In late 2025, after the US regime shocked the world by suspending global health aid, which experts said would lead to 700,000 more deaths annually, mostly children, Washington began proposing unusual bilateral health agreements to developing countries, infuriating officials and health activists alike. Critics alleged the deals, mostly with African nations, smack of “exploitation,” while at least two countries in dire need—Zimbabwe and Zambia—pushed back against them.
According to leaked memos, in November, the US approached Zimbabwean authorities, promising over $300 million in funding in return for sensitive health data in negotiations that Harare reportedly felt were “lopsided” and promptly withdrew from. Around the same time, the US publicly announced $1 billion in funding for neighboring Zambia pending talks. However, Lusaka also called out “problematic” clauses in the US proposal that sought access to the country’s minerals and has since requested a review. Several other countries, such as Nigeria and Kenya, have signed the health pacts, though the terms remain unclear as the agreements have not been fully published.
Demands for data or minerals in return for health aid are unprecedented in the history of the US, which is Africa’s largest health assistance provider. Policy experts warned that tying crucial funding to sensitive national assets could have negative consequences for African nations and even for the US itself. African nations have long relied on US funding to cover many of their health bills, receiving $5.4 billion in US assistance in 2024, largely spent on humanitarian, health, and disaster needs.
When the Trump administration abruptly cut funding in January 2025 and dismantled the US Agency for International Development (USAID), the impact reverberated across Africa and globally. Boston University’s Impactcounter aid funding tracker revealed that the shocks from the cuts have led to 518,428 child and 263,915 adult deaths from manageable diseases like HIV and tuberculosis, with nearly 10 million new malaria cases reported. Washington has argued that the aid cuts suit its America First agenda, where foreign aid must directly serve US national interests, backing long-held views from some economists that aid is often ineffective and causes overreliance.
Instead, Washington is now focused on government-to-government deals, with details filtering out through leaks in recent weeks. The unusual secrecy surrounding the negotiations is itself controversial: health NGOs and civil society groups in Africa said it excludes them from crucial talks, making it harder to plan programs or track government funding. The deals typically require governments to increase their share of health budgets over the next four to five years in a co-financing arrangement, which some analysts see as positive to reduce overdependence, but clauses leveraging aid for data and minerals have caused widespread outrage.
Source: www.aljazeera.com