Trump-Era Health Deals With Africa Face Backlash Over ‘Lopsided’ Terms & Data Sharing

Concerns are mounting over a series of bilateral health agreements between several African nations and the US administration, with critics labelling the deals as inequitable and potentially exploitative. The agreements, part of President Donald Trump’s “America First” global health strategy, are raising questions about national sovereignty, data privacy, and access to essential medical innovations. Zimbabwe recently halted negotiations for $350 million in health funding, citing concerns that the proposed terms compromised its independence.

Zimbabwe Halts Negotiations, Cites Sovereignty Concerns

In December 2025, Zimbabwe’s Foreign Affairs Secretary Albert Chimbindi issued a directive to discontinue negotiations with the US regarding the proposed health cooperation agreement. A memorandum, made public earlier this month, stated that President Emmerson Mnangagwa believed the agreement “blatantly compromises and undermines the sovereignty and independence of Zimbabwe.” The core issue, according to a Zimbabwean government spokesperson, centered around US requests for “sensitive health data, including pathogen samples,” without a reciprocal guarantee of access to any resulting medical advancements. The concern is that Zimbabwe would be providing the raw materials for scientific discovery without assurance that the resulting vaccines, diagnostics, or treatments would be accessible to its population during future health crises. The Zimbabwean government has emphasized that development aid should empower nations, not create dependencies or facilitate strategic extraction of resources.

Beyond Zimbabwe: A Pattern of Concerns

Zimbabwe is not an isolated case. Similar concerns are emerging from other African nations engaged in negotiations with the US. A deal with Zambia, linked to a separate agreement on mining collaboration, remains unfinalized. Asia Russell, director of the HIV advocacy organization Health Gap, accused the US of “conditioning life-saving health services on plundering the mineral wealth of the country,” characterizing the approach as “shameless exploitation.” At least 17 African countries have signed deals with the US, collectively securing $11.3 billion in health aid, but these agreements are increasingly scrutinized for the concessions demanded in return.

Data Sharing and Prioritization of Faith-Based Providers

A key point of contention revolves around data sharing. The US requests patient record data as part of these agreements, raising privacy concerns. Critics also point to a perceived prioritization of faith-based healthcare providers within the framework of these deals. In Nigeria, a US embassy statement indicated that the $2.1 billion funding agreement “places a strong emphasis on Christian faith-based healthcare providers.” Fadekemi Akinfaderin of Fòs Feminista wrote on Substack that singling out one religious group in a diverse country risks exacerbating existing tensions and politicizing healthcare access. She also cautioned that faith-based facilities may be less likely to offer comprehensive services, such as family planning and STI prevention, due to ideological beliefs.

The Broader Context: Shifting US Global Health Strategy

These bilateral agreements represent a significant shift in US global health policy. The Trump administration dismantled USAID, the traditional flagship aid body, and reduced engagement with large multilateral organizations like the World Health Organization. The “America First” strategy prioritizes direct, bilateral negotiations, often with conditions attached. This approach is being viewed by some as a maneuver to establish and solidify US power on the continent. The deals also commit African nations to rely on US regulatory approval for new drugs and technologies before implementation, potentially limiting their autonomy in healthcare decisions.

Kenya’s Case: Legal Challenges and Data Control

In Kenya, the first country to sign a deal, a court case brought by campaigners has temporarily halted the agreement due to concerns over data sharing terms. The Consumer Federation of Kenya (Cofek) argues that Kenya risks “ceding strategic control of its health systems” if pharmaceuticals and digital infrastructure, including data storage, are externally controlled. This highlights the broader anxiety surrounding data sovereignty and the potential for exploitation of health information.

Funding Commitments and Domestic Resource Mobilization

The five-year agreements require African countries to gradually increase their domestic funding for health, including salaries and equipment, while US investment decreases annually. This raises questions about the sustainability of these programs and the ability of African governments to meet these commitments, particularly given the historical failure to meet the 2001 Abuja declaration’s target of allocating 15% of national budgets to health. The deals also include requests for access to health data and information on emerging pathogens for up to 25 years, although some countries have negotiated shorter timeframes.

What Comes Next: Ongoing Negotiations and Scrutiny

The situation remains fluid. Negotiations are ongoing with several African nations, and the terms of existing agreements are subject to scrutiny. The US ambassador to Zimbabwe, Pamela Tremont, expressed regret over Zimbabwe’s decision to halt negotiations, stating that the collaboration would have benefited Zimbabwean communities, particularly those receiving HIV treatment through US-supported programs. However, the growing chorus of criticism suggests that a re-evaluation of the “America First” approach to global health aid may be necessary to ensure equitable and sustainable partnerships.

The unfolding situation underscores the importance of transparency and inclusivity in international health agreements. Greater public participation and consultation with community groups are crucial to ensure that these partnerships genuinely benefit the populations they are intended to serve. Continued monitoring of these agreements and their impact on national sovereignty, data privacy, and access to healthcare will be essential in the months and years to reach.