The Trump administration is offering hundreds of millions of dollars to African countries to support healthcare structures and fight disease through bilateral health deals that prioritize U.S. commercial interests. Ghana rejected a proposed $109 million health deal with the U.S. in April 2025 due to data protection concerns. Kenya's President William Ruto signed an initial agreement with the U.S. in Washington in December 2024.

U.S. Secretary of State Marco Rubio expressed optimism regarding the Kenya agreement, stating he hoped it would be the first of many. "We hope to sign, I don't know, 30, 40, how many? Fifty? Well, this is number one. We'll always remember this one… and we think we've picked the perfect partner," Rubio said. The health deal with Kenya is valued at $2.5 billion. Kenyan cabinet ministers approved the deal last month, although a Kenyan court initially suspended it following legal challenges concerning patient privacy. Activists also went to court to block the deal.

The U.S. bilateral health deals include a provision that recipient governments prioritize U.S. pharmaceuticals and medical firms for developing and delivering treatments. By mid-May 2025, 32 countries, including at least 20 in Africa, Latin America, and the Caribbean, had accepted these health Memorandums of Understanding (MOUs). A State Department spokesperson said, "The Trump administration has made clear, US foreign assistance is not charity - rather it is strategic capital to be wisely invested to advance US interests - and we expect all of our allies and recipient nations to take seriously American strategic and commercial priorities."

Ghana, Zimbabwe, and Zambia have resisted signing the health MOUs. Zimbabwe cited concerns about requests for medical data as its reason for rejection. Arnold Kavaarpuo, Executive Director of Ghana's Data Protection Commission, detailed Ghana's concerns. "We had concerns around the scope and breadth of data that was being required," Kavaarpuo said. He added that the process involved Ghana generating and passing data to U.S. authorities without reciprocal measures for the protection of Ghanaian data and sovereignty. "It was us generating data and passing it on to the US authorities, and there were no real reciprocal measures when it comes to the protection of Ghanaian data and Ghanaian sovereignty," Kavaarpuo said. "And so from our perspective, once the data left the Ghanaian borders, we had no control over what becomes of it," Kavaarpuo said.

Zambia Foreign Minister Mulambo Haimbe criticized an American attempt to connect health funding with U.S. economic interests, specifically linking the deal to a separate agreement that would grant Washington access to critical minerals. "Our [US] colleagues looked at it from the perspective that [the two deals] must be taken as a package to be negotiated and concluded at one particular time," Haimbe said. He continued, "The US felt that there is need for there to be a preferential treatment in the use of critical minerals. And the framework was to reflect that."

The U.S. announced last month its complete withdrawal from funding HIV/Aids programs in South Africa. An administration official connected this withdrawal to Pretoria's failure to make demonstrable progress on policy requests, which reportedly included the treatment of the white-minority Afrikaner community.