Kenyan officials enjoy broad legal authority to impose various forms of restrictions during public health crises. The Constitution authorizes the head of state to declare a state of emergency and put in place wide-ranging public security preservation measures, including restrictions on movement and assembly, appropriation of private property and labor, and restrictions on entry into the country. However, in order for actions under this authority to remain in place for an extended period of time, they need legislative approval.
Similarly, the Public Health Act (PHA), the primary legislation applicable to matters of public health crises, authorizes public health authorities, particularly the Minister of Health, to take various actions during public health crises, including declaring an infectious disease a “notifiable infectious disease” or a “formidable epidemic, endemic or infectious disease,” and taking the necessary prevention and suppression measures to fight the disease. Specific powers accorded to health authorities for the purpose of prevention and suppression of an infectious disease include search, seizure, and detention powers; the power to designate any place as a quarantine area, including ships and aircraft; and the power to restrict or ban immigration into the country.
Kenyan and international laws impose certain transparency requirements on the country’s government. Chief among these are the requirement under the PHA to periodically publish information regarding infectious diseases in Kenya, neighboring countries, and around the world, and the obligation under the International Health Regulations to report any public health emergency to the World Health Organization (WHO).
Although Kenya is geographically far from the Ebola-stricken West African region and to this day remains infection-free, the WHO recently declared the country at high risk for an Ebola infection given that it is a transportation hub in East Africa. As a result, the Kenyan government has taken various measures to prepare for an outbreak, including putting in place a contingency plan; establishing an Ebola response advisory task force; partially closing border crossings with Uganda, where there was a recent suspected Ebola death; and instituting a travel ban on persons traveling from the Ebola-stricken countries.
I. Government Structure
Kenya previously had a unitary system of government but recently introduced a system akin to a federation with the adoption of the 2010 Kenya Constitution, which established a two-tiered system of government involving the national and county levels.
A. National Government
In adherence to the principle of separation of powers, government power at the national level is shared by three branches tasked with constitutionally delimited powers and obligations: the executive, the legislature, and the judiciary.
1. The Executive
The national executive consists of the President, the Deputy President, and the rest of the Cabinet, which includes the Attorney-General, who is the principal legal advisor to the government among other functions, and fourteen to twenty-two Cabinet Secretaries.
2. The Legislature
Another new feature in the country’s government structure is the establishment of a bicameral legislative body consisting of a 349-member National Assembly and a sixty-seven-member Senate. The National Assembly enjoys broad legislative and supervisory powers, enacting legislation on any matter over which the national government has jurisdiction under the Constitution, determining revenue allocation between the different tiers of government, appropriating funds for government spending, and exercising oversight over government spending and the conduct of the executive branch of government. The role of the Senate, both in terms of legislative and supervisory powers, is by and large limited to matters that affect the interests of the counties.
3. The Judiciary
The Kenyan judiciary consists of what are known as superior courts (the Supreme Court, the Court of Appeal, and the High Court) and subordinate courts (magistrates’ courts, kadhis’ courts, the courts marshal, and tribunals).7 While all of these courts have distinct jurisdictional mandates, for the purposes of this report it is sufficient to point out that the High Court’s subject matter jurisdiction includes matters of constitutional interpretation in relation to “constitutional powers of State organs in respect to county governments” and “the constitutional relationship between levels of government,” and questions relating to conflicts between national and county-issued laws. This may be significant given that the national and county governments share legislative jurisdiction on public health issues (see below). Decisions of the High Court on issues relating to the Constitution may always be appealed to the Court of Appeal and thereafter the Supreme Court.
B. County Governments
Kenya has forty-seven counties, including Nairobi (the capital), which have their own legislative (county assembly) and executive (county executive) organs. The functions of the county assemblies include
- making laws on matters within their legislative jurisdiction (matters specified under the Fourth Scheduleof the Constitution);
- exercising oversight over county executive bodies (for instance the county assembly approves the appointments of the governor to the county executive committee, which is the cabinet of the county government); and
- approving management and exploitation plans for the counties’ resources, and the development and management of county institutions and infrastructure.
