US Health Deal Continues to Raise Data Privacy Concerns Across Africa

Ghana is the latest African country to reject the Trump administration’s effort to reshape global health aid. The country is walking away from a bilateral health agreement after hesitating at terms that required the transfer of sensitive citizen health data to the United States.

Accra rejected the deal after Washington imposed an  April 24 deadline to conclude talks. According to reports, negotiations were normal in the beginning, but pressure increased especially at the end. The proposed agreement would have unlocked $109 million in US health assistance over five years, significant for a country that received $96 million specifically for health in 2024, the year before the Trump administration’s aid cuts began. Ghana’s rejection is part of a broader trend in sub-Saharan Africa, as governments weigh American health funding against growing alarm about what the US wants in return.

The Trump administration unveiled its “America First Global Health Strategy” in September 2025, calling on recipient nations to take on a bigger financial role in fighting HIV/AIDS, malaria, tuberculosis, and polio, and to eventually wean themselves off foreign assistance. The strategy also restructured aid delivery. USAID, the long-time backbone of American global health spending, was dismantled in July 2025, with its functions consolidated under the State Department. As of late April 2026, Washington had signed 32 deals representing $20.6 billion in funding, made up of $12.8 billion from the US and $7.8 billion in co-investment pledged by recipient governments. But a growing number of African governments are questioning what they are giving up to access that money.

Kenya was the first country to sign the agreement in December 2025. As of February 2026, a Kenyan High Court had suspended some parts of the deal due to some data-sharing concerns. Following a petition by the Consumer Federation of Kenya (COFEK), the High Court suspended data-related aspects of the deal but left healthcare funding intact. COFEK warned that Kenya risked losing strategic control of its health system if foreign players came to control the digital health infrastructure. Critics noted the requirement for Kenya to provide health programme data to Washington, with no clear mechanism limits on how the US could use it. Data advocates noted that the agreements do not guarantee that any drugs or vaccines developed from shared data would be returned to the countries providing it.

Nigerian lawyer, Bernard Okpi, filed suit at the Federal High Court in Abuja in March challenging a similar MoU signed between Nigeria and the US in December 2025. The suit alleges that the agreement allows the transfer of medical records, blood samples, pathogen test, and genetic sequencing data to the United States, with a related “Specimen Sharing Agreement” requiring Nigeria to hand over such material within five days of any request, potentially for up to 25 years. The full text of the Nigerian agreement has not been made public.

American officials present the strategy as a push for greater accountability in global health spending and more efficient, results-driven partnerships. Priorities include disease surveillance, outbreak detection, and the integration of US-developed medical technology into African health systems. Critics see different intentions in the fine print. African nations carry some of the world’s highest burdens of infectious disease and represent an exceptionally rich source of epidemiological and genetic information, which is enormously valuable for pharmaceutical research and vaccine development. Several agreements reportedly require governments to notify the US of disease outbreaks within short timeframes and to share pathogen specimens for analysis.

Some agreements also reportedly grant the US government or its contractors direct access to national health data systems, including surveillance databases, laboratory management platforms, and electronic medical records, 10 years after any agreement is terminated. African countries could find themselves providing the raw material for treatments they cannot afford or access. The deals as currently reported are silent on this question. Granting a foreign government long-term access to national healthcare data shifts practical control of a country’s health infrastructure. This will increase African countries’ dependence on the US, rather than building institutions accountable to citizens.

During the 2014-2016 Ebola outbreak in West Africa, specimens were taken to foreign countries for research purposes, highlighting a pattern in which African health data and biological material flow outward during crises without guaranteed returns in the form of treatments or technologies. The practice became a defining example of what researchers call “parachute research,” where samples and data are collected in low and middle-income countries without local oversight, then sent to high-income countries for research purposes.

Health data containing genetic information can be used to stigmatise or discriminate against individuals and communities. A more recent case happened during the COVID-19 pandemic. When South African scientists and their counterparts in Botswana identified the Omicron variant in November 2021 and shared the data transparently in the interest of public trust, the reward was immediate travel bans against southern African countries. African scientists shared viral genomic data early, yet many African countries waited more than twelve months after vaccine rollouts began in high-income countries to achieve meaningful coverage. African data contributes significantly to worldwide health research, yet when it comes to cures and vaccines, the continent is sent to the back of the queue.

The collapse of USAID reveals that Africa has outsourced its disease response to a foreign government far too much. The solution is not improved bilateral agreement. Africa must fund its own healthcare, build its own research institutions, and own its surveillance systems outright. The continent manufactures less than 3% of the vaccines it uses. Until African governments invest in local pharmaceutical production, genomic research, and continental disease infrastructure through bodies like the Africa CDC, the continent  will keep facing the same impossible dilemma of either signing away data sovereignty or watching health programmes collapse.