ²⁸¹ Other academic research published in 2025 regarding the capacity and training needs of healthcare workers in two counties in Kenya found that there was a "substantial capacity gap in several of the elements of PHC [primary healthcare]". ²⁸² According to the WHO, despite increases in health worker numbers, there is still a "significant gap in health care provision". ²⁸³

4.1.1e Essential health services continuity plan for public health emergencies

Score: 0

There is insufficient evidence of a plan to ensure continuity of essential health services during a public health emergency in Kenya. According to the World Health Organization, the Ministry of Health did establish a Technical Working Group on Continuity of Essential Health Services during the COVID-19 pandemic, which was tasked with developing national guidelines for the continuity of essential services. There is no evidence of a distinct plan or of a plan being drawn up afterwards. ²⁸⁴ No plan is available on the Ministry of Health or Kenya National Public Health Institute websites. ²⁸⁵²⁸⁶ Pages 30-31 of the Kenya Public Health Emergency Operations Center (KPHEOC) Handbook produced by the Ministry of Health in 2021 outlines the structure of an operational continuity plan, but there is no evidence that such a plan exists. ²⁸⁷ There is no evidence in the Kenya Public Health Emergency Operations Centre National Strategic Plan 2021-2026, also published by the Ministry of Health. ²⁸⁸

4.1.2a Hospital beds per 100,000 people

Score: 32.25

4.1.2b In-country capacity to isolate patients with highly communicable diseases

Score: 100

There is evidence that Kenya has the capacity to isolate patients with highly communicable diseases in a biocontainment patient care unit and/or patient isolation room or unit located within the country, but details are sparse. There is evidence of a respiratory infectious disease unit at Kenyatta National Hospital, but there is no explicit mention that this unit can isolate patients. ²⁸⁹ According to news reports, an isolation ward has been recently opened in Kenya for Kala-Azar disease, but the details of this ward are sparse. ²⁹⁰ According to a Kenya COVID-19 emergency response project document produced in 2020, money was allocated for "construction/renovations and equipping of Isolation rooms in all PoEs [ports of entry], isolation rooms in all 14 high risk counties, strengthening capacity of Kenyatta National Hospital Infectious Disease Unit, Mbagathi, Kenyatta University Teaching and Referral Hospital and Moi Teaching and Referral Hospital to manage infectious diseases", but there is insufficient evidence that these are in use. ²⁹¹

4.1.2c Demonstrated capacity / evidence of plan to expand isolation capacity

Score: 0

There is insufficient evidence that Kenya has expanded isolation capacity in response to an infectious disease outbreak in the past two years, or has tested a plan to do so. According to news reports from 2024, in response to the Monkeypox outbreak, the Ministry of Health had urged counties within Kenya to reopen their COVID-19 isolation centres, but there is no evidence that this has been implemented. ²⁹² There is no available information on the Ministry of Health or Kenya National Public Health Institute websites of example of capacity or testing of plans. ²⁹³²⁹⁴ There is evidence that Kenya has conducted a multisectoral Intra-Action Review with the WHO to respond to mpox, but there is no evidence that this has included scaling of isolation centres or testing of a specific plan. Establishment of case management units and isolation centres was demonstrated to be a weakness that needed priority implementation, but there is no evidence of a plan being developed to do so. ²⁹⁵

4.2.1a National procurement protocol for the acquisition of routine laboratory/medical supplies

Score: 100

There is evidence of a national procurement protocol in place, in the form of national legislation, which can be utilized by the Ministries of Health and Agriculture for the acquisition of laboratory supplies and medical supplies. According to section 67 of the 2017 Health Act, procurement of health supplies must be done in line with the Public Procurement and Disposal Act. ²⁹⁶ The rules for public procurement are set out in the Public Procurement and Disposal Act, revised in 2010. Article two states that the purpose of the act is to establish "procedures for procurement and the disposal of unserviceable, obsolete or surplus stores
and equipment by public entities", establishes the Public Procurement Oversight Authority, and sets out the rules for procurement and open tendering. ²⁹⁷ The primary mechanism by which the Ministry of Health acquires medical products is through the Kenya Medical Supplies Authority (KEMSA), which the KEMSA Act 2013 mandated KEMSA to provide medical supplies for prescribed "public health programs, the national strategic stock reserve, prescribed essential health packages and national referral hospitals". ²⁹⁸²⁹⁹ According to their website, the Veterinary Medicines Directorate (VMD) responsible for the "manufacture, importation, exportation, registration, distribution, prescription and dispensing of veterinary medicines and other animal health products in Kenya". The VMD reports directly to the Cabinet Secretary in charge of Livestock matters. ³⁰⁰³⁰¹