The executive branch of the county government, the county executive committee, consists of the county governor, the deputy county governor, and county executive members.
II. Structure of the Public Health Management System
Ordinarily the national and county governments enjoy concurrent legislative jurisdiction on health-related matters. The national government enjoys legislative jurisdiction on matters relating to “[h]ealth policy” and “[n]ational referral health facilities,” while the county governments may legislate on issues relating to county health services, including county health facilities and cemeteries, funeral parlors, and crematoria. While the health issues over which the county governments are accorded jurisdiction appear local in nature, the ongoing Ebola crisis in Liberia reveals that rules on issues such as burial rituals during public health crises may have great ramifications for the prevention and suppression of an infectious disease outbreak.
As noted below, in times of public health crises, the national government has broad, unfettered powers to impose nationally applicable response measures regardless of whether a county government has jurisdiction over the matter.
III. Powers of National Public Health Authorities
A. Declaration of a State of Emergency Under the Constitution
One of the ways that the national government may respond to a public health crisis is through the application of constitutional powers of the executive body. Subject to certain limitations, the President has the power to declare a state of emergency, including when the country is under threat from a “natural disaster or other public emergency” and doing so “is necessary to meet the circumstances for which the emergency is declared.” Any law issued under a state of emergency can impose limitations on the rights and fundamental freedoms enshrined in the Bill of Rights, so long as the emergency requires the limitation and it is in keeping with applicable international law.
However, the declaration of an emergency and any laws issued or actions taken by the President are effective for only fourteen days unless extended by the National Assembly. The National Assembly can extend the declaration of a state of emergency by a maximum of two months at a time. While a first extension can be adopted with the support of at least two-thirds of all members of the National Assembly, all subsequent extensions require the support of three-quarters of all members of the National Assembly.
The President is authorized under the Constitution to bring into operation Part III of the Public Preservation Security Act and issue regulations for the purpose of “preservation of public security,” including “the securing of the safety of persons and property, . . . [and] the provision of administrative and remedial measures during periods of actual apprehensible national danger or calamity.” These regulations may make provisions for
- . . .
- B. the registration, restriction of movement (into, out of or within Kenya), and compulsory movement of persons, including the imposition of curfews:
- Provided that no person shall be restricted on account of his political beliefs or activities;
- C. the control of aliens, including the removal of diplomatic privileges;
- D. the censorship, control or prohibition of the communication of any information, or of any means of communicating or of recording ideas or information, including any publication or document, and the prevention of the dissemination of false reports;
- E. the control or prohibition of any procession, assembly, meeting, association or society;
- F. the control or prohibition of the acquisition, possession, disposition or use of any movable or immovable property or undertaking;
- G. the compulsory acquisition, requisitioning, control or disposition of any movable or immovable property or any undertaking;
- H. requiring persons to do work or render services, including the direction of labour and supplies, the conscription of persons into any of the disciplined forces (including the National Youth Service) and the billeting of persons;
- I. the control and regulation of harbours, ports and the movement of vessels;
- J. the control and regulation of transport by land, air or water;
- K. the control of trading and of the prices of goods and services, including the regulation of the exportation, importation, production, manufacture or use of any property or thing;
- L. amending, applying with or without modification or suspending the operation of any law (including legislation of the East African Common Services Organization) other than this Act or the Constitution;
- M. any matter, not being a matter specified in any of the foregoing paragraphs of this subsection, for which provision is necessary or expedient for the preservation of public security.
It is evident that the Preservation of Public Security Act is a catch-all statute that covers all aspects of security in the country including those dealing with a public health crisis or threat, such as bioterrorism, and infectious diseases, such as anthrax, malaria, cholera, leprosy, foot and mouth diseases, and other outbreaks such as severe acute respiratory syndrome (SARS) and Ebola. It appears that in order for a special public security measure to be put in place, the only thing required is the classification of an event as a threat or an act that threatens the security of Kenya.
