Human Rights Watch (HRW) has reported that the United States has entered into agreements with seven African nations—Ethiopia, Kenya, Nigeria, Uganda, Mozambique, Rwanda, and Liberia—to provide healthcare resources in exchange for access to surveillance data and pathogen specimens. These Memorandums of Understanding (MOUs), signed under the “America First” Global Health Strategy, are designed to support the development of resilient health systems in these countries. They detail cooperation in key areas such as surveillance, laboratory systems, and investments in healthcare infrastructure. Notably, these agreements came into effect on April 1, 2026, and are set to last until December 31, 2030, except for the agreement with Kenya, which follows a different timeline.
A prominent feature of these MOUs is the United States’ role in financing endeavors like healthcare data digitization, worker training, and laboratory system enhancements. The agreements impose specific obligations on the African nations, such as negotiating specimen sharing agreements to provide the U.S. with pathogen genetic data. Additionally, these countries must use designated technology systems for healthcare data digitization, agree to tax exemptions on U.S.-funded services, and comply with random audits, providing broad data access. The agreements also mandate adherence to the Helms Amendment, prohibiting U.S. funds from being used for abortions.
HRW’s analysis highlights how these responsibilities differ from one country to another. For instance, Mozambique, Rwanda, and Liberia are required to provide “any data” for audit compliance, while Nigeria’s agreement specifies “regulated data access.” Ethiopia’s MOU reserves the right to personal data protection under its laws, and Kenya conditions information sharing on compliance with its own regulations. Notably, specimen sharing agreements vary, with Nigeria’s arrangement tied to a future agreement, and Kenya’s MOU allowing for future negotiations conditioned by the framework’s provisions, as detailed in the Jurist’s report.
The America First Global Health strategy claims to enhance U.S. safety and prosperity while addressing health issues like malaria, HIV, and TB, and improving maternal and child health. Yet, this initiative faces criticism and resistance in Africa, as reported by The Africa Report. Activists and officials argue against data sharing without adequate control or benefit, emphasizing the move as part of a broader renegotiation of global health participation terms.