Dr. Mercy Nabwire Ouma
Abstract
Across the Global South, health systems are being reshaped by the growing power of private finance. In Kenya, this has taken the form of expanding private hospital chains, private equity involvement in healthcare, and public-private financing arrangements that increasingly treat health not as a public good, but as a site of accumulation. These developments are often presented as necessary responses to public underfunding. But in practice, they are deepening inequity, weakening public accountability, and making the health system more fragile.
Drawing from organizing experiences with healthcare workers, trade unions, and health justice actors in Kenya, this presentation examines how financialization is transforming the country’s private healthcare sector and what that means for worker rights, human rights, and public health preparedness. It argues that the expansion of profit-driven healthcare is producing a more precarious health workforce and a more exclusionary system of care while transforming the ownership and governance structures of the country’s health system.
In Kenya, these dynamics are evident in wage suppression, union resistance, casualization of skilled labour, and the weakening of professional and public accountability. They are also visible in more disturbing human rights abuses, including the detention of patients and retention of dead bodies over unpaid hospital bills. These are not isolated failures. They are symptoms of a health system increasingly organized around revenue extraction rather than care.
The paper locates these developments within a wider global political economy, including the role of international financial institutions and development finance actors in advancing private sector-led health reforms. It argues that if we are serious about global health security, we must move beyond narrow discussions of emergency response and confront the structural forces making health systems more unequal, more commercialized, and less capable of protecting life.
By centering labour conditions, worker organizing, and democratic control, this presentation makes the case that resilient health systems cannot be built on extractive finance. They must be built on public stewardship, workers’ rights, and health as a social good