4.2.2a Stockpile of medical supplies for national use during a public health emergency

Score: 0

There is insufficient evidence of a stockpile of medical supplies for national use during a public health emergency. There is evidence of a strategy for stockpiles of medical supplies for national use during a public health emergency within the 2021 Kenya Public Health Emergency Supply Chain Framework produced by the Ministry of Health, but it is unclear what this stockpile contains or if it exists. According to page 19 of the Kenya Public Health Emergency Supply Chain Framework, a "national stockpile plan will be developed". Page 12 states that the "ESC does not plan to stockpile the bulk of identified commodities, but rather will utilize existing supply chains (KEMSA, MEDS)". ³⁰² According to section 4(1)(a) of the Kenya Medical Supplies Authority Act, the Kenya Medical Supplies Authority (KEMSA) will be responsible the national strategic stock reserve, which includes medical supplies, which is stated as including laboratory supplies. ³⁰³ According to the KEMSA website, KEMSA is "mandated to procure, warehouse and distribute Health Products and Technologies (HPTs) for… the national strategic stock reserves", but there is no explanation of what the stock reserves include. ³⁰⁴

4.2.2b Stockpile of laboratory supplies for national use during a public health emergency

Score: 0

There is insufficient evidence of a stockpile of laboratory supplies in Kenya for national use during a public health emergency. There is evidence of stockpiles of laboratory supplies being mandated by Kenyan law, but it is unclear what is contained within the stockpiles. According to section 4(1)(a) of the Kenya Medical Supplies Authority Act, the Kenya Medical Supplies Authority (KEMSA) will be responsible the national strategic stock reserve, which includes medical supplies, which is stated as including laboratory supplies. According to page 19 of the Kenya Public Health Emergency Supply Chain Framework, a "national stockpile plan will be developed" for response to disease. There is no mention of reagents in the document. ³⁰⁵ According to the KEMSA website, KEMSA is "mandated to procure, warehouse and distribute Health Products and Technologies (HPTs) for… the national strategic stock reserves", but there is no explanation of what the stock reserves include. ³⁰⁶

4.2.2c Annual review of national stockpile to ensure sufficient supply

Score: 0

There is insufficient evidence that Kenya conducts or requires an annual review of the national stockpile to ensure the supply is sufficient for a public health emergency. The Kenya Medical Supplies Authority Act makes no mention of an annual review. ³⁰⁷ No evidence of an annual review is available from the Kenya Medical Supplies Authority website. ³⁰⁸ There is evidence that reviews have taken place, but it is not clear that this is annual. The Kenya Medical Supplies Authority recently began a nationwide stocktake in July 2025 across all its warehouses, but there is no reference to this being annual. ³⁰⁹ There is no available information on the Ministry of Health or Kenya National Public Health Institute websites. ³¹⁰³¹¹

4.2.3a Plan/agreement to produce/procure medical supplies during a public health emergency

Score: 100

There is evidence of a plan to procure medical supplies for national use during a public health emergency. Section 2.4 of the 2021 Kenya Public Health Emergency Supply Chain Framework produced by the Ministry of Health lays out the plan for procurement of medical supplies for national use during a public health emergency. This includes commodity planning, procurement and warehouse storage. The plan makes no mention of expedition of medicines through points of entry, nor leveraging of manufacturing. ³¹² There is no mention of manufacturing or expedition of medicines within the Public Health Act, or on the websites of the Ministry of Health or Kenya National Public Health Institute. ³¹³³¹⁴

4.2.3b Plan/agreement to produce/procure lab supplies during a public health emergency

Score: 100

There is evidence of a plan to procure laboratory supplies for national use during a public health emergency, but not to manufacture or expedite them through points of entry. Section 2.4 of the 2021 Kenya Public Health Emergency Supply Chain Framework produced by the Ministry of Health lays out the plan for procurement of medical supplies for national use during a public health emergency. This includes commodity planning, procurement and warehouse storage. Section 3.2.1 specifically lists laboratory supplies as part of commodity planning. It makes no mention of manufacturing or expedition of laboratory supplies. ³¹⁵ There is no mention of manufacturing or expedition of laboratory supplies within the Public Health Act, or on the websites of the Ministry of Health or Kenya National Public Health Institute. ³¹⁶³¹⁷