B. Statutory Regime
1. Powers of Authorities in a Public Health Crisis
Although there are various laws applicable to public health matters, the Public Health Act (PHA) of 1921, including its subsidiary legislation, is the primary law that governs matters of public health crises in Kenya. This law established and regulates the functions and powers of a number of health authorities that deal with public health crises.
The PHA requires that health authorities take all the necessary, lawful actions imposed on them under any law to prevent or deal with an outbreak or the prevalence of “any infectious, communicable or preventable disease, to safeguard and promote the public health and to exercise the powers and perform the duties in respect of the public health.”
2. Central Board of Health
The PHA envisages what is called the Central Board of Health (the Board), to be based in Nairobi, which is composed of the Director of Medical Services, a sanitary engineer, a secretary, and up to six additional members, at least three of whom must be medical practitioners. The main function of the Board is to advise the Minister of Health on “all matters affecting public health,” including on the prevention of infectious diseases from reaching Kenyan borders and the “prevention, limitation or suppression of infectious, communicable or preventable disease within Kenya.” However, sources consulted for this report indicated that the Board has yet to be established.
3. The Medical Department
The PHA also established the Medical Department, which is tasked with a host of responsibilities to prevent and/or play a key role in managing public health crises. The functions of the Department are
to prevent and guard against the introduction of infectious disease into Kenya from outside; to promote the public health and the prevention, limitation or suppression of infectious, communicable or preventable disease within Kenya; to advise and direct local authorities in regard to matters affecting the public health; to promote or carry out researches [sic] and investigations in connexion with the prevention or treatment of human diseases; to prepare and publish reports and statistical or other information relative to the public health; and generally to carry out in accordance with directions the powers and duties in relation to the public health conferred or imposed by this Act.
The Department is required by law to “obtain and publish periodically” information concerning infectious disease in Kenya and similar information regarding neighboring or other countries, as required by the interests of public health.
4. Minister of Health and General Delegated Authority
The Minister may, on the advice of the Board or the Department, order an inquiry regarding any public health matter. A person authorized by the Minister to conduct an inquiry is accorded broad powers under the Public Health Act, which states as follows:
When an inquiry is directed to be made by the Minister, the person directed to make the same shall have free access to all books, plans, maps, documents and other things relevant to the inquiry, and shall have in relation to witnesses and their examination and the production of documents similar powers to those conferred upon magistrates by the Criminal Procedure Code . . . , and may enter and inspect any building, premises or place the entry or inspection whereof appears to him requisite for the purpose of such inquiry.
5. Notifiable Infectious Diseases (NIDs)
The manner in which the Kenyan health authorities responded to the HIV/AIDS epidemic is illustrative of the process of declaring a disease to be an NID.
HIV/AIDS has impacted Kenya greatly since the first diagnosis of a case of AIDS in Kenya was made in 1984. By August 1993, the Kenya National Aids Control Program estimated that 841,700 persons were infected with HIV. By 2003, there were 1.2 million adults and children living with HIV/AIDS in Kenya. Of these, 1.1 million were adults between the ages of fifteen and forty-nine with an adult rate of 6.7%. Adult women age fifteen to forty-nine accounted for 750,000 of the total number, while 100,000 of the people living with HIV/AIDS were children under the age of fifteen. In the same year, an estimated 150,000 people (including adults and children) are said to have died of AIDS and 650,000 children under the age of seventeen lost one or two of their parents to AIDS in the country.
In response to this health crisis, in July 1987, the Minister declared AIDS an NID under section 17(1) of the Public Health Act. With such a declaration AIDS joined the ranks of other diseases already on the NID list. A disease can be added to this list in one of two ways: by legislative action or ministerial notice diseases already listed as NIDs under the PHA are
smallpox, plague, cholera, scarlatina or scarlet fever, typhus fever, diphtheria or membranous croup, measles, whooping-cough, erysipelas, puerperal fever (including septicaemia, pyaemia, septic pelvic cellulitis or other serious septic condition occurring during the puerperal state), enteric or typhoid fever (including para-typhoid fever), epidemic cerebro-spinal meningitis or cerebro-spinal fever, acute poliomyelitis, leprosy, anthrax, glanders, rabies, Malta fever, sleeping sickness or human trypanosomiasis, beri-beri, yaws and all forms of tuberculosis which are clinically recognizable apart from reaction to the tuberculin test.
