The impact of Chinese debt on health outcomes in Kenya

By Patrick Mbullo

News about inflation or increased tax on basic commodities were common features in 2019. Leading newspapers reported hard economic times, introduction of new tax and government’s efforts to raise more revenue and meet targets on tax returns. As search tax, one would say has been one of the words that received the most attention in the ending year.

Even as the government strive to collect more revenue, a number of reasons have been put forward to explain the rising cost of living.  Huge wage bill as a result of  many government positions has been cited one of the reasons fueling cost of living. The National Assembly alone has 349 seats. The Senate has 47 elected members, 16 nominated women and two members representing the youth.

In addition to 2,222 Members of County Assembly, the devolved government system, came with numerous positions and currently employs tens of thousands countrywide. All of whom are supported by the national treasury. This not to mention huge amounts of money lost through rampant corruption.

Indeed, the huge wage bill remains one of the most talked about revenue consumers in the country. The rapidly increasing Chinese debt, mainly to fund infrastructure, has also been widely identified as a significant consumer of the country’s revenue.  What is not clear are the possible health consequences and the pathways by which the increasing debt burden from China might impact health outcomes.

To date, Kenya debt to China is estimated to reach $9.8 billion making it the third largest recipient of Chinese loans in Africa. The interest on these loans are rapidly growing and are becoming a source of financial challenge. The loan repayments to China’s Exim Bank for the construction of the Standard Gauge Railway (SGR) for Instance has increased by 130 per cent.

When the countries revenue is primarily used to pay debts, the implications to government’s social programs can be far reaching. In this article, I will however focus on health outcomes. This is because health impact has been inadequately talked about as a possible consequence of Chinese loans to Kenya. The bulk of the talk has tended to focus on economic consequences.

A China-Africa Environmental Cooperation Center was jointly launched by China’s ministry of ecology and environment, and the UN Environment Program in Nairobi, Kenya

Therefore, when I overheard a young woman in a grocery store remark: “These Chinese loans are leaving us hungry and for the dead,” I began to think about other avenues by which Chinese loans could be affecting Kenyan economy, and consequently health outcomes.

With increased tax on basic commodities, livelihoods are impacted. Families have been left hungry and forced to adjust to the worsening economic situations. Impact on health outcomes cannot be over emphasized. More recently, the escalating suicidal rates, domestic violence, and deteriorating mental health in the country has been attributed to depression. There could be many causes of depression, however everyday challenges with food, and other basic needs form a bigger chunk of these causes.

Health care system which is essential for an ailing and sick population like Kenya, is likely to suffer in revenue starved environment. First, medical supplies, equipment and drugs will be affected. Secondly, there will be no enough money to adequately compensate health care providers, thus impacting provision of health services. In the recent past, Kenya has witnessed prolonged strikes by doctors and nurses countrywide due to delayed or poor renumeration and lack of proper working environment. Without medical personnel, the number of things that can go wrong cannot be overemphasized.

Imagine a country where of 1.6 million people live with HIV and depend on public health care system to access treatment. In this scenario, thousands of people would be at risk to accessing the essential ART treatment, this could lead to increase defaulting on drugs and consequently to drug resistance.

Patrick Mbullo is a graduate student in the department of anthropology at Northwestern University, Evanston, Illinois, USA. Contact:

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