4.2.3c Mechanism emergency logistics and supply chain management

Score: 100

There is evidence of an emergency plan for logistics and transport that includes cold storage and reviews of the system. Section 3.3 of the 2021 Kenya Public Health Emergency Supply Chain Framework produced by the Ministry of Health covers logistics and transport, and includes data on cold chain storage, and states that a "schedule of visits to these warehouses to determine their viability and verify that both the standard and the cold chain facilities are fully functional will be periodically done". The framework makes no mention of specific uses for cold-chain facilities, such as for vaccines specifically. It also states that this framework covers the public and private sectors, stating on page ix that the framework "provides evidence-based protocols for utilizing existing supply chains in the public health system as well as modalities for leveraging the private not-for-profit supply chains and engaging the private sector". ³¹⁸

4.3.1a Plan/program/guidelines for dispensing MCMs during a public health emergency

Score: 0

There is no available evidence of a plan, program, or guidelines in place for dispensing medical countermeasures (MCM) for national use during a public health emergency. According to the Joint External Evaluation for Kenya conducted in 2017 by the World Health Organization, there is the need for Kenya to develop "a framework to guide and support deployment of medical countermeasures and medical personnel during public health emergencies". ³¹⁹ A Joint External Evaluation was conducted for Kenya in 2024, but the report is yet to be published. ³²⁰ There is the Kenya Public Health Emergency Operations Centre Handbook and Strategy documents listed on the Kenya National Public Health Institute website, but these documents are not accessible. ³²¹ Neither the Disaster Risk Management Strategy 2025-2030 produced by the Ministry of Interior and National Administration, without a date of publication, nor the the Kenya National Emergency Response Plan produced in 2020 by the ACP-EU (African, Caribbean and Pacific Group of States – European Union) Natural Disaster Risk Reduction Program, mention medical countermeasures. ³²²³²³

4.3.2a Plan to receive foreign health personnel during a public health emergency

Score: 100

There is evidence of a plan to surge workforce in the case of a public health emergency in Kenya. According to the 2021 Kenya Public Health Emergency Operation Centre Standard Operating Procedures produced by the Ministry of Health, pages 15 to 18 set out the directives "to provide standard for selection, engagement and deployment for additional personnel for response". Under declaration of a public health emergency, the PHEOC manager calculates the human resource required "in terms of skills and expertise and advise the chairperson of the event specific taskforce on the human resource requirement". If further staff are needed, "the event specific taskforce chairperson will advise the Director General/ County Director of Health to request for surge staff locally or internationally based on identified gaps". ³²⁴

4.3.2b Plan to facilitate workforce surge in an emergency

Score: 0

There is insufficient evidence that Kenya could receive health personnel from other countries to respond to a public health emergency. According to the 2021 Kenya Public Health Emergency Operation Centre Standard Operating Procedures produced by the Ministry of Health, page 16 states that "[i]f additional staff is required, the event specific taskforce chairperson will advise the Director General/ County Director of Health to request for surge staff locally or internationally based on identified gaps", but it is not clear what this includes, and does not constitute a comprehensive plan. ³²⁵

4.3.2c Plan to redeploy existing health personnel within the country

Score: 0

There is insufficient evidence that Kenya could redeploy existing health personnel within the country to respond to a public health emergency. According to the 2021 Kenya Public Health Emergency Operation Centre Standard Operating Procedures produced by the Ministry of Health, page 16 states that "[i]f additional staff is required, the event specific taskforce chairperson will advise the Director General/ County Director of Health to request for surge staff locally or internationally based on identified gaps", but there is no information on what this would specifically include and does not constitute a comprehensive plan. ³²⁶

4.4.1a Constitutional guarantee of citizens’ right to medical care

Score: 75

The constitution of Kenya does explicitly guarantee citizens’ right to medical care. According to article 43 of the Constitution of Kenya, every citizen shall have the right "to the highest attainable standard of health, which includes the right to health care services, including reproductive health care" but does not state that it is free. ³²⁷

4.4.1b Access to skilled birth attendants (% of population)

Score: 83.82

4.4.1c Out-of-pocket health expenditures per capita, PPP (current international $)

Score: 92.27

4.4.1d Coverage of essential health services through universal health coverage

Score: 54.17

4.4.1e Total population pushed below a relative poverty line by household health expenditure (60% of media daily per capita consumption or income)

Score: 77.5

4.4.1f Rate of mortality amenable to health care

Score: 60.19

4.4.2a Guaranteed paid sick leave

Score: 66.67

There is evidence that guaranteed paid sick leave is available in Kenya. According to section 30(1) of the Employment Act, 2007, a worker is entitled to sick pay after working for an employer for two months of seven days full pay and then half pay thereafter for seven days, in each period of 12 consecutive months of work. The employment act makes no reference to mental health. ³²⁸