In addition, the PHA accords the Minister broad powers to list a disease as an NID, designate the geographic area to which the categorization will apply, and dictate the response to the disease. In addition to the 1987 declaration of AIDS as an NID, the Minister has used this authority to add to the list of NID the following diseases:
- Relapsing fever
- Blackwater fever
- Encephalitis lethargica
- Yellow fever
- Malaria, microscopically diagnosed within the municipality of Kitale
- Bacillary dysentery and amoebic dysentery (within the municipality of Nairobi)
6. Prevention and Suppression of Infectious Disease
Declaration of a disease as an NID triggers reporting as well as prevention and suppression measures whenever the disease is detected or its presence suspected. A person who comes across a case of an NID is required to report it to the nearest medical practitioner. A medical practitioner who comes across such a disease or is notified of its suspected presence is required to inform the nearest medical officer of health and to inform those who live in proximity to or looked after the patient of the infectious nature of the disease and the precautions they need to take in order to prevent it from spreading. Failure to provide such notice as required by the PHA is an offense.
In addition to the reporting requirements, the suspicion or detection of any infectious disease triggers the application of certain broad powers resembling those accorded to the executive for purposes of preservation of public security. For instance, a medical officer is authorized to search a premises or medically examine any person found there if “he has reason to believe” a person exposed to or suffering from an infectious disease is or was on the premises. In addition, the medical officer may cause other actions to be taken, including
- having the premises exposed to infectious disease cleaned and disinfected;
- having a building, bedding, or other articles exposed to an infection destroyed;
- removing an infected person to a hospital; or
- putting an exposed person in isolation by an order of a magistrate.
The PHA states that the health authority may bear certain cost associated with the suppression or prevention of an infectious disease, including compensating a person for destroyed property and paying for disinfecting premises or other articles. The cost of isolating an infected person is born by the local authority where the person resides.
The PHA criminalizes certain acts that spread infectious diseases. Any infected person who, without proper precautions, willfully exposes himself “in any street, public place, shop, inn or public conveyance, or enters any public conveyance without previously notifying the owner, conductor or driver thereof” commits an offense and is, on conviction, subject to a fine of up to KES 30,000 (about US$337) and/or up to a three-year prison term. The same applies to a person tasked with caring for an infected person who exposes anyone to such person, and to a person who “gives, lends, sells, transmits or exposes” anything exposed to infection without first disinfecting the item. In addition, failure to properly disinfect any mode of transportation or dwelling exposed to an infection before transporting or leasing it to other people is an offense.
7. Formidable Epidemic, Endemic or Infectious Disease
A number of infectious diseases are categorized as formidable epidemic, endemic or infectious diseases (FEEIDs). These are smallpox, plague, Asiatic cholera, yellow fever; sleeping sickness, and human trypanosomiasis. In addition, the Minister is authorized to declare any infectious disease an FEEID.
Whenever any part of the country is under the threat of an FEEID, the Minister is authorized to issue rules on a variety of measures, including
- quarantining infected areas and preventing anyone from leaving the area without first going through the applicable precautionary measures put in place, including a medical examination, disinfection, or spending time in an observation camp/station;
- removing infected persons and anyone with whom they have been in contact;
- removing corpses; and
- destroying or disinfecting buildings and any other articles that may have been exposed to an FEEID.
The Minister is also authorized to issue rules specifying which areas in the country or vessels within the country’s territory are considered infected areas.
In addition, the Director or his representatives are accorded broad powers to deal with FEEIDs. The PHA gives the Director or his representatives the power to enter any premises in order to enforce any rules the Minister issues for the purpose of dealing with an FEEID. The Director also has the power to requisition land, equipment, or any other item for the purpose of dealing with an FEEID in return for reasonable compensation.
