Calls grow for accountability as Kenya mobilises billions for Ebola response

As scientists and the Ministry of Health race to contain Ebola, concerns are growing over accountability for the resources being mobilised  for the response.

The Covid-19 pandemic, which struck Kenya in 2020, remains a painful reminder of the misuse of public funds, with individuals making fortunes from emergency procurement as the country battled a deadly health crisis. During the pandemic, individuals milked public coffers dry, turning themselves into ‘Covid-19 billionaires’.

With the possibility of an Ebola outbreak, health professionals, economists, civil society organisations and political leaders are warning that billions being mobilised to contain the disease must not become another opportunity for corruption, inflated tenders and questionable expenditure.

The concerns come as the Government seeks to mobilise more than Sh70 billion for Ebola preparedness and response. Civil society organisations are also calling for safeguards to prevent the misuse of funds.

KELIN Executive Director Allan Maleche said organisations were considering issuing a joint advisory to the Ethics and Anti-Corruption Commission, Parliament, the Auditor-General and the Ministry of Health to strengthen oversight of the response.

“We learnt difficult lessons from Covid-19, and we cannot afford to repeat the same mistakes. Our call is for transparency, proper oversight and accountability from the outset, rather than waiting for funds to be misused before action is taken,” said Maleche.

Former Chief Justice David Maraga has also warned against a repeat of the Covid-19 experience.

“Let us not repeat the mistakes of the Covid-19 pandemic as we handle the first imported Ebola. Certainly, let us not have ‘Ebola billionaires’ out of this unfortunate crisis,” said Maraga.

The Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) said the history of emergency procurement had left health workers and Kenyans deeply suspicious of how public funds would be managed.

“There are people already smiling and waiting for the worst part of it to benefit,” said KMPDU Deputy Secretary-General Dr Dennis Miskellah.

“We have every right to be fearful about our tendering and procurement processes because there is very little trust in the Government. We have not forgotten that, in the middle of a tragic pandemic, individuals benefited and we ended up with Covid-19 billionaires.”

Miskellah said it would be unacceptable for the Ebola response to create another class of beneficiaries while health workers and the public bear the consequences of a poorly managed emergency.

“They smiled all the way to the bank as we cried to the grave,” he said.

He warned that emergency funding could be undermined by inflated prices for personal protective equipment (PPE), medicines and other supplies, as well as tenders awarded to politically connected individuals and the purchase of substandard commodities.

His concern is that money could be released in the name of preparedness without translating into practical measures to contain an outbreak.

Miskellah wants resources directed towards properly equipped isolation centres, the recruitment and training of health workers, public education and support for people who cannot afford the cost of seeking care.

He also urged development partners to consider providing essential commodities or conditional grants instead of releasing unrestricted cash. Direct support for clearly defined needs, he argued, could reduce opportunities for misuse.

“You can play games anywhere, but not in the middle of a tragedy like this one,” he said.

The warning comes as the Government and its partners mobilise resources for preparedness, surveillance, contact tracing, isolation and treatment.

Figures circulating around the response include a preliminary Sh2.6 billion risk-mitigation requirement, alongside much larger sums linked to anticipated international support and emergency financing.

However, the figures relate to different funding arrangements and stages. The amounts required, pledged, approved, received and actually spent must be distinguished to establish the true size of the response budget.

That distinction is critical because announcing billions in support does not automatically mean the money is available to health facilities or that it has been spent on the intended interventions.

Public Health Officers Union Secretary-General Brown Ashira said officials responsible for the response must ensure that spending is tied to clearly identified needs.

“The responsibility lies with the PS and the CS. They must ensure that money is spent on what is required,” he said.

Ashira said the Government must prioritise protective equipment, disinfectants and training for personnel involved in the response. Procurement should be transparent and competitively advertised to reduce the risk of favouritism and bribery.

“We don't want to open a can of worms of people bribing,” he said.

He warned that poorly planned preparedness could leave health workers exposed even when money had been allocated.

“If we leave it like an open market, we expose health workers to a time bomb,” he said.

Ashira also questioned whether the available resources were sufficient for the scale of preparedness required, warning against a system that depends heavily on donors without a clear and sustainable domestic financing framework.

“Money is lost when we have no clear budgets. You can have money without a framework on how to spend it,” he said.

He called for compliance with the Public Finance Management Act, saying expenditure should be guided by clear budgets, procurement procedures and accountability mechanisms.