4.4.3a Government prioritisation of care for healthcare workers during response

Score: 0

There is no evidence of a specific legislation, a policy, or a public statement committing to provide prioritized healthcare services to healthcare workers who become sick as a result of responding to a public health emergency. No evidence is available on the websites of the Ministry of Health or Kenya National Public Health Institute. ³²⁹³³⁰ Kenya does have an Occupational Safety and Health Act, 2007, as well as Occupational Safety and Health Policy Guidelines for the Health Sector in Kenya 2014 produced by the Ministry of Health, but neither of these specifically mention prioritized healthcare services to healthcare workers. ³³¹³³²

4.5.1a Existence of system for communication during a public health emergency

Score: 100

There is evidence of a system in place for public health officials and healthcare workers to communicate during a public health emergency. According to pages 22-23 of the Kenya Public Health Emergency Operation Centre Standard Operations Procedures produced by the Ministry of Health in 2021, on witnessing a public health emergency, information will be communicated to the regional focal point and then upwards to the Public Health Emergency Operation Centre. A watchers team lead will "determine the severity of the incidence and determine communication urgency to the EOC manager", and the Public Health Emergency Operation Centre manager will then contact health workers dealing with the event via email, phone or text. ³³³

4.5.1b Inclusion of public and private sector in healthcare communication system

Score: 0

There is no evidence of a system for public health officials and healthcare workers to communicate during an emergency that encompass healthcare workers in both the public and private sector. The Kenya Public Health Emergency Operation Centre Standard Operations Procedures produced by the Ministry of Health in 2021 makes no mention of the private sector. ³³⁴ According to the website of the Kenya Healthcare Foundation, which is the Health Sector Board of the Kenya Private Sector Alliance (KEPSA), public private dialogue can help in cases of "[e]mergency Care and disaster response", but there is no evidence of a specific mechanism for doing this. ³³⁵ No information is available on the websites of the Ministry of Health or the Kenya National Public Health institute. ³³⁶³³⁷

4.6.1a Evidence of national public health system monitoring and tracking of HCAIs

Score: 100

There is evidence that the national public health system is monitoring and tracking the number of healthcare associated infections (HCAI) that take place in healthcare facilities, but it is not clear that this monitoring is accurate. According to page 9 of the National Guidelines on Healthcare Associated Infections Surveillance published by the Ministry of Health in 2023, the Ministry of Health has undertaken "a rigorous process to select five healthcare-associated infections (HAIs) to monitor nationally, ensuring effective surveillance and focused intervention strategies". On page three, it is stated the surveillance is insufficient. ³³⁸ There is academic research published in 2014, which shows that the Kenyan Ministry of Health, the Kenya Medical Research Institute, and the Centers for Disease Control and Prevention initiated surveillance research for respiratory HAIs at 3 hospitals in Kenya. ³³⁹

4.6.1b Infection prevention and control programme

Score: 100

There is evidence of an infection prevention and control programme in place nationally. Page iii of the Kenya National Infection Prevention and Control Policy for Health Care Services produced by the Ministry of Health in 2021, states that the document "lays down the policies required for the practice of a nationally acceptable standard of IPC [infection prevention and control] in health care settings". ³⁴⁰

4.6.1c National plan to ensure a safe environment in health facilities

Score: 100

There is evidence of a plan to ensure a safe environment in health facilities nationally in Kenya. The Kenya National Infection Prevention and Control Policy for Health Care Services produced by the Ministry of Health in 2021 is tasked with improving safety in healthcare facilities. This includes improving blood safety practices, safe injection practices, as well as safety in the workplace for healthcare workers, and reduction of hospital acquired infections. ³⁴¹ The draft Quality Healthcare and Patient Safety Bill, 2025, is also available on the Ministry of Health website, but it is not clear that this has become law. Section 13 states that everyone has the right to access quality healthcare services that are "safe and dignified as provided in this Act". Section 8(1) also states that "[e]very patient has the right to provision of healthcare services in a safe and accessible health facility". ³⁴² According to the National Guidelines on Healthcare Associated Infections Surveillance published by the Ministry of Health in 2023, there are specific procedures in place for surgical sterilisation, hand hygiene, and other specific risks to HAIs in healthcare settings. ³⁴³