The PHA imposes reporting and other requirements on residents and health authorities of a locality during an outbreak of an FEEID. Anyone aware of “any unusual sickness or mortality among rats, mice, cats, dogs, or other animals susceptible to plague” or another FEEID is required to report the matter to the closest medical officer of health; failure to do so is a crime. The medical officer of health in any part of Kenya is bound by law to promptly report to the Director “every notification received” with regard to a suspected case of an FEEID. In addition, the local medical authority or the medical officer of health must do everything possible to mitigate the spread of an FEEID or execute rules made to suppress the FEEID.
8. Ports and Borders
Unless it is in danger, the master or anyone on board a vessel arriving in Kenya is prohibited from communicating with the shore or other vessels or boats except via a signal until it is granted pratique. When necessary, the Minister may apply this or any other requirement under the PHA to aircraft arriving in Kenya. However, this restriction does not affect the right of any authorized person to approach or board the vessel or aircraft. As a matter of procedure, pratique is granted to an arriving vessel or aircraft via radio communication if the appropriate health officer, based on the information provided by the vessel or aircraft is satisfied that clearing the vessel or aircraft will not result in the introduction of a quarantinable disease (plague, cholera, yellow fever, smallpox, typhus, and relapsing fever) into Kenya. Notification requirements regarding the detection or suspicion of infectious disease discussed above are applicable to vessels or aircraft arriving in Kenya.
Kenyan health authorities are accorded broad powers in dealing with vessels seeking entry into the country. For instance, the port health officer is authorized to board a vessel, inspect any of its sections, and examine and/or ask any person on board any question for the purpose of establishing the existence of an infectious disease. If the health officer suspects the existence of an infectious disease on board a vessel, he may grant conditional pratique or deny pratique and quarantine the vessel. He may have any infected person on a ship, aircraft, vehicle, or train removed and isolated on arrival to Kenya. He may also put anyone exposed to an infectious disease under surveillance and subject the person to medical testing. In addition, he may require a person in charge of a vessel or aircraft suspected of carrying an infectious disease to provide a passenger and cargo manifest as well as a crew list.
The Minister’s authority includes regulating immigration into the country for the purpose of preventing the introduction of infectious diseases. Thus, he may issue an order to
prohibit, restrict or regulate the immigration or importation into Kenya of any person, animal, article or thing likely, in his opinion, to introduce any infectious disease, or impose restrictions or conditions as regards the examination, detention, disinfection or otherwise of any such animal, article or thing.
In addition, the Minister is authorized to engage in foreign relations activities in which he is authorized to enter into agreements with other governments regarding reciprocal notification of outbreaks of any FEEID or any other matter relating to public health relations with other nations.
IV. Transparency of the Public Health Management System
As noted above, the Department is mandated to collect and periodically publish information regarding infectious diseases and other matters of public health concern in Kenya, contagious countries, or any other part of the world. In addition, categorization of a particular infectious disease as an NID via a ministerial order requires publication of a notice in the Gazette. Any medical practitioner who becomes aware that a patient has an NID must inform those people who, due to their proximity to the patient, may have been exposed to the infection. Similarly, the terms or summary of every agreement with another country concerning reciprocal notification of infectious disease outbreaks must be published in the Gazette. In addition, Kenya is required to notify the WHO of any event in its territory that may constitute a public health emergency of international concern within twenty-four hours of detection (see discussion, Part V, below).
V. Cooperation with the World Health Organization
Kenya cooperates with the WHO a great deal with regard to matters relating to public health crises. As a member state to both the WHO and the International Health Regulations (IHR), Kenya is bound by the requirements under the 2005 IHR, an international legal instrument aimed at preventing the spread of disease. Among other things, the IHR require that Kenya “develop, strengthen and maintain . . . the capacity to detect, assess, notify and report” outbreaks of infectious diseases. Accordingly, Kenya has put in place systems for early detection through what is known as an Integrated Disease, Surveillance and Response Strategy (IDSR). The objectives of this strategy are to
- Strengthen capacity for effective capacity[;]
- Improve use of surveillance information[; and]
- Improve laboratory involvement in epidemic detention.
