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Gambling is increasingly gaining popularity in Kenya. BCLB which is a government agency under the ministry of Interior and Coordination of National Government is tasked with controlling and licensing of betting and gaming premises, recovery of tax on betting and gaming, and authorising public lotteries. Projections are that gross gambling revenue in Kenya would rise to Sh2. The projections were contained in a report by auditing firm PwC, which added the revenues is expected to rise to Sh2.

In the current scenario, some of the big names in the industry are in sports betting. Under devolution, most political, fiscal, operational, and administrative responsibility was delegated to 47 decentralized counties. Starting in , devolution also split responsibility for different elements of the immunization system.

The federal government has maintained control of nationwide policy, procurement, and financing of vaccines themselves. However, commodities such as syringes and safety boxes are procured nationally but paid for by the counties. Under devolution, immunization operations were also split, with the national government delivering vaccines to regional warehouses but the counties responsible for transporting vaccines to local facilities for delivery.

While overall national immunization coverage rates continued to rise after the devolution, there has been backsliding in many of the lowest performing counties, which often prioritize other objectives over investment in health, such that some have not yet risen back to pre-devolution coverage levels. Immunization Coverage Vs. Covid Cases by County The interactive maps above show Kenyan counties' immunization coverage left side-by-side with their Covid caseloads right as reported on July 27, A darker color indicates a higher volume of immunization coverage and reported Covid infections.

Vaccination coverage is represented by the third dose of diphtheria toxoid, tetanus toxoid, and pertussis containing vaccine DTP3. Click on either map to see exact figures for each county. Hotspots of regional instability, largely driven by the Al-Shabaab militant group in Somalia, have pushed hundreds of thousands of refugees into Kenya. However, refugees are often overlooked by health services when they settle in urban areas.

For example, refugees living in the large, crowded cities of Nairobi, Mombasa, and Kisumu have access to fewer services, are less well documented, and are highly mobile, making them difficult to reach and easily lost by the health system. In fact, the pandemic has caused nearly three times as much disruption to routine immunization in urban areas as the rest of the country. Kenya is a diverse, multilingual, multireligious country, and confidence in the government and the health system varies widely.

As the world looks forward to an eventual Covid vaccine, many Kenyans still deny the existence of the coronavirus. Samson Waithaka, C chats with a man by the road side as he rides his bicycle. It can also rely on key lessons learned from the Global Polio Eradication Initiative, including the importance of listening to community concerns and clearly communicating the risks and benefits of vaccines to instill community confidence, and can utilize the vast infrastructure that program has built over the past three decades.

Some players, such as the CDC, continue to work exclusively on national-level technical assistance. Leading up to this, it will be important for U. A nurse R talks with mothers at their home about polio vaccines. These cooperative global mechanisms build on the successes of past Gavi initiatives, such as the AMC for the pneumococcal vaccine, but they are still unproven, operating in a more competitive space and currently facing a significant gap in donor financing.

The CDC could support future pilots of an electronic immunization registry and use of sub-county data in targeted jurisdictions to better track coverage among traditionally marginalized communities, as it did in one county in The long-standing U. This decision may allow Kenya, and all countries benefitting from Gavi support, the time and flexibility to recover from the pandemic.

The tourism industry has seen its revenues cut in half , and the informal jobs sector , making up 80 percent of the workforce, has been devastated by lockdowns. The government, still reeling from recent corruption scandals , has been accused of misusing millions in pandemic relief funds. Furthermore, the government is struggling with its considerable debt service —nearly a third of the budget—leaving very little fiscal room for a social safety net, even if the global economy rebounds quickly in While Kenya has thus far resisted asking international creditors for complete debt forgiveness, a decision by the G20 countries to extend debt relief beyond the end of could give LMICs the space to respond to and recover from the pandemic.

The United States has an opportunity to support such flexibility through its participation in multilateral commitments by the G7 and the G Strengthening U. As Kenya works to address gaps in its immunization system, build community confidence in vaccines, and mitigate the risk of further political and economic turmoil, a strong routine immunization system can serve as the backbone that supports it through pandemic recovery and growth beyond Covid Child refugees receive their vaccination certificates after they were immunized at Dadaab refugee camp in northeastern Kenya.

Three critical ways to do this are: Supporting the technical review of subnational capacities to identify and better serve frequently missed populations; Working through multilateral platforms to support financial flexibility for emergency response; and Contributing to efforts by the COVAX Facility, AU, and Africa CDC to help Kenya secure access to an eventual Covid vaccine and facilitating its introduction.

Implementing the reforms necessary for Kenya to strengthen its routine immunization services and move toward fully self-financing vaccine procurement and distribution will help avert outbreaks of vaccine preventable disease and build toward a successful transition from Gavi support.

Prior to joining CSIS, she worked as an intern on projects concerning antimicrobial stewardship, conflict resolution, and human rights, and managed her university partnership with a grassroots non-profit organization in Coimbatore, India.

Simoneau holds a B. Katherine E. Bliss brings her expertise in the social sciences, Latin American studies, and international relations to her work analyzing U. Trained as a historian, Katherine spent the early part of her career teaching at the university level and publishing books and articles on gender relations and public health in twentieth-century Mexico. A Council on Foreign Relations International Affairs Fellowship enabled her to shift her focus to global health policy, placing her at the U.

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