4.7.1a Requirement for ethical review before beginning a clinical trial

Score: 100

There is a national requirement for ethical review before beginning a clinical trial in Kenya. According to section 4(3)(n) the Pharmacy and Poisons (Conduct of Clinical Trials) Rules, 2022 (No. 95), an application is required to have ethics committee approval before an application can be made to the Pharmacy and Poisons Board. Ethics approval must come from a scientific and ethical review committee of an institution which is accredited by the National Commission for Science, Technology and Innovation. ³⁴⁴

4.7.1b Expedited approval for clinical trials of unregistered MCMs during epidemics

Score: 100

There is evidence of an expedited process for approving clinical trials for unregistered medical countermeasures (MCM) or mutual recognition of clinical trial results taking place elsewhere to treat ongoing pandemics or epidemics in Kenya. According to the 2022 Guidelines for the conduct of clinical trials during public health emergencies and pandemics In Kenya produced by the Pharmacy and Poisons Board, page vii states that the Pharmacy and Poisons Board can "[a]approve the use of any unregistered medicinal substance for purposes of clinical trials and compassionate use", without mention of pandemics or epidemics. ³⁴⁵ The Scientific and Ethics Review Unit (SERU) of the the Kenya Medical Research Institute (KEMRI) can also expedite a review process "if it requires a faster than usual review due to a major public health concern e.g. an epidemic". ³⁴⁶

4.7.2a Existence of agency responsible for approving new human MCMs

Score: 100

There is a government agency responsible for approving new medical countermeasures (MCM) for humans in Kenya. According to their website, the Pharmacy and Poisons Board established by the Pharmacy and Poisons Act, Chapter 244, is responsible for the practice, manufacture and trade of drugs and poisons in Kenya. ³⁴⁷ According to the Pharmacy and Poisons Act, section 3 establishes the board and section 9(1) states that the board is responsible for requiring proper investigations of medicine before they can be registered in Kenya. ³⁴⁸

4.7.2b Expedited approval for human MCMs during public health emergencies

Score: 100

There is evidence of an expedited process for approving medical countermeasures (MCM) for human use and recognition of approval decisions taking place elsewhere during public health emergencies in Kenya. According to the 2022 Guidelines for the conduct of clinical trials during public health emergencies and pandemics In Kenya produced by the Pharmacy and Poisons Board, pages 17-18 state that for studies related to public health emergencies or pandemics, there will be a rapid review of ten days, in which there will be review of clinical trials carried out in multiple African countries. ³⁴⁹

5.1.1a Submission of IHR reports to the WHO in past year

Score: 100

Kenya has submitted an IHR Self-Assessment Annual Report (SPAR) to the WHO for the last calendar year, with the latest submission in 2024.³⁵⁰

5.1.2a Existence of specific risk reduction strategies for epidemics and pandemics

Score: 100

There is evidence that epidemics and pandemics are integrated into the national risk reduction strategy, and there is no evidence of a standalone national disaster risk reduction strategy just for epidemics and pandemics. Page two of the Disaster Risk Management Strategy 2025-2030 produced by the Ministry of Interior and National Administration, without a date of publication, designates pandemics as biological hazards and epidemics as hydro-meteorological hazards. ³⁵¹ Likewise, the Kenya National Emergency Response Plan produced in 2020 by the ACP-EU (African, Caribbean and Pacific Group of States – European Union) Natural Disaster Risk Reduction Program, listed on the website of the National Disaster Operations Centre website, does mention epidemics and pandemics, but does not address them specifically. ³⁵² There is no evidence of a standalone risk reduction strategy just for epidemics and pandemics on the Ministry of Health or the Kenya National Public Health Institute. ³⁵³³⁵⁴ The Joint External Evaluation (JEE) for Kenya, conducted in 2017 by the World Health Organization, makes no mention of a risk reduction strategy. ³⁵⁵ A Joint External Evaluation was conducted for Kenya in 2024, but the report is yet to be published. ³⁵⁶

5.2.1a Existence of public health emergency agreements with regional neighbors

Score: 100

There is evidence that Kenya has cross-border agreements with neighboring countries as part of a regional group with regards to public health emergencies, and there is evidence of implementation in relation to the recent Mpox outbreak. According to the Africa Centre for Disease Control and Prevention, in May 2025 Kenya is one of 12 countries that have joined together in collaboration to respond, prevent and control disease outbreaks, especially the recent monkeypox outbreaks. ³⁵⁷ There is no available evidence of implementation on the Ministry of Health or the Kenya National Public Health Institute. ³⁵⁸³⁵⁹ Kenya is a member of the East African Community (EAC), which has utilised its Rapidly Deployable Expert (RDE) Pool in response to the Mpox virus disease outbreak. ³⁶⁰ Kenya is also a member of the East African Community Pandemic Preparedness Project, implemented by the German government, "to improve the regional preparedness and response capacity", and there is evidence of this already being implemented. ³⁶¹³⁶² Kenya is also a member of the African Field Epidemiology Network (AFENET), the aims of which includes strengthening of emergency response preparedness. ³⁶³

