President Ruto Calls for Community-Led Health Systems at UN Assembly

Kenyan President William Ruto has called for a shift towards community-led health systems, urging countries to reduce reliance on foreign aid and strengthen domestic ownership of healthcare.

Speaking at the 80th United Nations General Assembly in New York, President Ruto warned that declining international health funding is exposing deep vulnerabilities in national health systems. He highlighted the importance of involving communities in decision-making, budget oversight, and local resource mobilisation to build more resilient and sustainable healthcare structures.

Kenya’s recent efforts to achieve Universal Health Coverage (UHC) reflect this approach. In 2023, the country passed several key health laws, including the Primary Health Care Act, the Social Health Insurance Act, the Facilities Improvement Financing Act, and the Digital Health Act. 

These laws aim to guarantee access to healthcare for all citizens. However, the rollout of the Social Health Authority has faced ongoing operational difficulties, particularly in coordinating with healthcare providers.

Despite these domestic challenges, President Ruto continues to advocate for international reforms that place citizens at the centre of health governance. He expressed support for recent World Health Assembly resolutions on Social Participation (2024) and Social Connection (2025), which seek to establish inclusive decision-making processes across all levels of healthcare policy. 

“The health of nations depends not only on the strength of their hospitals, but also on the strength of their citizens’ voices,” he said.

Ruto stressed that effective laws must be implemented with transparency and accountability, arguing that genuine progress requires direct citizen involvement in both policymaking and resource tracking. He said this approach can help align healthcare systems with the actual needs of the population and build greater public trust.

The push for community-led models comes as global health funding faces significant pressure. According to the Institute for Health Metrics and Evaluation, development assistance for health declined by 21 percent between 2024 and 2025, the largest drop in 15 years.

At the same assembly, the Bill & Melinda Gates Foundation pledged $912 million to the Global Fund for its 2026–2028 replenishment cycle. The funding will support efforts to combat HIV/AIDS, tuberculosis, and malaria. 

Co-chair Bill Gates described the current period as a “critical juncture” for global health, warning that millions of lives remain at risk without urgent action. With donor support becoming less reliable, Ruto’s remarks underscore a growing recognition that lasting health improvements must come from within. 

He called for a future in which no community is excluded from health decision-making and no citizen is denied access to care.