Nairobi County has emerged as the biggest offender in a growing list of county governments that owe the Kenya Medical Supplies Authority (KEMSA) millions of shillings, threatening the agency’s ability to deliver essential medicines and medical supplies to public health facilities across the country.
According to a new report, county governments collectively owe KEMSA substantial amounts, with Nairobi leading the pack. The unpaid bills have pushed the medical supplies agency into a cash crunch, forcing delays in procurement and distribution of critical drugs to hospitals and dispensaries that millions of Kenyans depend on.
The Scale of the Problem
KEMSA has been struggling with mounting debts from county governments for years, but the situation has worsened considerably in recent months. The agency relies on payments from counties to maintain its supply chain, procure medicines from manufacturers, and keep warehouses stocked.
When counties fail to pay, the ripple effect is felt directly by patients who turn up at public hospitals only to find empty shelves. Health workers have repeatedly raised the alarm about drug shortages, particularly in rural areas where public facilities are the only option for many families.
Why Counties Are Not Paying
Several factors contribute to the payment delays. Some counties cite delayed disbursements from the national government through the equitable share allocation. Others point to competing budget priorities and competing demands on limited resources. However, health advocates argue that medical supplies should never be treated as an optional expenditure.
The Council of Governors has acknowledged the debt issue and promised to work on a payment plan, but progress has been slow. Meanwhile, KEMSA has warned that it may be forced to suspend supplies to the worst-affected counties if the situation does not improve.
Patients Pay the Price
The real victims of this funding crisis are ordinary Kenyans who cannot afford private healthcare. When public hospitals run out of essential drugs for conditions like malaria, diabetes, and hypertension, patients are forced to buy from private pharmacies at significantly higher prices — or simply go without treatment.
Health sector watchdogs are now calling on both levels of government to ring-fence health budgets and ensure timely payments to KEMSA before the crisis deepens further.