5.2.1b Existence of animal health emergency agreements with regional neighbors

Score: 50

There is evidence that Kenya has cross-border agreements with neighboring countries regarding animal health emergencies. According to the Intergovernmental Authority on Development website, Ethiopia, Kenya, South Sudan and Uganda signed an agreement in 2024 to share animal disease information, which will facilitate collection and sharing of animal disease information. [1] There is no available evidence of implementation on the Ministry of Health, Kenya National Public Health Institute, or Intergovernmental Authority on Development websites. [2][3][4]. According to the Food and Agriculture Organization of the United Nations, a Memorandum of Understanding was established between Ethiopia, Kenya, South Sudan and Uganda, which will "formally establish a coordinated approach to animal health and sanitary issues". [5] Kenya is also a member of the Eastern Africa Regional Animal Health Network (RAHN), whose aim according to the IGAD (Intergovernmental Authority on Development] Centre for Pastoral Areas and Livestock Development (ICPALD) website, is to "to create a regional platform where CVOs [Chief Veterinary Officers] and epidemiologists share technical know-how and key data and information on animal diseases and zoonoses, an information used for wider use and understanding in the Great Horn of Africa (GHoA)". [6] The Eastern Africa Regional Animal Health Network does not have its own website, or evidence of implementation.

5.3.1a Biological and Toxin Weapons Convention status

Score: 100

Kenya does have signatory and ratification status to the Biological Weapons Convention. According to the United Nations Office for Disarmament Affairs, Kenya is a state party of the Biological Weapons Convention, and acceded in 1976. ³⁶⁴

5.3.1b Submission of CBMs to the Biological and Toxin Weapons Convention

Score: 100

There is evidence that Kenya has submitted confidence building measures for the Biological Weapons Convention in the past three years. According to the BWC Confidence Building Measures website of the United Nations, Kenya submitted a report in April 2025. ³⁶⁵

5.3.1c Submission of UNSCR 1540 reports

Score: 100

There is evidence that Kenya has provided United Nations Security Council Resolution (UNSCR) 1540 report to the Security Council Committee established pursuant to resolution 1540 (1540 Committee). According to the website of the 1540 Committee, Kenya provided its report in 2005, and its updated report in 2007. ³⁶⁶

5.3.1d Extent of UNSCR 1540 implementation on public health emergencies

Score: 25

5.3.2a Membership in global health security and/or biological weapons agreements

Score: 0

Kenya is not a member of the Global Partnership Against the Spread of Weapons and Materials of Mass Destruction (GP), the Australia Group (AG), or the Proliferation Security Initiative (PSI). ^367368369

5.4.1a Completion and publication of JEE (or GHSA pilot external assessment) report

Score: 100

There is evidence that Kenya has completed a Joint External Evaluation (JEE) in the last five years and the report is publicly available. Kenya completed a Joint External Evaluation organized by the National Public Health Institute (NPHI) in 2024. ³⁷⁰ The report is publicly available on the WHO website. ³⁷¹

5.4.2a Completion and publication of PVS report (past five years)

Score: 0

There is no evidence that Kenya has completed and published a Performance of Veterinary Services (PVS) assessment in the last five years. According to the World Organization for Animal Health website, the last evaluation that was published for Kenya was in 2019 and that was a follow-up to the 2011 evaluation. ³⁷² No evidence is publicly available on the Ministry of Health or Kenya National Public Health Institute websites. ³⁷³³⁷⁴ The Directorate of Veterinary Services does not have a locatable website. Kenya did host a National Bridging Workshop on the International Health Regulations (IHR) and the Performance of Veterinary Services (PVS) Pathway, but this does not constitute a full assessment. ³⁷⁵

5.4.2b Completion and publication of PVS gap analysis (past five years)

Score: 0

There is no evidence that Kenya has completed and published a Performance of Veterinary Services (PVS) gap analysis in the last five years. According to the World Organization for Animal Health website, the last gap analysis that was published for Kenya was in 2011. ³⁷⁶

5.5.1a Evidence of allocated national funds to improve capacity to address epidemic threats

