The Kenya Medical Supplies Authority went through tough times between 2000 through to 2008. The Kenya Medical Supplies Agency was established through Legal Notice No. 20 of 2000 with the hope of curing the challenges that its predecessor, the Medical Supplies Coordination Unit (MSCU), faced. However, the Agency was unable to fully deliver on its mandate due to inadequate funding, lack of timely disbursement of procurement and operational budgets, and an overall lack of confidence in transparency, accountability and performance. This necessitated the recommendation by stakeholders to establish a more efficient and autonomous institution to deliver on the expanded duties through the KEMSA Amendment Act of 2013. This Act provided for a new legal framework, enabling KEMSA to transition from a Public Agency to a Public Authority with an expanded role that factored in a devolved health system and greater autonomy. The autonomy also paved the way for the Authority to offer higher salaries to its employees after being re-categorised from Category 7C to 7B.

The KEMSA Act spells out the roles of the Authority in a devolved healthcare system in line with the provisions of the Constitution of Kenya 2010, which provides for a devolved system of government.  According to KEMSA, the legal and institutional reforms aim at strengthening its institutional and governance capacity with a view to “improving governance, self-sustainability and being more responsive to provision of HPTs in the country”.

Apart from the legal reforms, KEMSA has undertaken institutional changes aimed at turning around the Authority, including restructuring of its enterprise resource system.

The KEMSA Act 2013 also required that a board of governors be instituted as envisaged in the Mwongozo Code. The Code addresses matters of effectiveness of boards, transparency and disclosure, accountability, risk management, internal controls, ethical leadership and good corporate citizenship. In the new governance structure, membership of the board includes prominent leaders from different fields and not limited to civil servants. Specific board committees are created with clearly outlined charters, roles and responsibilities.

KEMSA, before 2008, faced a myriad of challenges, especially a talent deficit at the top leadership. To address this, the Authority began with re-organisation of  its human resource (HR) by creating departments headed by competent directors, recruited competitively through consultancies and appointed by the Board of Directors.