Data sovereignty questions have emerged to threaten the United States health deals with African states.

 

While those deals are structured to replace most aid provided by the defunct US Agency for International Development (USAid), a number of African countries have slowed discussions on the access demanded by Washington to crucial local data.

This explains why the State Department has advised its diplomats abroad to start fighting claims of data sovereignty, arguing that it could hurt the development of artificial intelligence and other crucial technologies in health.

On February 26, the Democratic Republic of Congo became only the latest country to sign a memorandum of understanding establishing a new bilateral framework for health cooperation in a ceremony presided over by Prime Minister Judith Suminwa.

Rwanda, Kenya, Lesotho, Burkina Faso, and Uganda are among those who had already signed on the continent.

The DRC agreement paves the way for a $1.2 billion in funding for local health programmes, with $900 million provided by the US and $300 million by the Congolese government.

According to the DRC authorities, this partnership aims to strengthen the national health system in the long term and support efforts to achieve universal health coverage.

Samuel Roger Kamba, Minister of Public Health, Hygiene and Social Welfare, said that "the memorandum covers several priority areas, including the fight against HIV/Aids, tuberculosis and malaria, improving maternal and child health, continuing the eradication of polio, strengthening epidemiological surveillance, training health personnel, and preparing for and responding to health emergencies."Congolese officials emphasise that these interventions aim to consolidate existing achievements, while improving access to care and the system's resilience to crises.

In the DRC deal, as with Liberia, Rwanda, Kenya, Zambia, Zimbabwe and Burkina Faso, there is a proposal for bilateral agreements to supplant multilateral arrangements, such as through the World Health Organisation (WHO), from which the Donald Trump administration withdrew in January.

For Washington, this represents a break with the old method, which focused on aid, in favour of cooperation centred on mutual gains.'Unbalanced' dealBut this cooperation is not welcome everywhere. While some countries signed, considering it beneficial, others, such as Zimbabwe and Zambia, have rejected it. Zimbabwe has stalled on a US health agreement that would have provided $367 million in funding over five years because of the request for sensitive data, officials said.

Pamela Tremont, US Ambassador to Zimbabwe, said she regretted the Zimbabwean government's decision, especially as the rejected agreement could have been important in the intervention of “health programmes, including HIV/Aids treatment and prevention, tuberculosis, malaria, maternal and child health, and disease outbreak preparedness.”A leaked government memo from December revealed that President Emmerson Mnangagwa considered the agreement to be “unbalanced.”A Zimbabwe government spokesperson explained that the US demanded access to biological samples for research and commercial gain, but was unwilling to share the benefits for future vaccines and treatments. Following this failure, the US said it was ending “our health assistance to Zimbabwe.”Zambia, too, rejected a proposal for more than $1 billion in health assistance from the Donald Trump administration, saying that the terms of the agreement are not in line with the country's national interests.

In Burkina Faso, after signing the five-year agreement, the US State Department assured that the agreement “strengthens regional health security in the Sahel while improving Burkina Faso's ability to independently manage infectious disease threats before they reach our shores.”Ouagadougou’s decision to sign was curious, especially after legal wrangles with some American firms over taxes. Burkina Faso has, for the last four years, been leaning towards Russia. In January, however, a delegation from the US State Department toured the country, promising to reverse some “mistakes” in Burkina Faso.

US investmentsThe DRC and other countries that have signed the deal see financial benefits. Kenya, for instance, said it would gain in US support for health research. Nairobi was also among the first countries to receive the new injectable preventive (Prep) drug for HIV. But the High Court had suspended the implementation of the deal in December, after consumer lobbies sued over privacy violations on data. The case is pending in court.

DRC Finance Minister Doudou Fwamba Likunde said the US investments made under the agreement would also require Kinshasa to raise its health budget.

And US Chargé d'Affaires Ian McCary said the partnership marks a shift towards a collaborative model based on shared responsibility, with the objectives of strengthening health security and establishing a more resilient health system in the DRC.

Through this memorandum, Kinshasa and Washington intend to structure their cooperation around long-term financial and technical commitments.

The DRC was one of those for which US aid provided through USAid to battle local health challenges such as Ebola, Mpox and Covid-19. The DRC has received some $1 billion from the US, representing about 70 percent of the aid provided to the DRC in 2023.

Its abrupt interruption had several consequences, including the closure of several health NGOs and a decline in the treatment of tuberculosis and HIV/Aids, with a definite increase in mortality linked to these diseases.

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