Kenya used the opening of the 2026 HIV Coverage, Quality and Impact Network (CQUIN) High-Level Meeting in Nairobi to set out an unambiguous new direction for its HIV response: integrate it into the broader health system, fund it more from domestic resources, and protect hard-won gains from the growing pressure of donor funding cuts. Medical Services Principal Secretary Dr Ouma Oluga — representing Health Cabinet Secretary Aden Duale — told the more than 260 delegates from over 20 countries that Kenya is edging closer to the UNAIDS 95-95-95 targets, with roughly 1.4 million people living with HIV, but that the fragility of those gains demands a decisive shift away from vertical, siloed HIV programmes toward integrated, people-centred care. The summit landed at a particularly consequential moment: Kenya is absorbing the aftershocks of the Trump administration’s cuts and restructurings at USAID and PEPFAR, even as it rolls out the long-acting HIV prevention injectable Lenacapavir, the UNAIDS Global AIDS Strategy 2026–2031 gets underway, and the country seeks to embed HIV within its Universal Health Coverage reforms.
Key Overview
- Kenya has around 1.4 million people living with HIV and is approaching the UNAIDS 95-95-95 cascade of testing, treatment and viral suppression targets.
- PS Ouma Oluga called for a shift “beyond vertical HIV programmes” toward integrated, people-centred care aligned with maternal and child health, tuberculosis and non-communicable diseases.
- The CQUIN High-Level Meeting brought together more than 260 delegates from over 20 countries, operating as a multi-country learning network hosted by ICAP at Columbia University.
- Kenya has recorded 98% of those testing positive linked to care, a 83% drop in new infections and a 65% reduction in AIDS-related deaths over the past decade.
- Domestic ownership and sustainable financing are being prioritised as PEPFAR and other donor flows contract following 2025 executive orders and a proposed $1.9 billion cut to the FY2026 PEPFAR budget.
- Kenya launched the long-acting HIV prevention injectable Lenacapavir in February 2026, targeting 15 high-burden counties with an initial 21,000 doses.
- The government is pursuing Universal Health Coverage reforms intended to improve financing, workforce capacity and service delivery while reducing reliance on external funding.
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A Summit Framed by Both Progress and Pressure
The 2026 HIV Coverage, Quality and Impact Network (CQUIN) High-Level Meeting opened in Nairobi with Kenya’s government using the stage to restate a clear message to the global HIV community: the country is still on track, but the rules of the game have changed. Addressing more than 260 delegates from over 20 countries, Medical Services Principal Secretary Dr Ouma Oluga — representing Health Cabinet Secretary Aden Duale — said Kenya remains committed to ending AIDS as a public health threat by 2030 but that the path there requires a strategic shift toward integrated, sustainable and domestically driven health systems.
“We must move beyond vertical HIV programmes and embrace integrated, people-centred care that responds to broader health needs,” Oluga told the delegates. Speaking on behalf of the country’s more than 1.4 million people living with HIV, he framed Kenya’s progress as real but fragile, edging closer to the UNAIDS 95-95-95 targets — 95 percent of people living with HIV knowing their status, 95 percent of those diagnosed on antiretroviral therapy, and 95 percent of those on treatment achieving viral suppression.
The summit is hosted under the auspices of the HIV Coverage, Quality and Impact Network, known as CQUIN, which was launched in 2017 withGates Foundation support as a multi-country learning network for differentiated service delivery in HIV. Operated by ICAP at Columbia University, CQUIN has grown to 21 member countries across sub-Saharan Africa, each represented in Nairobi this week alongside development partners including the US Government, PEPFAR and the Bill & Melinda Gates Foundation.
Kenya’s Progress — In Numbers
Kenya’s numbers are, by most measures, a public-health success story. In announcing the country’s new Public Service Workplace Policy on HIV/AIDS and Other Syndemic Diseases in September 2025, the Ministry of Health reported that 98 percent of those testing positive are linked to care, that new infections are down 83 percent from their peak, and that AIDS-related deaths have fallen by 65 percent over the past decade.
Those figures are the backdrop to Oluga’s argument. Kenya has built one of Africa’s most robust HIV service delivery systems in record time, and the question now is no longer whether more infrastructure needs to be created from scratch but whether the existing HIV platform can carry a broader public-health load.
