AN OPEN LETTER TO PRESIDENT WILLIAM RUTO AND THE SHA IMPLEMENTING COMMITTEE
This morning, I write to you, Mr President @WilliamsRuto , and other relevant stakeholders @_shakenya, @MOH_Kenya, urging you to reconsider the SHA/SHIF tariffs for cancer patients.
The Cost of Cancer Treatment using Breast Cancer as a Case Study
To illustrate the financial burden on cancer patients, let me walk you through the treatment journey of a typical breast cancer patient in Kenya.
1. Initial Evaluation & Diagnosis
Before treatment begins, we need a confirmed diagnosis, which requires:
•Breast Ultrasound – Ksh. 3,000
•Mammogram – Ksh. 5,000
•Breast MRI (if indicated) – Ksh. 10,000
•Image-Guided Biopsy – Ksh. 15,000 (Not covered under SHA)
•Histology (Pathology Analysis) – Ksh. 10,000
•Immunohistochemistry (to determine specific cancer markers) – Ksh. 15,000
2. Staging Tests (To Determine Disease Extent)
To provide appropriate treatment, we must stage the disease using:
•CT Scan (Chest) – Ksh. 15,000
•CT Scan (Abdomen & Pelvis) – Ksh. 15,000
•Brain MRI (if indicated) – Ksh. 30,000
•PET-CT Scan (Gold standard for staging) – Ksh. 70,000
3. Treatment Phase
Biweekly Laboratory tests-10,000
Chemotherapy (Neoadjuvant, before surgery)
•Ksh. 40,000 per cycle × 8 cycles = Ksh. 320,000
Surgery (Mastectomy + Reconstruction, if needed)
•Ksh. 250,000 – 350,000
Radiotherapy (Post-Surgery)
•Planning CT Simulation – Ksh. 10,000
•Radiotherapy @ Ksh. 3,600 × 25 sessions = Ksh. 90,000
Restaging CT scans every 3 months = 45,000
Targeted Therapy / Immunotherapy (Herceptin – for HER2+ Breast Cancer)
•Ksh. 140,000 per session × 18 sessions = Ksh. 2.5 Million
The SHA/SHIF Funding Gap
Under SHA/SHIF, a household is allocated only Ksh. 550,000 annually for ALL oncology care—including diagnosis, chemotherapy, surgery, radiotherapy, and immunotherapy.
Let’s be clear: This amount is not enough to cover even one cycle of targeted therapy, let alone an entire cancer treatment plan.
Previously, NHIF provided Ksh. 600,000 per individual annually. If both spouses had NHIF, this amounted to Ksh. 1.2 million per household—yet, even then, patients struggled.
Now, SHA has abolished individual covers, capping the entire household at Ksh. 550,000 for cancer care. How can families possibly afford treatment with such limited funding?
The Reality on the Ground
•Many families cannot even afford transport to the hospital, let alone treatment.
•Kenya has very few oncologists, most of whom are based in Nairobi, making access even harder.
•Patients are dying—not because their cancer is untreatable, but because they simply cannot afford care.
Where Is the Fairness in This?
How does the government expect healthcare providers to explain this to their patients—mothers and fathers who shed tears daily, struggling to afford life-saving care?
Shouldn’t all Kenyans, regardless of income, receive free, quality cancer care in public hospitals?
Cancer does not wait. It does not discriminate. The current SHA/SHIF model is pushing patients into despair and premature death.
A Call to Action
I urge you, President William Ruto, the Ministry of Health, and all relevant stakeholders, to:
1.Reassess the SHA/SHIF funding model and increase oncology coverage.
2.Reinstate individual medical covers to avoid burdening entire households with a single limit.
3.Ensure timely access to cancer diagnostics and treatment in all counties.
4.Guarantee free cancer care for senior citizens and vulnerable populations.
We are losing too many lives. It’s time for change.
Sincerely,
Dr. Bosibori Ondari
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