Inside Amoth, Muthoni silent war at Afya House that threatens fight against Mpox

A silent war at the Ministry of Health between Director General Patrick Amoth and Public Health Principal Secretary Mary Muthoni escalated on Saturday over a document on Kenya’s Mpox preparedness and response plan.

Dr Amoth, the most senior technical official in the Ministry of Health who is expected to lead such an initiative, disowned the document, saying he had not been consulted about the plan and did not approve it.

The report, signed by Ms Muthoni and Dr Sultan Matendechero, who is acting deputy director general of Health, explains the government’s Mpox preparedness plan.

Dr Amoth said he would ordinarily be involved in coming up with such a plan but he was not aware of the one released recently.

“I did not approve it, was not consulted and have not seen what that document contains. Go and ask PS Muthoni and Dr Matendechero, who I am told appended their signatures, where that document came from,” said Dr Amoth.

In scenario one, the plan estimates that Kenya needs Sh1,741,248,200 to contain 99 Mpox cases locally.

In Scenario two, PS Muthoni and Dr Matendechero say that the country will need Sh2,349,314,200 to contain the regional spread of 1,000-9,999 Mpox cases while in scenario three the country will need Sh2,564,379,000 to deal with a national spread of the deadly disease.

This comes after Dr Amoth was officially appointed on August 2, 2024 following recommendation from the National Assembly and Senate Health committees.

According to the committees, Dr Amoth, who had been acting as DG for four years since January 2020, demonstrated extensive knowledge and experience essential for the role.  

He has more than 30 years of experience in health systems management, reproductive health and public health at community, country, regional and global level.

Investigations by Nation have established that for almost two months, a deepening conflict over who should take charge of the fight against Mpox has resulted in the DG and Ps Muthoni not seeing eye to eye.

It all started during a partners meeting attended by officials from the Kenya Medical Research Institute (Kemri), the World Health Organization and the United States Agency for International Development (USAID).

PS Muthoni announced that results of samples collected from a truck driver for testing had come back positive at the time, making the patient Kenya’s second positive Mpox case.

A senior official at the ministry, who is not authorised to speak to the media, said at the time that the official statement announcing this had not yet been signed because it had to be approved by the Director-General of Health. He said staff were confused about who to report to on such matters.

And recently, on her social media account, PS Muthoni announced Kenya’s fourth Mpox case.

The Nation has learnt from multiple insiders, who spoke on condition of anonymity, that Health Cabinet Secretary Deborah Barasa recently embarked on a mission to resolve the stalemate.

Medical Services Principal Secretary Harry Kimtai, however, denied knowledge of such a meeting when asked by Nation Africa. Ms Muthoni and Dr Matendechero did not immediately respond to our enquiries.

However, Ministry officials said the PS is overstepping her mandate, given provisions of the Health Act and role of the director-general. 

“The director-general shall be the technical advisor to the government on all matters relating to health within the health sector, be the technical advisor to the CS Health and be responsible for preventing and guarding against the introduction of infectious diseases into Kenya,” Section 17 of the Health Act states. 

“The DG shall obtain and publish periodically information on infectious diseases and other health matters and such procurable information regarding epidemic diseases in territories adjacent to Kenya or in other countries as the interests of public health may require.”

PS Muthoni’s state department was created as a result of Executive Order No 1 by President William Ruto.

According to the Public Service Commission (PSC) Act 26, 27 and 28 which provides for establishment and abolition of public offices, when two laws, in this case the Health Act and an executive order, are in conflict, the Constitution takes precedence.

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