The USAID Office of Inspector General (OIG) has previously identified challenges associated with government-to-government (G2G) awards, particularly in the global health sector, where host government systems are used for procurement, warehousing, and distribution of health commodities.
On December 4, 2025, the U.S. Department of State and the Republic of Kenya announced a $2.5 billion bilateral health cooperation framework establishing a G2G partnership for the detection, prevention, and response to emerging and existing infectious disease threats. Under this proposed framework, Kenya intends to utilize the Kenya Medical Supplies Authority (KEMSA), a state-run corporation under the Kenyan Ministry of Health, for procurement, warehousing, and distribution. Past OIG investigations into a $650 million USAID award to KEMSA identified significant vulnerabilities in KEMSA’s core business processes.
Given the systemic risks associated with G2G awards and KEMSA’s proposed role in the newly announced health cooperation framework, OIG is alerting the Department of State to previously identified vulnerabilities in KEMSA’s capacity to warehouse and distribute U.S.- funded health commodities.