In 2017 the Kenya Medical Professionals and Dentists Union concluded a strong Collective Bargaining Agreement with the government which sought to ensure that more doctors and doctor interns were employed; to improve the very low doctor-patient ratio and produce better health outcomes for all Kenyans.

Yet despite the fact over a thousand doctor-interns are now trained and ready, the government has refused to release the budget needed to fund their work, delaying their deployment. On the 15th of March, health sector unions led by KMPDU begun a strike to have the working conditions laid out in the Agreement finally respected for interns, clinical workers and laboratory technicians.

Several attempts to reach an agreement between the unions and employers, including national and county governments, have reached a dead end. The government has taken a hard stance, attempting to water down the 2017 CBA. It claims this agreement was signed ‘under duress’ during a political election period and therefore did not need to be respected. The government is now attempting to cut the intern-doctor allowance to just a third of the agreed salary (70,000 shillings rather than 206,000 shillings). This would be significantly below what the intern doctors used to earn even before the CBA. Such a move would make working in the sector even less attractive for young people, at a time when massive health employment across the country and region is essential.

The government has threatened to fire striking doctors, arrest the KMPDU leadership and cut workers across the public sector. The Council of Governors, which signed the CBA in 2017, say doctors are already earn enough and respecting the CBA by paying them more would distort wages among other public sector workers.

But such disregard for the terms of the agreement suggests the political elite are making promises to win votes, then breaking promises once elected. Health workers, across the public and private sector, are commiting to continue the strike and hold a protest every Tuesday until the government honours the CBA.

The Kenya public wage bill represents just 4.5% of GDP, against the global average of 9%. Despite this, the head of Kenya’s public service, under pressure from the International Monetary Fund, is continuing to push for a further 10% cut to funding for public sector workers.

Meanwhile the courts have found the attempts by the Salary Review Commission to cut intern allowances and veto or undermine conditions agreed on collective bargaining agreements, unlawful. Instead of reducing salaries for critical public sector workers, the government must address issues such as the high levels of corruption revealed in auditor general reports and the wasteful spending by politicians through unjustified travel allowance, litigation expenses, etc.

To this day, Kenya’s health spending remains far below the Abuja Declaration o and the WHO-recommended 15% of GDP.

As the striking unions continue to emphasize: increasing employment and improving conditions is key to building a better public healthcare system which is a net positive for the economy and society as a whole.