Since most African countries gained their independence from European colonial powers over 60 years ago, they were allegedly granted absolute national sovereignty, asserting their economic, political, and social independence from European and foreign interference.
Fast forward to today, African sovereignty can be classified as an inherently mythic phenomenon where former African colonies are still entrapped in an economically, medically, and politically dependent state in the international world order. As Kwame Nkrumah, the first president of Ghana, wrote in 1965, “The essence of neo-colonialism is that the State which is subject to it is, in theory, independent and has all outward trappings of international sovereignty. In reality, its economic system and thus its political policy is directed from outside.”
In a post-COVID AI-driven age, this neo-colonial relation that Nkrumah speaks of has morphed into “biomedical imperialism,” a state where African countries’ medical sovereignty is being eroded through unfair bilateral health agreements with the United States.
To provide necessary background, on September 18, 2025, the Trump administration released its new America First Global Health Strategy. As part of this new strategy, the US will be establishing bilateral health agreements with countries, predominantly African ones, that receive US global health assistance. The agreements consist of five-year programs (2026-2030) where the US would slowly phase out funding for the national health budgets of 17 African countries that signed on to the Memorandums of Understanding (MOUs). Talks of implementation between the US and partner countries are slated for later this year.
These bilateral health agreements, or MOUs, between the US and African countries are supposedly meant to act as an “evolution” of the USAID, which, according to a White House statement, was “not aligned with American interests and in many cases antithetical to American values.” If saving the lives of millions of Africans who rely on access to HIV/AIDS medication through the USAID contradicts American values, then we are heading towards a bleak international world, where the ulterior political agenda of the Trump administration reigns above all.
Additionally, the US claims these agreements will aid in a self-sufficient state in Africa, where countries move toward resilient and durable local health systems. This mimicry of Pan-African language used to describe the America First Global Health Strategy obscures the fine print embedded into the MOUs — details which are unsurprisingly absent from the official US Department of State website, many mainstream news articles, and think tanks trackers in the US.
The fine print reads that US funding for HIV/AIDS, malaria, and tuberculosis is contingent on the provision of sensitive national health data and pathogen information collected through disease surveillance, while offering no binding guarantees that African signatories will receive equitable access to medical technologies, such as pharmaceutical patents and vaccines, developed from them.
In late February, after realizing the unfair negotiations, Zimbabwe pulled out of a proposed $367m US bilateral health funding agreement after objecting to the provisions. In an official statement obtained from Tafi Mhaka’s opinion article on Al Jazeera, Harare called the proposal an “unequal exchange,” warning that Zimbabwe risked supplying the “raw materials for scientific discovery” while the resulting benefits could remain concentrated in the US and global pharmaceutical firms.
Kenya followed suit with a bottom-up approach after a consumer rights group challenged the agreement, deeming it an infringement on the privacy of Kenyans under the country’s Data Protection Act. Consequently, the High Court of Kenya froze implementation of a $2.5 billion health deal with the US last December.
Zambia, attempting to follow in the footsteps of Kenya and Zimbabwe, hit an unfortunate dead end due to its entrenched economic and medical dependence on the US, raising questions about the state’s sovereignty and negotiating power.
According to a draft memo prepared by the Zambia desk in the US State Department’s Africa Bureau, “Repeatedly, we (i.e., the US government) needed to threaten or actually withdraw assistance important to the Government of the Republic of Zambia (GRZ) to elicit progress on our priorities.” The blatant use of threats to the GRZ clearly illustrates that unlike the USAID, these agreements only serve the strategic and economic interests of the US, while encroaching on Africa’s medical sovereignty and negotiating power.
In Zambia’s health agreement, not only did the US link funding to the provision of sensitive national health data and pathogen information, it additionally linked it to a “bilateral compact”, requiring Zambia to grant American firms preferential access to its vast copper, cobalt, and lithium mineral reserves. In order to achieve this, the US employed the use of threats and bullying tactics to force the hand of the GRZ and seek their compliance.
The breaking point for the GRZ was when the US threatened to cancel a planned deal that would relieve Zambia of hundreds of millions of dollars from its foreign debt payments. According to the memo, “Within days, the Zambian Mines Minister explicitly reversed course, telling US Government (USG) officials the GRZ is amenable to negotiating preferential access, and the GRZ gave USG technical experts unprecedented access to their mining database.”
As Zambia has relied on funding from the President’s Emergency Plan for AIDS relief (PEPFAR) for over two decades, approximately 1.3 million people immensely depend on US funding for their HIV/AIDS medication. The Trump administration has elucidated that the evolution of American values now lies in gambling with the lives of millions of Africans for the purpose of gaining and asserting its economic and medical superiority over all nations.
More importantly, with the global biotechnology sector estimated to be worth over $3.88 trillion by 2030, biological data obtained from African countries has become as strategically valuable and profitable as oil, minerals, or rare earths. African countries risk creating a new scientific form of neo-colonial dependency — one that feeds the global bioeconomy, fueling vaccine platforms, AI-driven drug discoveries, and pharmaceutical patents — where none of those medical benefits will touch the ground of any given African nation.
The bilateral health agreements position African states as passive subjects at the behest of the US political and economic agenda. Africa needs to do away with the Trump administration’s destructive path from multilateralism to realist-oriented bilateral partnerships and foster more intra-regional cooperation that prioritizes African interests and way of life. As Dr. Jean Kaseya, Africa CDC Director-General, impeccably said: “We want to own our data in Africa. We want to own our future. We cannot accept not owning our data.”
The Zeitgeist aims to publish ideas worth discussing. The views presented are solely those of the writer and do not necessarily reflect the views of the editorial board.
