A fresh internal outcry has emerged from the Kenya National Union of Medical Laboratory Officers (KNUMLO) whose leadership has accused senior Ministry of Health officials of orchestrating a systematic campaign to weaken the autonomy and effectiveness of the medical laboratory sector.
In a detailed communication addressed to this publication, the union’s National Chairman expressed frustration over what he described as sustained undermining of laboratory services by officials based at Afya House, singling out the Director General of Health for allegedly issuing misleading advice to senior government officials in order to curtail the sector’s independence. Senior laboratory officers accuse Ministry of Health officials of undermining sector governance, risking patient care and donor-funded programmes.
The union has raised alarm that the ongoing transfer of the Division of National Laboratory Services (DNLS) to the National Public Health Institute (NPHI) — an institution created through a 2022 legal notice without parliamentary approval — would expose the sector to unregulated practices, compromise service quality, and endanger lives, particularly among HIV and TB patients.
According to the communication, laboratory operations which guide approximately 75% of patient management decisions, would be severely disrupted in areas such as policy formulation, regulatory oversight, sample referral networks for specialised tests, and the maintenance of testing algorithms and standard operating procedures.
The union further claimed that the Ministry’s actions would result in a regulatory vacuum, leaving the medical laboratory field open to exploitation by unlicensed operators, a situation they blamed on deliberate decisions by senior officials to weaken professional oversight.
Specific allegations have been levelled against the Director General, ranging from enabling the proliferation of quacks within the Ministry, disregarding court orders on the exclusive handling of laboratory tests by licensed professionals, to fostering a culture of exclusion by concentrating leadership roles among medical doctors while sidelining other health professionals.
The communication also mentioned a named individual alleged to be practising without a valid license, who has reportedly been positioned to take control of the DNLS following its transition to the NPHI.
The union warned that the wider implications of the transfer would compromise Kenya’s disease surveillance efforts, limit access to free specialised tests for rural communities, and erode the gains made in managing communicable diseases through laboratory-driven interventions. "Good afternoon Mr Cyprian. I am Nicholas Odipo, a Senior Medical Laboratory Officer. I double up as the National Chairman of Kenya National Union of Medical Laboratory Officers (KNUMLO). This is a union that was registered in 2018 to represent Medical Laboratory Practitioners in the country. Our work basically includes diagnosis of patients' conditions, disease surveillance, monitoring disease prognosis and blood transfusion services. Seventy-five percent of decisions made in patient management are guided by laboratory reports. Now the real matter as to why I am reaching out is the kind of undermining we are receiving from the Ministry of Health. The Laboratory Sector controls billions of shillings from donors and the Exchequer. Due to these billions, the Laboratory Sector has become a sector that almost everyone wants a piece of. This has resulted in huge frustrations from Afya House mandarins and especially from the Director General of Health who has always given wrong advice to the CS and PSs. This wrong advice has always been intentional in order to stop the Laboratory from being independent but instead be under strong control of doctors. Sir, my colleagues who work at the Ministry have always done magic even with these kinds of frustrations. You remember during the COVID pandemic, as the Afya House mandarins were busy enriching themselves, my members were busy helping the country to overcome the pandemic which eventually we overcame. Sir as at today, Mr Patrick Amoth recently misadvised CS Duale to transfer entire Medical Laboratory Services to a moribund institute called National Public Health Institute (NPHI). This institute was created through Legal Notice No. 14 of 2022 by President Uhuru Kenyatta. It bypassed Parliament and Senate. Now with the help of the Head of Public Service Mr Kosgei, Amoth has ensured that the Division of National Laboratory Services is transferred to this institute for them to easily pocket the billions donors are giving.
The dangers of this are as follows.
(1) Medical Laboratory Services are going to be greatly affected in terms of policy formulation and setting standards for practice.
(2) Regulation of Medical Laboratory Services is going to be greatly affected in that the Head of this Division is the one supposed to be the Registrar of our Regulator. With inexistence of the Registrar, the Board will not function opening the sector for anyone. This has always been the vision of medical doctors working at the Ministry. Have a free will to open labs without regulations. They do not care whether the quality of services will be compromised or not.
(3) Sample referral networks will not be there. Sir I know you are alive to the economic situation of our citizens. Majority of them cannot afford specialised medical tests in the private medical laboratories. The Division of National Laboratory Services in conjunction with the donors organised for sample referrals from the villages to the National Reference Labs in Nairobi. This was done to alleviate economic hardship that acted as a barrier to the village folks accessing free specialised medical laboratory tests.
(5) HIV and TB patients are going to suffer. They might even die from multi-drug resistance strains. This Lab has for a long time been able to identify whether a patient has MDR/AMR strains of these pathogens. This would be used to change treatment regimen. These patients might find themselves in a dire situation.
(6) Testing algorithms will greatly be affected. These labs have been used to formulate testing algorithms and Standard Operating Procedures for all labs including County Labs. With these labs being moved, testing will remain a mirage and whatever will remain we might not guarantee quality of test results.
Areas where we believe Amoth has terribly failed as a Director General of Health and he should be forced out of office.
(1) In 2017, the courts ruled that non-medical laboratory professionals should not handle any medical test. In his tenure we have tried to persuade him to advise the Ministry to obey the court ruling. We told him to explain to the CS the importance of engaging licensed professionals, we are not dealing with animals but human health, he refused, instead he watched as the Ministry enacted the Primary Health Care Act to incorporate every Tom, Dick and Harry to handle primary health care.
(2) Amoth has been fighting any profession that he thinks can give doctors a threat. He has enabled Ministry of Health top management to be medical doctors only.
(3) He has enabled MoH to be a good breeding ground for quacks. Sometimes we wonder why we should have regulators while the person who represents the government in the Boards of these regulators is making it easy for quacks to thrive at the Ministry. He has a gentleman who does not have any practice license in the name Leonard Kingwara. He uses this gentleman to undermine the authority of DNLS. It is quite unfortunate that he has fronted him as a front runner to take over DNLS once this transition is done. Your guess is as good as mine once a quack sits at the helm. There are so many issues that I cannot highlight. But through this scheme, the lives of our citizens will be at risk. The mess at Afya House is brought about by misadvice."