Michael Gwarisa
There appears to be growing pushback among African countries regarding a United States (US) government health aid deal, with Zambia becoming the latest to reject parts of the deal.
A Reuters report indicates that Zambia turned down a US$1 billion global health aid package from the United States, citing that the agreement does not align with the country’s interests.
Like Zimbabwe and other African nations, the deal was designed to govern over US$1 billion in funding to address conditions such as HIV and malaria, while strengthening disease outbreak surveillance and preparedness over the next five years.
Under the America First Global Health Strategy, Zambia was expected to contribute US$340 million over the same period. Reuters also reported that the agreement, initially scheduled for signing in November, was delayed after revised drafts included a contentious section.
Kenya, which led the way in 2025 by signing a similar deal, faced judicial intervention. The US-Kenya five-year Health Cooperation Framework, signed on December 4, 2025, involved US$1.6–1.7 billion from the US and US$850 million from Kenya, targeting HIV/AIDS, tuberculosis, malaria, and health system improvements such as data tracking and electronic medical records.
Kenya’s High Court issued temporary orders in December 2025 halting the implementation, following petitions from the Consumers Federation of Kenya (COFEK) and a senator. Key concerns included data privacy risks under Kenya’s Data Protection Act, lack of public participation, absence of parliamentary approval, and potential budget strain.
Meanwhile, several other African countries have already signed similar agreements. According to the KFF Tracker, which monitors bilateral deals under the America First Global Health Strategy, 16 African nations had signed Memorandums of Understanding (MOUs) with the US as of early February 2026.
These five-year agreements (2026–2030) commit US funding alongside partner co-investments for health priorities such as HIV, TB, malaria, surveillance, and system resilience. The KFF Tracker, updated February 6, lists 16 signed deals based on US State Department and embassy announcements.
Early signers include Kenya (Dec 4), Rwanda, Uganda, Lesotho, Eswatini, Mozambique, Cameroon, Nigeria, Sierra Leone, Ethiopia, Botswana, Madagascar, Liberia, Côte d’Ivoire, and Malawi (Jan 14). More recent signings, such as Burkina Faso, may increase the count to 17 by late February, although official trackers lag behind.