According to the WHO, the IDSR is “the backbone for communicable disease prevention and control in Kenya” and the WHO provides technical support in its development and expansion. For instance, the WHO is currently assisting in the training of healthcare workers in Kenya in preparation for a possible Ebola outbreak (see discussion, Part VI, below).
Similarly, by simply being a member state of the WHO and IHR, Kenya has agreed to fulfill its obligation under the IHR to notify the WHO of any event that constitutes a public health emergency within twenty-four hours of assessment of such event.
Significantly, the WHO-Kenya 2008–2013 cooperation strategy indicates that providing technical assistance in strengthening Kenya’s ability for early detection, diagnosis, management, and control of communicable diseases, including strengthening the country’s capacity to prevent and respond to major epidemics and pandemic-prone disease, is one of the main areas of cooperation.
VI. Recent Developments
The Ebola outbreak in West Africa, specifically in Guinea, Liberia, and Sierra Leone, is the most recent public health crisis of global concern. Although Kenya is thousands of miles away from the Ebola-stricken countries in West Africa, in August 2014, the WHO classified the country as a high-risk country for Ebola transmission (level two) due to the fact that it is a transportation hub in East Africa.
According to reports, Kenya has put in place a contingency plan (the Plan) to guide health institutions in the event of an Ebola outbreak following the WHO declaration. The Plan, which is intended to serve as a roadmap for preparing and responding to an Ebola outbreak, calls for the establishment of a reference and response information center to “provide accurate information for health workers and the community, provide guidance on key actions to be taken during different phases of the outbreak, prepare clinicians for appropriate action, and identify and mobilise resources for response.” As part of the Plan, the Ministry of Health has put together a taskforce, including representatives from various, relevant governmental and nongovernmental organizations, to advise on how to respond to the outbreak. The taskforce is currently coordinating and implementing surveillance through the screening of travelers at entry points, which has been intensified following the WHO declaration.
The Plan also calls for training of various healthcare workers in dealing with an Ebola outbreak. The Kenyan government recently announced plans to train thirty-thousand health care workers on Ebola screening, prevention, control, and case management. This training will take place in all forty-seven counties in the country (it calls for counties to be involved in its implementation) and will target 60% of all health care workers in the country, including clinicians, epidemiologists, health promotion experts, and health workers stationed at airports and border crossings. The government has allocated KES 350 million (about US$3.9 million) for the purpose of implementing the Plan, a large percentage of which will likely be used for the training program. The WHO has deployed training experts to help facilitate the training.
The Plan puts in place procedures for dealing with a person suspected of exposure to Ebola. Those procedures call for isolating persons exposed to Ebola, limiting the number of medical workers that have direct contact with the person, and reserving contiguous rooms for medical personnel to change into protective gear.
In addition to putting a plan in place, Kenya has also suspended entry of passengers traveling from the three Ebola-stricken West African countries as of August 19, 2014, except for Kenyan citizens and health workers participating in the effort to curb the spread of Ebola. Similarly, following reports of an Ebola-related death in Uganda’s Bukwo district, Kenya recently closed the northwest region border crossings with Uganda.
As of the date of this report, Kenya remained free of Ebola. Although there have been a number of cases in which Ebola infection was suspected, all were ruled out after testing. In one of the cases, where the person suspected of having contracted Ebola arrived in an aircraft from West Africa, it appears that the protocols required under the PHA were properly followed. According to Nicolas Muraguri, the Director of Medical Services, the flight crew alerted Kenyan health authorities that one of the passengers was ill, as required by the PHA. The health authorities immediately quarantined the aircraft and screened everyone on board, also in accordance with the provisions of the PHA, and released everyone only after discovering that the suspected person was in fact suffering from other, noncommunicable ailments.
Prepared by Hanibal Goitom
Foreign Law Specialist*
[*] This report updates a report originally prepared in 2003 by Charles Mwalimu, former Senior Legal Specialist.
 Constitution art. 1 (2010), available on the Kenya Law website, at http://www.kenyalaw.org:8181/exist/ kenyalex/actview.xql?actid=Const2010.
