Following funding cuts caused by donors withdrawing support from the Neglected Tropical Diseases (NTDs) Program, Amref Health Africa, in collaboration with End Fund and partners including WASH Alliance Kenya and Africa Institute of Health and Development, is strengthening county health systems. The initiative targets Bungoma, Kakamega, Vihiga, and Trans Nzoia counties to sustain program gains and mobilize domestic resources for NTD interventions.
Speaking during a multi-stakeholder workshop in Eldoret attended by county executives, assemblies, water and education representatives, and NGOs, KNPHI NTDs Program Manager Titus Watitu said, “The workshop emphasizes domestic resource mobilization by creating policies to sustain the gains achieved over five years in NTD elimination across the four western counties.”
Watitu explained that NTDs, a group of 21 diseases often linked to poor sanitation, contaminated water, and inadequate health education, remain a threat in several areas. “Nationally, we have eliminated two diseases—guinea worm in 2018 and human African trypanosomiasis last year—and we are on track to eliminate five more,” he said. He noted that schistosomiasis (bilharzia), soil-transmitted helminthiasis (STH), and snakebites remain prevalent in western Kenya.
“The successes in reducing NTD prevalence in Western Kenya are remarkable,” Watitu added. “With support from AMREF and End Fund, we have brought prevalence to sustainable levels. Counties must now take ownership through resource mobilization to achieve long-term impact.”
He highlighted variations in disease prevalence: “Along lake regions, schistosomiasis prevalence can reach 50 percent, whereas in Nairobi, Central, and parts of Western Kenya, prevalence is below one percent, consistent with WHO recommendations.”
Amref Health Africa Program Director Juma Chitiavi said, “We began work in 2021, first mapping the diseases in target regions, then implementing interventions to interrupt transmission.” He stressed mass drug administration (MDA) as a key strategy. “One of the silver bullets has been MDA for entire at-risk populations,” he noted.
Chitiavi also emphasized health education in schools and communities, advocacy for water and sanitation resource allocation, and rigorous monitoring through surveys. “When we began, intestinal worm prevalence was around 8 percent and bilharzia around 5 percent. Today, intestinal worms are at 5 percent and bilharzia below 1 percent,” he said.
He encouraged counties to integrate NTD interventions into primary healthcare networks, including Community Health Promoters, to sustain activities. “Health is a devolved function and a cornerstone of universal health coverage. Counties are best placed to continue these interventions,” Chitiavi added.
End Fund Head of Programs Irene Chami noted the importance of transition planning following donor exits. “USAID has pulled out, and previously the UK government. It is time to explore sustainable domestic resources for continued NTD program implementation,” she said.
Chami revealed that End Fund has invested $1.5–2 million (Sh195–260 million) per county since 2021. “We are working on a transition plan so that by 2027, counties will have the knowledge, skills, and systems needed to continue the program independently,” she added. She highlighted integration under Primary Health Care (PHC) and digitization via the Kenya Health Information System (KHIS) for data-driven planning.
County governments have pledged continued support. Trans Nzoia County CECM for Health and Sanitation Services Christopher Kerio Lorot said, “We have allocated Sh13.5 million this year and Sh15 million next year to continue deworming and public sensitization programs. We will not let down the achievements attained by our partners.”
Lorot highlighted progress: “Soil-transmitted helminthiasis has dropped from 6.9 percent to 3 percent, while bilharzia now stands at 0.5 percent.”
Bungoma Chief Officer for Health Dr. Magrina Mayama emphasized WASH activities such as handwashing, facewashing, and eliminating open defecation. “These measures are critical to preventing and managing NTDs by interrupting transmission routes and reducing risk factors,” she said.
Khainga Fanuel, Vihiga County NTD Program Head, noted the importance of community engagement and training to maintain low prevalence levels. Kakamega County Health Director William Olaka reported high prevalence in some areas, underscoring the need for intensified MDA and school-based deworming.
Olaka explained, “We are addressing funding gaps through facility improvement funds. Thirty percent of funds collected are channeled to purchase commodities for NTD interventions. Our over 4,000 CHPs distribute drugs during household visits.”
According to WHO guidelines, control strategies for schistosomiasis and related intestinal worms include preventive chemotherapy via mass drug administration with praziquantel for schistosomiasis and albendazole or mebendazole for soil-transmitted helminths. Multi-pronged approaches aim to reduce morbidity, prevent reinfection, and achieve elimination by 2030.
Watitu concluded, “Counties must now take ownership to ensure sustainable NTD elimination, leveraging the health systems strengthened over the past five years.” Chami added, “By 2027, counties will have the knowledge, expertise, and systems to continue independently, ensuring continuity and improved health outcomes for their populations.”
by Ekuwam Sylvester