Integration: The New Operating Model
Oluga’s integration argument was both philosophical and operational. He emphasised the importance of aligning HIV services with other critical health areas — maternal and child health, tuberculosis, and non-communicable diseases — and revealed that Kenya is already integrating HIV services across community, primary and referral healthcare levels to enhance efficiency, continuity and dignity of care.
This is not a new direction. Kenya’s Ministry of Health held a Health Integration Summit in Mombasa in mid-March 2026, where officials argued that the country must sustain gains in the fight against HIV/AIDS while responding to emerging challenges, including shifting global health financing and the need to embed HIV services inside the wider health system. The CQUIN summit is, in effect, the regional version of that conversation.
The investments Kenya has already made through HIV programmes, Oluga argued, should now function as the backbone of a broader system. Laboratory systems, data infrastructure and community health platforms built under HIV funding should be leveraged to strengthen the rest of the health system. “These investments must serve as a foundation for a resilient and responsive healthcare system that meets the needs of all Kenyans,” he said.
The approach is explicitly tied to the country’s Universal Health Coverage reforms, which Oluga said are designed to improve healthcare financing, strengthen the workforce, enhance service delivery and reduce reliance on external funding.
The Donor Backdrop: PEPFAR Under Pressure
Behind the rhetoric of integration and domestic ownership is an unmistakable funding squeeze. In January 2025, President Donald Trump signed an executive order pausing US foreign assistance for a 90-day review, followed by stop-work orders that froze almost all US global health funding. Kenya was among the hardest-hit countries, with approximately 41,500 health workers — around 18 percent of the country’s estimated total health care workforce — supported through US funding, many of whom suddenly faced layoffs.
The President’s Emergency Plan for AIDS Relief (PEPFAR), the single largest donor programme to Kenya’s HIV response, saw its scope of work dramatically reduced from January 2025 onward. The Trump administration’s FY2026 budget request included a proposed $1.9 billion cut to PEPFAR, taking the programme from roughly $4.85 billion in bilateral funding to $2.9 billion. Although Congress subsequently appropriated close to $6 billion for global HIV/AIDS work — funding PEPFAR at nearly the previous fiscal year’s level — NPR reporting this month found that the State Department is deliberately withholding some of the funds, putting key HIV efforts the administration itself has deemed “lifesaving” at risk of shutting down.
In Kenya specifically, the effects were swift. CNN reported that World Vision’s large PEPFAR programme in Kenya had been outright terminated, while community-based drop-in centres for HIV monitoring and prevention were suspended abruptly, some antiretroviral therapy clinics closed temporarily, and peer support services for key populations were halted.
The impact is not hypothetical. A modelling study in The Lancet estimated that the PEPFAR funding freeze, applied across seven sub-Saharan African countries including Kenya, would increase HIV deaths and new infections materially if implementation shortfalls persisted. Kenya’s own parliament responded in February by backing a Sh280 million budget request to plug HIV funding gaps amid the donor cuts, though Medical Services PS Oluga told the Departmental Committee on Health that discussions on external financing remained unresolved at the time.
In December 2025, UNAIDS and Kenya did secure a new bilateral agreement with the US under which Washington committed up to US$1.6 billion over five years to support technical assistance, capacity building and financial resources for Kenya’s HIV response. The signing, by US Secretary of State Marco Rubio and President William Ruto, was framed by UNAIDS as a renewed demonstration of solidarity and co-investment aligned with the 95-95-95 targets and the goal of reducing new HIV infections and AIDS-related deaths by 90 percent by 2030 compared to 2010 levels.
But even with that agreement, Kenya’s overall donor envelope is smaller and more conditional than it was a year ago. That is precisely why the rhetoric in Nairobi this week is shifting so visibly toward domestic mobilisation.
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Innovation: Lenacapavir and the New Prevention Frontier
The donor conversation is also happening against the backdrop of the biggest HIV prevention innovation in years. In late February 2026, Kenya launched the long-acting HIV prevention injectable Lenacapavir at Riruta Health Centre in Nairobi, becoming one of the first African nations to roll out the twice-yearly injection alongside South Africa, Uganda, Nigeria and others.
