NAIROBI — May 2, 2026 — Margaret Kanini, a 57-year-old lung cancer patient, stares at her phone every morning, hoping for a notification that never arrives. Two months ago, her Social Health Authority (SHA) cover ran out. Her life-saving medication costs Sh56,320 per month——more than she earns in a month. The hospital where she once received treatment now tells her to pay cash upfront. Her oncologist has warned: without drugs, her cancer will keep spreading unchecked.
"My cover was exhausted months ago," she says, her voice trembling. "I was told the limit was increased, but at the hospital, they say there is no communication, and I must pay cash. I don't have cash."
Margaret Kanini is not alone. She is one of thousands of Kenyans trapped between a presidential promise made on national television and a health financing system that, according to a damning new parliamentary report, is failing the most vulnerable patients at precisely the moment they need it most.
The Report That Unmasked the Crisis
On Wednesday, the National Assembly Departmental Committee on Health, chaired by Seme MP and medical doctor James Nyikal, released its findings following a petition filed by the Kenya Network of Cancer Organisations (KENCO)——an umbrella body representing more than 70 civil society groups and thousands of patients and caregivers across the country.
The report lays bare nine glaring structural failures within the Social Health Authority that are actively harming cancer patients. Among the most alarming findings:
One: The current combined household benefit of Sh550,000 per year——comprising Sh400,000 under the Social Health Insurance Fund (SHIF) and just Sh150,000 under the Emergency, Chronic and Critical Illness Fund (ECCIF)——falls below the Sh600,000 individual annual cover previously available under the defunct National Hospital Insurance Fund (NHIF). Worse, the shift from individual to household coverage has eliminated the flexibility that once allowed spouses to supplement each other's benefits.
"For a household with more than one cancer patient, the entire family's treatment is forced into a finite bucket," committee chair James Nyikal noted grimly.
Two: The Primary Health Care Fund——essential for cancer screening, prevention, and early detection——received just Sh4.1 billion against an identified requirement of Sh61 billion. That is a funding gap of 93 per cent.
Three: The ECCIF, specifically designed as the safety net for patients who exhaust their regular SHIF benefits, received only Sh2 billion against a requirement of Sh107 billion. A staggering 98 per cent shortfall.
"The direct cost of comprehensive treatment for this patient easily exceeds Sh3.8 million," the report reads. "This demonstrates beyond any doubt that the current SHA cancer cover of Sh550,000 per year is grossly insufficient to provide equitable access to care. Reducing the oncology package is not just a technical policy change. It is a life-and-death decision for thousands of Kenyans."
A Broken Promise
In November 2025, during his State of the Nation Address in Parliament, President William Ruto announced an increase in the SHA cancer benefits package from Sh550,000 to Sh800,000, effective December 1, 2025. It was a headline-grabbing moment——a dramatic expansion meant to cushion families against catastrophic health expenses.
Five months later, the increased cover remains unimplemented.
Hospitals across the country say they have not received any formal gazettement of the new tariff structures. Without official documentation, providers cannot operationalise the higher limit. Patients who exhausted their Sh550,000 cover months ago are told the same message: the promise exists, but the system cannot honour it.
Grace Achieng', a cervical cancer patient, has been caught in this Kafkaesque loop. "My SHA system still shows a balance, but every request is declined," she says. "I have been denied medication and even a PET scan since December. I had to look for money to pay for my January treatment cycle." A PET scan required for staging her cancer cost Sh120,000——borrowed from friends.
Phoebe Ongadi, Executive Director of KENCO, summed up the collective anguish: "Effective health coverage is vital not just to protect lives, but to protect livelihoods and preserve the dignity of those fighting for survival. Policy proclamations alone are insufficient if they are not translated into functional systems on the ground."
Digital Delays and Human Toll
The committee further identified that the SHA's administrative and digital systems have created "serious bottlenecks in the approval and delivery of cancer treatment, posing significant risks to patient health and survival due to disease progression".
At the Kenyatta National Hospital Oncology Centre——East Africa's largest public cancer referral facility——patients sit for hours on hard wooden benches, waiting for SHA authorisations that may never come. Dishon Munase, a 60-year-old from Kakamega diagnosed with refractive Hodgkin's lymphoma, was forced to delay his chemotherapy by nearly a week because the system could not generate an invoice.
"I am supposed to be undergoing chemotherapy every three weeks," he explains. "Since Monday, the system has been so slow I am yet to get an approval. This system serves about five patients only in a day." Any further delay, his doctors warn, will lead to a drop in his blood levels, requiring additional costly treatments before chemotherapy can resume.
Betty Odero, who accompanies her mother for cancer care, says the delays are not just administrative burdens——they are acts of slow violence. "Remember, these are patients who are on chemotherapy. Some of them cannot even sit for long. The disease is already pushing them down, and now you are mentally and emotionally trying to disturb them." When she asked why private facilities like Texas Cancer Centre process claims in 20 minutes, the response was consistent: "The system is down."
The Maths of Misery
The gap between what the SHA provides and what cancer care actually costs is not academic——it is a chasm measured in lives.
According to KENCO's submissions to Parliament, a woman diagnosed with triple-positive breast cancer accessing services from a public health center ends up paying in excess of Ksh.3.8 million. A full cycle of treatment for breast cancer can cost up to Sh50,000; chemotherapy for cervical cancer up to Sh40,000; colon cancer treatment between Sh80,000 and Sh100,000. For metastatic cancers requiring specialty drugs or overseas referrals, the figures spiral into tens of millions.
KENCO's survey of 118 patients and caregivers found that 60 per cent of cancer patients exhaust their SHA cover before the end of the year. Alarming: 35 per cent exhaust their benefits in less than three months, and 13 per cent are forced to abandon treatment completely.
Fiscal Reality Check
The SHA itself is bleeding red ink. According to the 2026 Economic Survey from the Kenya National Bureau of Statistics, the Social Health Insurance Fund collected just Sh57.7 billion in premiums in 2024/25 but paid out claims totalling Sh91.5 billion——a payout ratio of 158.6 per cent. The system is paying out Sh1.59 for every Sh1 it collects. This is not sustainable by any measure.
The World Bank has warned that Kenya's health spending has dropped to just two per cent of GDP——far below the WHO recommendation of five per cent——while noncommunicable diseases have become the leading cause of death.
There is a bitter irony at play: the government's own 2024/25 budget cut health allocations year-on-year, even as it promised Universal Health Coverage. You cannot build a safety net while simultaneously cutting its ropes.
A Way Forward——If the Will Exists
The Health Committee has delivered a road map. It demands that the Ministry of Health and the SHA urgently review the Tariffs for Healthcare Services, 2025 to enhance oncology benefits to a minimum of Sh800,000 per patient per year. It calls for nationwide civic education on benefit packages——because, as the report notes, there is a "severe and systemic information deficit" among both patients and providers. It wants a forensic audit of SHA payments, faster digital approvals, and hospitals reimbursed within 90 days.
But reports alone do not save lives. Implementation does. The Ministry of Health and SHA have been given four months to report back to Parliament. For Margaret, Grace, Dishon and the thousands of others whose SHA benefits are already exhausted, four months is not a deadline——it is a lifetime.