Score: 0

There is insufficient evidence that Kenya has allocated national funds to improve capacity to address pandemic or epidemic threats within the past three years. According to Open Budget Kenya, the budget for disease surveillance and response the has risen to KES 309,519,852.00 (2,405,258 USD) in 2025, from KES 308,326,641.00 (2,395,986.29 USD) in 2024, and KES 47,330,671.00 (367b803.57 USD) ³⁷⁷. There is no evidence for these increases in official sources however. The State Department for Public Health and Professional Standards budget is referenced in Sector Working Group Report – Medium Term Expenditure Framework (MTEF) for the Period 2023/24-2025/26 produced by the Ministry of Health, but for which it is unclear when it was published. According to the page 283 of the report, spending for communicable diseases rose in the years from 2023/24 to 2024/25. ³⁷⁸ According to page 46 of the Medium Term Expenditure Framework Report (2025/26-2027/28), there is money allocated to a "Health Emergency Preparedness, Response and Resilience Program", but there is no explanation of what this contains, or that this represents an increase in financing. ³⁷⁹ According to an African Institute for Development Policy (AFIDEP) blog post from July 2025, the "budget allocated to health in Kenya persistently falls below the 15% target set by the Abuja Declaration with only 9.7% of the national budget to health in the FY2023/24. Within this budget, pandemic preparedness receives a disproportionately small share". ³⁸⁰

5.5.2a National budget to address gaps identified in JEE, NAPHS or GHSA roadmap

Score: 0

No specific funding commitment is mentioned in the latest publicly available Joint External Evaluation (JEE) report from 2025. ³⁸¹ According to the WHO website, no National Action Plan for Health Security (NAPHS) is available for Kenya. ³⁸² There is no evidence of a national GHSA roadmap for Kenya available on the GHSA website. ³⁸³

5.5.2b National budget to address gaps identified in PVS assessment or gap analysis

Score: 0

There is no evidence that Kenya has completed and published a Performance of Veterinary Services (PVS) gap analysis or analysis in the last five years. According to the World Organization for Animal Health website, the last gap analysis that was published for Kenya was in 2011 and the last evaluation follow-up was in 2019. ³⁸⁴

5.5.3a Emergency public financing during a public health emergency

Score: 100

There is evidence of a publicly identified special emergency public financing mechanism which Kenya can utilise in the face of a public health emergency. According to section 110 of the Public Finance Management Act, revised in 2022, "[a] County Executive Committee may, with the approval of the county assembly, establish an emergency fund…[t]he purpose of an Emergency Fund is to enable payments to be made in respect of a county when an urgent and unforeseen need for expenditure for which there is no specific legislative authority arises". ³⁸⁵ Kenya is also eligible for emergency finance from the International Development Association. ³⁸⁶

5.5.4a Commitments to improve domestic or foreign capacity for epidemic threats

Score: 100

There is evidence in Kenya that senior leaders, in the past three years, have made a public commitment for improving Kenya's domestic capacity to address its HIV epidemic by expanding financing and requesting support. According to the Ministry of Health website, in March 2025 Health Cabinet Secretary Dr. Deborah Mulongo Barasa assured stakeholders concerned with Kenya’s HIV response following disruptions to foreign funding, that the Ministry of Health was engaging the U.S. Government on the matter to mitigate disruptions. She also stated that strengthening domestic capabilities would ensure long-term resilience. ³⁸⁷

5.5.4b Investments to improve domestic or foreign capacity for epidemic threats

Score: 100

There is evidence that Kenya has received money from foreign donors in order to improve the country’s domestic capacity to address epidemic threats. According to the Global Fund website, in 2024, Kenya received six new grants worth US$407 million in order to combat AIDS, tuberculosis (TB) and malaria from the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) in conjunction with the government of the Republic of Kenya and other health partners. ³⁸⁸ According to its website, the Global Fund is based in Switzerland. ³⁸⁹

5.5.4c Evidence that the country has fulfilled its full WHO contribution within the past two years

Score: 100

There is evidence that Kenya has fulfilled its full contribution to the WHO within the past two years. According to the Status of collection of assessed contributions that is produced by the WHO annually, Kenya has no outstanding debts to the WHO. ³⁹⁰