The Ministry of Health’s initial rollout targets 152 health facilities across 15 high-burden counties, following a phased approach. Kenya received an initial consignment of 21,000 starter doses delivered through its partnership with the Global Fund, with a further 12,000 continuation doses expected by April and another 25,000 doses earmarked from the US government. The drug — shown in trials to be at least 96 percent effective in preventing HIV — has been endorsed by the World Health Organization and registered in Kenya by the Pharmacy and Poisons Board in January 2026.
Lenacapavir matters for Kenya’s 2030 target for a simple reason: compliance. Daily oral pre-exposure prophylaxis (PrEP) has been available for years but adherence has been patchy, particularly among the populations most at risk. A twice-yearly injection removes that barrier. UNAIDS has gone further, warning that for Lenacapavir to actually bend the epidemiological curve, it will need to be paired with large-scale generic manufacturing, especially on the African continent, and transparent pricing that enables widespread uptake in low- and middle-income countries.
Equity, Stigma and Key Populations
Beyond the macro questions of money and innovation, Oluga used the Nairobi summit to sharpen a point that is sometimes obscured in headline statistics. He called for a renewed focus on equity, urging stakeholders to address stigma, discrimination and persistent barriers to access, particularly among adolescents, young women and key populations.
That emphasis is consistent with the government’s public positioning. At a November 2025 Leadership Dialogue Meeting for Adolescents and Young People Living with HIV held at the Kenya Medical Training College, Oluga said young people are not just the future but key partners in decisions that influence their health and wellbeing, and singled out mental health, gender-based violence and sexual and reproductive health as intersecting issues that cannot be separated from HIV outcomes.
The UNAIDS Global AIDS Strategy 2026–2031 — which will guide the global response over the next five years and will inform the UN General Assembly High-Level Meeting on AIDS and the Political Declaration on HIV/AIDS in 2026 — keeps the 95-95-95 cascade at its core, alongside a 90 percent reduction in new infections and AIDS-related deaths by 2030 compared to 2010 levels. Crucially, the Strategy also flags the full integration of HIV responses, including linkages to tuberculosis and viral hepatitis within resilient national, subnational and community health and social systems — the same integration logic Kenya’s ministry is championing at home.
Who Was in the Room
The CQUIN summit drew a broad constellation of stakeholders beyond Oluga. Dr Andrew Mulwa, Head of Kenya’s National AIDS and STI Control Programme, represented the country’s technical leadership. Development partners in attendance included representatives of the United States Government, the Bill & Melinda Gates Foundation, the Global Fund, UNAIDS and ICAP at Columbia University.
ICAP itself has been a particularly close partner to Kenya’s HIV architecture. Its Kenya country programmes are led by Doris Naitore, who helped design and implement Kenya’s first comprehensive HIV programme in 2002 — laying the groundwork for subsequent national efforts — and the CQUIN network is complemented by the HIV Impact Network for Vertical Transmission Elimination (HIVE), a Gates Foundation-funded project that partners with Kenya, Mozambique, Nigeria, South Africa, Tanzania and Zambia to reduce mother-to-child transmission of HIV.
What to Watch Between Now and 2030
Three threads will shape whether Kenya actually delivers on its 2030 commitment. First, domestic financing: whether the Social Health Authority, Universal Health Coverage reforms and broader tax-financed healthcare architecture can absorb a rising share of the HIV bill as external support evolves. Second, integration execution: whether ministries, county governments, primary health centres and community platforms can actually blend HIV, TB, maternal health and NCD services into one coherent clinical offering rather than stack parallel vertical programmes. Third, innovation scale-up: whether Lenacapavir and similar long-acting therapies can reach the populations — adolescents, young women, men who have sex with men, sex workers, people who inject drugs — where Kenya’s remaining transmission gap is concentrated.
None of those threads are guaranteed. All of them are within reach. And that, in effect, is the argument Kenya is making in Nairobi this week: the tools exist, the evidence exists, and the political will — at least at the ministerial level — exists too. What needs to change is the model of delivery and the source of the money. As Oluga told delegates, the commitment to ending AIDS as a public health threat by 2030 is intact, but only if the country, its partners and its donors are willing to let the next phase of the response look genuinely different from the last.
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