Experts say Kenya's Ebola response faces gaps in healthcare system

Despite government assurances that Kenya is prepared to handle an Ebola outbreak, health experts warn that the country’s isolation and treatment systems remain largely inadequate, with gaps in training, laboratory capacity, and infection control infrastructure.

This comes at a time when the Ministry of Health is rolling out 23 proposed Ebola isolation and treatment facilities across the country, including in Laikipia County, as part of a national preparedness and response framework.

Health Cabinet Secretary Aden Duale told Parliament on Wednesday that the facilities are being developed under a coordinated strategy involving Kenya and international partners, including the United States.

Duale defended the initiative, saying the designation of isolation centres is guided strictly by scientific and legal considerations.

“Every county where we are setting isolation quarantine treatment centres, they are based on science and the law, and it’s done by experts who are Kenyans,” he said.

He clarified that the isolation units are deliberately located away from the main hospital wards to reduce transmission risks.

“Isolation centres are not part and parcel of the hospital where citizens access other services,” he said, emphasising that Kenya’s approach follows global infectious disease control standards.

However, virologists and infectious disease experts warn that Kenya is still far from meeting the minimum requirements for safe Ebola management.

Ameyo Daglus an International vaccinologist, said that while Kenya has made progress in surveillance and policy development, critical gaps remain in laboratory readiness, staff training, and facility certification.

“Ebola preparedness requires highly specialised systems, including Biosafety Level 3 (BSL-3) laboratories for testing. Kenya currently has only a few such facilities, mainly in Nairobi and Kisumu,” said Ameyo.  

He further explained that isolation centres must meet strict requirements, including negative pressure rooms, HEPA filtration systems, and strict waste disposal mechanisms to prevent contamination.

“The gowns, spacing between patients, and how waste is handled are all critical. Samples must also be transported safely to BSL-3 labs, and that is a major challenge,” he said.

He warned that without proper systems in place, isolation facilities could themselves become sources of infection if protocols are not strictly followed.

“If biosafety procedures are not followed, the facility can become a transmission point. Even recovered patients can carry the virus in bodily fluids for months,” he said.

Beyond infrastructure, experts also point to gaps in human resource preparedness. They argue that many health workers have not undergone specialised training for handling highly infectious diseases such as Ebola.

“There is no evidence of comprehensive retraining of health personnel for Ebola response. You cannot assume doctors trained for routine care are automatically ready for outbreak management,” the expert noted.

The Ministry of Health has maintained that surveillance teams are being deployed and that mapping of border points and high-risk areas is ongoing. However, experts argue that surveillance alone is insufficient without fully functional treatment and laboratory systems.

Infection prevention and control (IPC) measures, they say, are central to Ebola response. These include strict patient isolation, use of protective equipment, controlled movement within facilities, and safe decontamination of all waste.

The design of Ebola treatment units, according to global standards, requires complete separation from general hospital services, with restricted access limited only to trained personnel. Facilities must also ensure secure disposal of infectious waste and continuous monitoring of air filtration systems.

Experts further stress that laboratory confirmation of Ebola cases must be done in certified BSL-3 facilities using polymerase chain reaction (PCR) technology, which allows rapid and accurate detection of the virus.

However, Kenya’s limited number of advanced laboratories raises concerns about delays in diagnosis and sample handling, increasing the risk of exposure during transportation.

The discussion comes amid public concern in several counties where isolation centres are being set up. In Nanyuki, residents protested on Monday the establishment of such facilities, fearing possible exposure.

Health experts, however, say proper isolation units should pose no risk to surrounding communities if correctly designed and fully contained. Such facilities must be located away from densely populated areas, schools, and water systems, with strict access control and environmental safety checks.

“What is missing in many cases is transparency,” the vaccinologist said. “The public needs clear documentation showing how these facilities are designed to prevent any risk.”

He added that public trust is essential in outbreak preparedness, warning that misinformation thrives when governments fail to communicate clearly.

“The government must be open. Trust is built through transparency and evidence, not reassurance alone,” he said.

The Democratic Republic of Congo and Uganda are battling the rare Bundibugyo strain of the Ebola virus in an outbreak that has so far killed 48 people and been declared a public health emergency of international concern by the WHO. The outbreak is outpacing the global response, which got off to a late start.