5.6.1a Sharing of genetic/biological data and materials beyond influenza

Score: 0

There is no publicly available evidence of a plan or policy for Kenya to share genetic data, clinical specimens or isolated specimens beyond influenza with international entities. No such plan was found on the Ministry of Health or Kenya National Public Health Institute websites. ³⁹¹³⁹² The National Public Health Laboratory does not have its own website. There is no evidence of the Verification Research, Training and Information Centre database. ³⁹³ There is no evidence of a plan within the Joint External Evaluation for Kenya conducted in 2017 by the World Health Organization. ³⁹⁴ The Zoonotic Disease Unit does not have its own website. Kenya is a member of East African Community (EAC) One Stop Border Posts Act, 2016, created by several East African countries, section 22 of which states that participating countries shall "develop and implement comprehensive mandatory information and communications technology requirements at their common borders to enable seamless, reliable and effective data exchange of high integrity and appropriate format within and between the various agencies of the adjoining Partner States", but makes no mention of sharing genetic data, clinical specimens or isolated specimens. ³⁹⁵ Kenya is also a member of the East Africa Public Health Laboratory Network Project, a World Bank funded project whose aim is to "to establish a network of efficient, high quality, accessible public health laboratories for the diagnosis and surveillance of Tuberculosis and other communicable diseases". This includes the East African Integrated Disease Surveillance Network, but it is unclear whether this network includes sharing of genetic data, clinical specimens or isolated specimens. ³⁹⁶³⁹⁷ Kenya is also a member of the African Field Epidemiology Network (AFENET), but there is insufficient evidence of sharing of genetic data, clinical specimens or isolated specimens as part of this membership. ³⁹⁸

5.6.1b Evidence of non-compliance with sample sharing element of PIP framework

Score: 100

There is no publicly available evidence that Kenya has failed to share influenza virus samples in accordance with the WHO’s Pandemic Influenza Preparedness (PIP) Framework over the past two years. No evidence of any news of this was found on the WHO website. ³⁹⁹⁴⁰⁰ No evidence of was found on the Ministry of Health or Kenya National Public Health Institute websites. ⁴⁰¹⁴⁰²

5.6.1c Evidence of non-sharing of pandemic pathogen samples during an outbreak

Score: 100

There is no evidence that Kenya has not shared pandemic pathogen samples during an outbreak in the past two years. No evidence of any news of this was found on the WHO website. ⁴⁰³⁴⁰⁴ No evidence was found on the Ministry of Health or Kenya National Public Health Institute websites. ⁴⁰⁵⁴⁰⁶

6.1.1a Policy formation

Score: 75

6.1.1b Quality of bureaucracy

Score: 0

6.1.1c Excessive bureaucracy/red tape

Score: 25

6.1.1d Vested interests/cronyism

Score: 25

6.1.1e Corruption

Score: 32

6.1.1f Accountability of public officials

Score: 25

6.1.1g Human rights risk

Score: 25

6.1.2a Orderly transfers of power

Score: 50

6.1.3a Risk of social unrest

Score: 25

6.1.4a Risk of terrorism

Score: 50

6.1.4b Level of illicit arms flows within the country

Score: 50

6.1.4c Risk of organized criminal activity

Score: 25

6.1.5a Presence or risk of armed conflict

Score: 50

6.1.6a Government territorial control

Score: 100

6.1.7a International tensions

Score: 25

6.2.1a Adult literacy rate (15+ years old, both sexes)

Score: 87.11

6.2.2a UNDP Gender Inequality Index score

Score: 34.4

6.2.3a Poverty gap at $1.90 a day (2011 PPP) (%)

Score: 52.63

6.2.3b Share of employment in the informal sector

Score: 0

6.2.3c Coverage of social insurance programs (% of population)

Score: 0

6.2.4a Public confidence in government

Score: 0

6.2.5a Robust, open, diverse local media and reporting

Score: 100

6.2.6a Gini coefficient

Score: 61.3

6.3.1a Adequacy of road network

Score: 0

6.3.2a Adequacy of airports

Score: 25

6.3.3a Adequacy of power network

Score: 0

6.4.1a Urban population (% of total population)

Score: 80.45

6.4.2a Change in forest area (percentage points)

Score: 77

6.4.3a Natural disaster risk

Score: 50

6.5.1a Total life expectancy (years)

Score: 41.66

6.5.1b NCD mortality rate

Score: 84.99

6.5.1c Population aged 65+

Score: 91.2

6.5.1d Tobacco use (% of adults)

Score: 60.25

6.5.1e Level of adult obesity (%)

Score: 71.07

6.5.1f Age-standardised prevalence of mental health disorders (per 100 000 people)

Score: 69.47

6.5.2a Access to potable water

Score: 65.95

6.5.2b Access to at least basic sanitation facilities

Score: 40.92

6.5.2c Percentage of health-care facilities with no access to any electricity supply

Score: 81.25

6.5.3a Domestic general government health expenditure per capita (PPP)

Score: 9.84

6.5.4a Trust medical and health advice from the government

Score: 50

6.5.4b Trust medical and health advice from medical workers

Score: 100