Why some African nations are rejecting the new U.S. health aid

After the Trump administration shut down the U.S. Agency for International Development last year, it redesigned the aid framework to hand large sums directly to national leaders, hoping to build lasting health systems that are less dependent on donors. The new contracts still contain conditions that many African governments find unacceptable.

Kenya signed a $2.5bn partnership with Washington in December. Washington is to provide $1.6bn while Kenya commits $850m over five years. The U.S. also seeks to tie the health deals to its access to critical minerals, a move that sparked criticism from Zambia, whose foreign minister said the package was being sold as a bundle and pushed for separate negotiations.

Ghana, Zimbabwe and other states halted discussions because of concerns over data sharing, lack of reciprocity and the potential for American pharmaceutical companies to profit from biological samples. The Ghanaian data‑protection chief warned that once data left the country there would be no control over its use.

Critics argue that the new bilateral approach sidesteps the World Health Organization and NGOs that previously helped mobilise resources during outbreaks such as the 2014 Ebola crisis in West Africa and the most recent wave in the Democratic Republic of Congo. They favour a multilateral system to keep health aid fair and coordinated.

The deal remains contested. While Tanzania recently joined, many other African leaders remain cautious. The outcome will help determine how the United States and other powers steer global health funding in the coming years.