The human face of the World Bank’s private sector bias: The privatisation of Kenya’s healthcare

21 July 2022

A November 2021 report by Hakijamii, a Kenyan human rights organisation, and the Center for Human Rights and Global Justice at New York University (NYU) titled Wrong Prescription: The Impact of Privatising Healthcare in Kenya provides a damning picture of the rapidly expanding role of private sector healthcare in Kenya promoted by the World Bank under its Maximising Finance for Development (MFD) approach (see, Observer Spring 2022, Summer 2017). It finds that privatisation can compromise universal access to healthcare (a human right under both the Kenyan Constitution and international human rights law) by diverting resources away from the public sector and prioritising services focused on profit. The trend of financialisation, both generally and of essential public services in particular, has been noted by civil society as a barrier to the ability of states to fulfill their human rights obligations (see Observer Spring 2022).

Despite well-founded concerns, Kenyan policymakers, urged on by development actors such as the World Bank, have adopted policies to increase private sector participation in the country’s health system by subsidising private care, pursuing public-private partnerships (PPPs; see Observer Autumn 2015) and offering tax incentives to investors. The NYU report concludes that healthcare privatisation in Kenya is bad value for taxpayers and has had severe negative human rights impacts for Kenyans, proving costly for individuals and the government while pushing Kenyans into poverty and crushing debt.

The report adds to civil society concerns about the promotion of private solutions by international financial institutions (IFIs). The report states that private actors are “insulated from the obligations and democratic processes associated with the public sector”, adding that international actors who influenced Kenya into privatising its healthcare system are “arguably even less accountable” than private actors. The World Bank and others failed to respond to questions from the authors about whether they assess the impact of their support for private sector healthcare on human rights, social risks, or access to healthcare.

Joint author Rebecca Riddell commented: “The World Bank has aggressively pushed for more private sector participation in healthcare in Kenya, despite widespread concerns about rising costs, inequality in access, and uneven quality of care. These are not just minor problems that can be downplayed or blamed on regulators—they really go to the core of whether the MFD approach is fit for purpose.”