 Id. §§ 130, 152 & 156.
 Id. §§ 93, 97 & 98.
 Id. §§ 95 & 109.
 Id. §§ 96, 109–113.
 Constitution § 165.
 Id. § 186.
 Id. §§ 163 & 164.
 Id. §§ 6 & 176.
 Id. § 185; County Governments Act, No. 17 of 2012, §§ 5 & 8 (July 24, 2012), available on the Kenya Law website, at http://www.kenyalaw.org:8181/exist/kenyalex/actview.xql?actid=NO.%2017%20of%202012.
 Constitution § 179; County Governments Act § 30.
 Constitution§ 186.
 Ebola Cremation Ruling Prompts Secret Burials in Liberia, The Guardian (Oct. 24, 2014), http://www.theguardian.com/world/2014/oct/24/ebola-cremation-ruling-secret-burials-liberia.
 Constitution§§ 58, 132.
 Id. § 58.
 Preservation of Public Security Act of 1960, 16 Laws of Kenya, Cap. 57 (rev. ed. 2012), available on the Kenya Law website, at http://www.kenyalaw.org:8181/exist/kenyalex/actview.xql?actid=CAP.%2057.
 Id. §§ 2 & 4.
 Id. § 4.
 Public Health Act of 1921, 16 Laws of Kenya, Cap. 242 (rev. ed. 2012), http://www.kenyalaw.org:8181/exist/ kenyalex/actview.xql?actid=CAP.%20242.
 Id. § 13.
 Id. § 3.
 Id. §§ 8 & 10.
 David I. Muthaka et al., Kenya Institute for Public Policy Research and Analysis (KIPPRA), A Review of The Regulatory Framework for Private Healthcare Services in Kenya 28 (KIPPRA Discussion Paper No. 35, Mar. 2004), available on the International Finance Corporation (IFC) website, at https://www.wbginvestment climate.org/toolkits/health-in-africa-policy-toolkit/upload/PNADS076.pdf; Transparency International-Kenya, The Kenya Health Sector Integrity Study Report 15 (2011), http://www.gtzkenyahealth.com/ blog3/wp-content/uploads/2011/01/TI%20Health%20report.pdf.
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 Id. § 11.
 Id. § 12.
 Center for Reproductive Rights, Women of the World: Laws and Policies Affecting Their Reproductive Lives. Anglophone Africa 11 (1997), http://reproductiverights.org/sites/crr.civicactions. net/files/documents/WOWAA01.pdf.
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 Notice of the Minister of Health (July 23, 1987) Gazette Notice, No. 3539, The Kenya Gazette of July 31, 1987, at 110.
 Public Health Act § 17.
 Id. § 18.
 Id. § 21.
 Id. §§ 22, 23, 26 & 27.
 Id. §§ 23 & 24.
 Id. § 27.
 Id. § 28.
 Id. §§ 29 & 30.
 Id. § 35.
 Id. § 36.
 Id. § 38.
 Id. § 42.
 Id. § 40.
 Id. § 41.
 Id. § 37.
 Id. § 58.
 Id. § 71.
 Id. § 58.
 Id. § 59; Public Health (Port, Airport, and Frontier Health) Rules, Public Health Act-Subsidiary Legislation, §§ 2 & 5.
 Public Health Act § 60.
 Id. § 62; Public Health (Port, Airport, and Frontier Health) Rule § 22.
 Public Health Act § 66; Public Health (Port, Airport, and Frontier Health) Rule § 7.
 Public Health Act § 68; Public Health (Port, Airport, and Frontier Health) Rule § 8.
 Public Health (Port, Airport, and Frontier Health) Rule § 14.
 Public Health Act § 63; see also id. § 71.
 Public Health Act § 72.
 Id. § 10.
 Id. § 17.
 Id. § 18.
 Id. § 72.
