Global Drug Pricing Pressure and Kenya’s Access-to-Medicines Debate

Washington’s push for most-favoured-nation drug pricing is reshaping how global pharmaceutical manufacturers think about pricing everywhere, including in markets like Kenya where prices were never controlled to begin with. Kenya’s own access-to-medicines debate is really two separate conversations that get conflated: what the government can legally do about drug prices, and what it has actually chosen to do so far. The two are not the same thing.

Kenya Has No Binding Price Controls

Kenya’s private pharmaceutical market operates on what a 2022 peer-reviewed review in Risk Management and Healthcare Policy described as an informal, non-binding societal price mark-up that is not anchored in any legislation. There is no statute setting maximum medicine prices. Government influence on pricing runs indirectly, through KEMSA’s public procurement and the Social Health Authority’s reimbursement schedules, rather than through direct price-setting. SHA itself is a recent creation: the Social Health Insurance Act, No. 16 of 2023, assented to on 19 October 2023, established it to replace NHIF, and the Ministry of Health confirmed SHA’s formal launch on 1 October 2024. Kenya also maintains an Essential Medicines List, last updated in 2023, which functions as a clinical and procurement reference rather than a price schedule. The access gap this creates is real and documented: the same 2022 review found essential medicine availability at roughly 44 percent in public facilities against 72.4 percent in private ones, using 2018/19 data, illustrating that Kenya’s medicines access problem has historically been more about supply and financing than about price control as such.

The US Pricing Pressure Kenya Cannot Ignore

Executive Order 14297, “Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients,” signed 12 May 2025, directed US manufacturers toward MFN pricing targets, with a follow-on order on 2 April 2026 tying import tariffs directly to a manufacturer’s compliance. The Centers for Medicare and Medicaid Services has advanced this through the GLOBE and GUARD payment models, with a comment period that closed 23 February 2026, and the GENEROUS model for Medicaid, announced 6 November 2025. The mechanism that matters for Kenya is indirect but real: manufacturers facing compressed margins in their largest market often respond by tightening differential pricing elsewhere, including in markets like Kenya where volumes are lower and negotiating leverage is weaker. The WHO’s recurring Fair Pricing Forum exists precisely to give lower-income markets a coordinated voice in that conversation, but Kenya’s position in it depends on active government and industry engagement, not automatic protection.

The Legal Tools Kenya Already Has

Kenya is not without leverage of its own. Section 58(2) of the Industrial Property Act, 2001 establishes international exhaustion of patent rights, meaning goods lawfully placed on the market anywhere can generally be parallel imported into Kenya without infringing the Kenyan patent, an important safety valve if a manufacturer prices a medicine sharply higher in Kenya than in comparable markets. Sections 72 and 80 of the same Act provide compulsory licensing and government-use mechanisms for genuine public-interest situations, the same provisions discussed in the context of TRIPS flexibilities generally, though as noted elsewhere Kenya has no recorded history of actually using them for pharmaceuticals. One notable absence: the Competition Authority of Kenya’s published market inquiries do not currently include a pharmaceutical-sector inquiry, unlike sectors such as banking, fertiliser, or digital credit that have been reviewed. Whether that reflects an assessment that the market does not need scrutiny, or simply that it has not yet been prioritised, is not something this article can resolve from public materials alone.

A Concrete Access Pressure Point

HIV treatment access illustrates how funding disruption, not patent law, has been the more immediate threat to access in Kenya recently. UNAIDS documented the impact of the 2025 pause in US foreign aid on Kenya’s HIV treatment programmes, and Kenya’s Ministry of Health issued its own statement on strengthening continuity of HIV treatment amid global funding changes. This is a useful corrective to a debate that sometimes focuses entirely on patent flexibilities and pricing mechanisms: for many Kenyan patients, financing continuity has mattered more than the underlying list price of the medicine itself. The legal tools discussed above, parallel importation and compulsory licensing, address a different problem than a sudden gap in donor-funded procurement, and Kenya’s access strategy needs to account for both, since neither a favourable patent ruling nor a parallel import shipment fixes a funding shortfall at the point of care.