Why some African nations are rejecting Trump's health aid money
After dismantling the main U.S. body for foreign assistance, the Trump administration is again offering hundreds of millions of dollars to African countries to support their healthcare systems and fight disease. The offers come with conditions that test the sovereignty and data protection of recipient states, leading to resistance from several governments.
Kenya signed a $2.5 bn (US$3.6 bn) health cooperation framework last December, drawing praise from Secretary of State Marco Rubio who said it could be the first of many. Kenya’s President William Ruto agreed to invest $850 m of its own money over five years, with the U.S. providing $1.6 bn. The plan shifts away from the traditional donor‑NGO model, encouraging direct government‑to‑government partnerships.
However, the condition that Kenya, and other African nations, share patient data and pathogen samples with American authorities has sparked legal challenges. In Ghana, the Data Protection Commissioner rejected a $109 m health deal, citing a lack of reciprocal data protection and sovereign control once data leaves national borders. Zimbabwe has similarly refused, worried that samples might be used by U.S. pharmaceutical companies without benefit for Zimbabwean patients.
Zambia’s Foreign Minister highlighted that the health aid package was bundled with a separate agreement giving Washington access to critical minerals, making the deal appear more like a commercial transaction than humanitarian aid. While the U.S. denies linking the two, the perception of “America First” policy has fueled scepticism.
The new strategy also raised concerns over the U.S. withdrawal from the World Health Organization and the reliance on bilateral schemes. Critics argue that a multi‑lateral system is essential for tackling transnational health threats such as Ebola and HIV/Aids. Yet the Trump administration insists that increased national spending and strategic partnerships will make aid more effective and reduce government overhead.
The complexity of the negotiations is underscored by the Democratic Republic of Congo’s experience. While it accepted a new U.S. health deal, cuts to USAID had already weakened its Ebola surveillance and treatment capacity, leading to a slower response in 2025 when a new viral haemorrhagic fever emerged.
In conclusion, while the U.S. offers substantial funds, the conditions attached to data sharing, pharmaceutical prioritisation and bundled commercial agreements are causing several African states to reconsider or outright reject the aid.
