Why Some African Nations Are Turning Down Trump Aid Money
Several African countries are rejecting new US health aid deals due to conditions requiring data sharing, prioritizing US pharmaceutical firms, and linking to strategic interests.
After dismantling the main US foreign aid agency USAID last year, the Trump administration is again offering hundreds of millions of dollars to African countries to support healthcare and fight disease. However, the new deals come with conditions that are facing resistance from some governments.
In December, Kenyan President William Ruto signed a landmark $2.5 billion deal in Washington. US Secretary of State Marco Rubio called it the first of many, but activists went to court to block it. Cabinet ministers finally approved it last month.
The State Department's new global health strategy requires recipient governments to increase their own health spending, aiming for sustainable systems. For Kenya, the US contributes $1.6 billion, while Kenya pledges $850 million over five years. The administration says partnering with national leaderships will replace traditional donor-NGO relationships that created dependency.
This marks a shift from a model of global cooperation anchored in the World Health Organization (WHO) to direct bilateral agreements tied to US strategic and commercial interests. The US withdrew from WHO earlier this year, citing mismanagement and lack of transparency.
Controversially, the bilateral deals explicitly promise to prioritize US pharmaceutical and medical firms. By mid-May, 32 countries, including at least 20 in Africa, had accepted the health MOUs. But Ghana, Zimbabwe, and Zambia have resisted.
Zambia's Foreign Minister Mulambo Haimbe criticized the US for linking health funding to economic interests by connecting the deal to a separate agreement on critical minerals. He said Zambia wanted to discuss them separately.
Some African countries raised concerns about US access to health data, including patient information and pathogens. Arnold Kavaarpuo of Ghana's Data Protection Commission said the deal lacked reciprocal data protection. Zimbabwe also cited concerns, saying there were no guarantees that drugs developed from pathogens would be available to its people.
Debates over health diplomacy intensified after an Ebola outbreak in the Democratic Republic of Congo. Although DRC was among the first to accept the US deals, humanitarian workers and former US officials say USAID cuts weakened the response. Amadou Bocoum of Care said 36 staff were laid off, causing a 10-day delay in Ebola response.
Critics argue that the bilateral approach is risky. Former CDC director Dr. Kevin DeCock noted that global health is transnational and requires global solutions. However, the American Enterprise Institute defends the strategy as a test of whether conditional partnerships are more effective than deference to the WHO.
Tanzania has just signed up, but several African nations have said no. It remains to be seen how far the reshaping of US global health strategy will go.
