SHA takes centre stage in Ruto’s UNGA health agenda

By  Angela Oketch

Content Lead Health and Science

Nation Media Group

In NEW YORK, UNGA

President William Ruto used a meeting with the Kenyan diaspora in New York on Sunday evening to mount his most direct defence yet of the Social Health Authority (SHA), telling Kenyans abroad to disregard what he called deliberate misrepresentation of the programme's record.

"The defunct National Health Insurance Fund had between six and seven million registered members. But SHA has registered 33 million Kenyans since October 2024," Ruto told the gathering. "I want to say without fear of contradiction that through SHA, we have transformed the delivery of health in Kenya."

But SHA's registration numbers sit at the centre of an ongoing dispute between the authority and the hospitals it depends on to deliver care to those 33 million Kenyans.

Private hospital associations have raised formal objections to SHA's new 2026 to 2029 contracting terms. They object to a clause stating that the authority's obligation to pay is conditional on available funding, that no interest accrues on delayed payments, and that there is no enforceable guarantee that repayable debt, rather than a cost, will be absorbed by the hospital.

Ruto's call for Kenyans to judge SHA by its enrolment figures rather than by social media criticism sidesteps a question hospitals are asking in writing: whether registration numbers mean anything if the system behind them cannot reliably pay for the care it has promised.

The remarks came during a diaspora engagement at 30 Hudson Yards, where Ruto also witnessed the signing of a joint Declaration of Intent between the Kenyan government, the United Nations and Equity Group Holdings. The event also saw the unveiling of the Kenya Diaspora Impact Platform, a digital platform meant to channel diaspora investment into sectors including health, housing and agriculture back home.

SHA CEO Dr Mercy Mwangangi was on hand, alongside Housing Principal Secretary Charles Hinga, walking diaspora members through how the health financing programme and the affordable housing initiative are structured — an appeal for confidence in SHA's future even as its present terms are contested by the very providers who deliver its care.

Ruto is scheduled to deliver Kenya's main address to the General Assembly on Tuesday and is expected to attend a Global Health Summit on Friday. Both engagements are likely to offer a fuller picture of where health financing and SHA sit within his UNGA81 agenda.

Beyond health, Ruto defended his administration's broader economic record at the diaspora event. He cited growth in National Social Security Fund savings from Sh320 billion in 2023 to Sh690 billion currently, a figure he said would reach Sh1 trillion by June 2027, alongside job creation tied to the digital economy, affordable housing and the Kazi Majuu programme. He also defended the government's government-to-government fuel import model.

Also present were Cabinet Secretaries Opiyo Wandayi (Energy), Alice Wahome (Lands and Housing), Hassan Joho (Blue Economy and Mining), Deborah Mulongo (Environment) and Lee Kinyanjui (Investment and Trade).

Ruto's SHA defence lands inside a wider gathering that is, by most accounts, unusually subdued this year. The Sustainable Development Goals remain well off target, and worsening fuel and food shortages have sparked protests in multiple countries.

Even so, this year's session is still drawing a vast diplomatic turnout: 73 heads of state, 45 heads of government and 49 ministers are expected, alongside more than 3,000 accredited journalists. China's Xi Jinping, Russia's Vladimir Putin and South Africa's Cyril Ramaphosa are all absent from this year's list.

This year's High-Level Week is presided over by newly elected Assembly President Khalilur Rahman of Bangladesh, under the theme "Restoring trust, managing transformation: A United Nations that delivers for all." It runs alongside a packed formal agenda beyond the General Debate itself, which opened on 22 September. This session also marks the last General Assembly to open under Secretary-General António Guterres, whose second and final term ends on 31 December 2026.

This year's health calendar looks noticeably different from last year's. In 2025, the Fourth High-Level Meeting on Non-Communicable Diseases and Mental Health was the health event of the week. This year, the official health summit is the High-Level Meeting on Pandemic Prevention, Preparedness and Response (PPPR), set for September 25, given the Bundibugyo Ebola outbreak still unfolding across the Democratic Republic of the Congo and Uganda, which had surpassed 7,200 confirmed cases as of September 16.

Much of the health energy in the room this year is flowing toward noncommunicable diseases, healthy ageing and AI-enabled health systems, arguably drawing as much attention as the traditional infectious disease agenda.

The Gates Foundation's 10th annual Goalkeepers Report, released this week, centres specifically on artificial intelligence, arguing the technology risks widening global inequality unless deliberately built around the people who stand to benefit most, a framing that echoes the AI governance conversations Ruto himself sat in on at UN Headquarters.

The Ministry of Health's delegation to this year's Assembly also includes Health Cabinet Secretary Aden Duale, Dr Ouma Oluga (Principal Secretary for the State Department for Medical Services), Director-General for Health Dr Patrick Amoth, and several departmental heads covering family health, international health and primary health. The size of this delegation reflects how much of Kenya's health financing picture now hinges on conversations happening on the sidelines of UNGA rather than in the General Debate itself.

Dr Amoth pointed to shrinking Western funding as the single biggest driver of the pressure now facing the ministry.

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