The call reflects a broader concern that emergency procurement can create opportunities for irregular spending when institutions are under pressure to act quickly and ordinary scrutiny is weakened.

During Covid-19, the Kenya Medical Supplies Authority (KEMSA) came under intense scrutiny over the purchase of medical supplies.

A special audit report considered by Parliament's Public Investments Committee found that the agency spent Sh8.39 billion on Covid-related items and issued commitment letters worth Sh7.7 billion against an approved budget of Sh4.66 billion.

The audit also raised concerns about supplies procured without an approved budget, the absence of market surveys and the use of suppliers who had not been prequalified.

The revelations triggered public outrage and investigations into procurement at the agency. Years later, questions remain over whether those responsible for the alleged irregularities have been held accountable.

With KEMSA still serving as the Government's medical supplies procurement agency, experts say the priority is to ensure that emergency procedures do not become a licence to bypass controls.

KEMSA Chief Executive Officer Dr Waqo Ejersa said the authority had learnt lessons from the Covid-19 experience and strengthened its digital systems to improve visibility across the medical supply chain.

“We are on high alert because of the bad experiences that happened during the Covid-19 response,” he said.

Ejersa said KEMSA's enterprise resource planning system integrates procurement, warehousing, distribution and financial management.

The authority also uses electronic locks to track consignments and an Electronic Proof of Delivery (EPD) system that captures photographs of goods delivered to health facilities.

These systems are intended to make it easier to track stock, monitor expiry dates, identify discrepancies and establish whether supplies have reached their intended destinations.

The authority said open tendering remained the standard approach and that procurement processes had become largely digital.

KEMSA had also developed standard operating procedures for emergency procurement, which Ejersa said would reduce confusion when urgent supplies were needed.

“A lot of problems during Covid-19 were because of a lot of restructuring of procurement. Now we have guidance on emergency procurement,” he said.

The changes allow the authority and other stakeholders to track supplies through the system and audit transactions when necessary.

“Kenyans should have confidence that whatever moves through our supply chain, procurement, warehousing and distribution by government, partners or anybody else, should be visible, traceable and auditable at any time,” he said.

Kenya has received consignments of PPE and other health commodities to support its Ebola response. The assistance has come from various partners, including the World Health Organisation (WHO), China and India.

On Friday, Public Health Principal Secretary Mary Muthoni announced the distribution of Ebola-related commodities valued at Sh171 million. The consignment includes laboratory equipment and protective gear.

According to Muthoni, the commodities are to be distributed to areas considered to be at high risk of Ebola transmission.

Emmanuel Wa-Kyendo, a programme officer at the Institute of Economic Affairs Kenya, said epidemic preparedness should be understood as a public investment rather than an expense that governments can postpone until a crisis emerges.

He said preparedness requires functioning disease surveillance, trained personnel, protective equipment, essential supplies and facilities capable of responding when cases rise.

Detecting a disease early is of little value if hospitals lack the capacity to isolate and treat patients safely.

“Preparedness is not just about having surveillance. When you detect a disease, you must ask whether you have the capacity to respond,” he said.

Wa-Kyendo said governments often underinvest in preparedness because its benefits are not immediately visible and are shared across the population.

The cost of neglect, however, can be enormous when an outbreak overwhelms health services, disrupts economic activity and forces governments to spend under pressure, he said.

“Pandemics are rare, but severe when they happen. They can cause more than $60 billion in losses annually, while a global pandemic can cost about five per cent of global GDP,” he said.

“We need to mobilise money to avoid getting into disaster.”

The economist cited estimates of the resources required to strengthen preparedness under international health frameworks. He said Kenya needed to assess the gap between its preparedness ambitions and the funding available.

Amid these efforts, the Ministry of Health has faced criticism over what some describe as an excessive emphasis on a United States-supported Ebola isolation facility at Laikipia Air Base.

Maraga argued that the country must be clear about its level of preparedness and the risks facing communities.

“When our brothers and sisters demonstrated in Nanyuki, we were given assurances that everything was under control, and that nobody was going to die,” he said.

“They said all measures had been taken to make sure that the disease doesn't spread here.”

The presidential hopeful also raised concerns over uncertainty about the number of people infected or exposed as contact-tracing and isolation efforts continue. He urged authorities to take appropriate action to prevent further deaths.