 WHO, International Health Regulations (2005): A Brief Introduction to Implementation in National Legislation 1 (Jan. 2009), http://www.who.int/ihr/Intro_legislative_implementation.pdf?ua=1; WHO, International Health Regulations (IHR) app. 1 (2d ed. 2005), http://whqlibdoc.who.int/publications/2008/9789241 580410_eng.pdf?ua=1; Countries, WHO, http://www.who.int/countries/en/ (last visited Oct. 24, 2014).
 IHR, supra note 76, § 5.
 WHO, WHO Country Cooperation Strategy 2008–2013: Kenya 9 (2009), http://www.who.int/country focus/cooperation_strategy/ccs_ken_en.pdf.
 Kenya National Council for Science and Technology, Disease Surveillance and Response in Kenya, available on the United Nations Office at Geneva (UNOG) website, at http://www.unog.ch/80256EDD006B8954/%28http Assets%29/BFC81C5C68522575C12576460049B118/$file/BWC_MSP_2009_MX-Poster-Kenya.pdf (last visited Oct. 24, 2014).
 WHO Country Cooperation Strategy, supra note 78, at 24.
 IHR, supra note 76, art. 6.
 WHO Country Cooperation Strategy, supra note 78, at 33.
 WHO: Kenya at High Risk for Transmission of Ebola, Voice of America (Aug. 12, 2014), http://www.voanews. com/content/germany-guinea-bissau-react-to-ebola-outbreak/2411822.html.
 Action Plan over Ebola Risk, Health Rights Advocacy Forum (HERAF) (Aug. 21, 2014), http://www.heraf. or.ke/index.php?option=com_content&view=article&id=1352&catid=24?option=com_content&view=article&id=1352&catid=24.
 Press Release, WHO Regional Office for Africa, Kenya Steps Up its EBOLA Contingency Plan with Training of Trainers (Sept. 26, 2014), http://www.afro.who.int/fr/kenya/press-materials/item/7053-kenya-steps-up-its-ebola-contingency-plan-with-trainings-of-trainers/7053-kenya-steps-up-its-ebola-contingency-plan-with-trainings-of-trainers.html; Kenya Intensifies Surveillance to Prevent Ebola Outbreak, Xinhua (Oct. 24, 2014), http://news. xinhuanet.com/english/africa/2014-08/13/c_133553824.htm.
 Press Release, WHO Regional Office for Africa, supra note 87.
 Kenya to Train 30,000 Health Workers on Ebola, Xinhua (Oct. 23, 2014), http://news.xinhuanet.com/ english/africa/2014-10/23/c_133735637.htm.
 Press Release, WHO Regional Office for Africa, supra note 87; HERAF, supra note 84.
 Press Release, WHO Regional Office for Africa, supra note 87.
 HERAF, supra note 84.
 Flight Bans from Ebola-hit Countries Will Stay in Effect, Kenya Tells AU, Sabahi (Sept. 17, 2014), http://sabahionline.com/en_GB/articles/hoa/articles/newsbriefs/2014/09/17/newsbrief-04; Travel Restrictions, Flight Operations and Screening, International SOS (Nov. 3, 2014), https://www.internationalsos.com/ebola/index. cfm?content_id=435&.
 Kenya Closes Border with Uganda over Ebola Fear, Xinhua (Oct. 11, 2014), http://news.xinhuanet.com/ english/africa/2014-10/11/c_133706916.htm.
 Kenya Rules Out Ebola After Two Tested Negative, The New Indian Express (Sept. 5, 2014), http://www.new indianexpress.com/world/Kenya-Rules-out-Ebola-After-Two-Tested-Negative/2014/09/05/article2415768.ece; Kenya Rules Out Ebola Case Following Scare at Airport, Xinhuanet (Aug. 2, 2014), http://news.xinhuanet. com/english/health/2014-08/02/c_133525986.htm; Press Release, WHO Regional Office for Africa, supra note 87.
 Xinhuanet, supra note 96; Public Health Act §§ 59 & 71; Public Health (Port, Airport, and Frontier Health) Rule § 5.
 Public Health Act § 62; Public Health (Port, Airport, and Frontier Health) Rule § 8.
 Xinhuanet, supra note 96.
Last Updated: 06/09/2015