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\n 5 Jan 2026
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PREVIEW<\/p>\n
\n Washington is pushing health contracts including tough conditions on big pharma, sexual health and data access<\/p>\n
President Donald J Trump<\/a>\u2019s administration is reshaping\u00a0 development policy again with 13 bilateral pacts with African states so far as part of the \u2018American First Global Health Strategy\u2019. The latest deals are with Ethiopia, Madagascar, Botswana, and C\u00f4te d’Ivoire and worth a cumulative US$2.8 billion, taking the overall total to $16bn. The most lucrative are with Nigeria and Kenya, worth $2.1bn and $1.5bn respectively.<\/p>\n The latest agreements follow the blueprint of prioritising programmes offering treatment and prevention of HIV\/AIDS and TB and malaria, as well as infectious diseases (Dispatches, 15\/12\/25,\u00a0Trump\u2019s USAID 2.0 takes shape<\/a>). That is standard Western development spending and will be a near like-for-like replacement for much of work done by the USAID agency, which was shuttered weeks after Trump\u2019s inauguration in January.\u00a0<\/p>\n But there will still be losers. Organisations such as the Red Cross are reporting that funding for sexual and reproductive health programmes has been dramatically reduced (AC Vol 66 No 6,\u00a0Targeted by Trump \u2013 Africa and Europe draw closer<\/a>).<\/p>\n Several of the agreements have caveats that explicitly promote Washington\u2019s policy interest. Besides promoting private sector medicine that already dominates most health provision across Africa, most notably, Nigeria\u2019s is based on a \u2018strong emphasis on promoting Christian faith-based health care providers\u2019, according to a State Department statement which adds that the US \u2018expects Nigeria to continue to make progress ensuring that it combats extremist religious violence against vulnerable Christian populations.\u2019<\/p>\n Talks with at least ten other African states are close to completion, says the State Department.<\/p>\n The data sharing aspect of the Kenya deal has been used by petitioners to obtain a Nairobi court injunction preventing William Ruto<\/a>\u2019s government from ratifying it pending a Supreme Court ruling.<\/p>\n