Kenya has entered into a significant five-year health cooperation deal with the United States, marking the first arrangement of its kind since Donald Trump reshaped America’s foreign assistance policies.
The agreement, valued at $2.5bn (£1.9bn), is designed to strengthen Kenya’s fight against infectious diseases, with similar frameworks set to be extended to additional African states aligned with the current US administration’s diplomatic objectives.
The direct bilateral structure is intended to improve oversight and reduce misuse of funds, though critics worry it may grant Washington continuous access to vital health systems and potentially sensitive medical records.
Kenya’s Health Minister Aden Duale addressed those concerns, stating that “only de-identified, aggregated data” would be shared.
On assuming office in January, Trump placed a hold on external aid during a review of public spending, dissolved the US Agency for International Development (USAID), and significantly reduced support for lower-income nations.
The change has sharply decreased the availability of some essential medicines in parts of the developing world.
In September, the administration unveiled an “America First Global Health Strategy”, tying assistance to new negotiations that officials said would reduce inefficiency while advancing US interests.
Under the Kenyan agreement, Washington will provide $1.7bn, while Kenya is expected to invest $850m and eventually assume greater financial responsibility over time.
The programme focuses on preventing and treating HIV/Aids, malaria, and tuberculosis, improving maternal health services, eliminating polio, and strengthening responses to epidemics.
During the signing ceremony with Kenya’s President William Ruto, US Secretary of State Marco Rubio described the pact as a “landmark agreement,” and called Kenya a “longstanding American ally”.
He commended Kenya’s leadership within the UN-supported mission confronting heavily armed criminal networks in Haiti.
“If we had five or 10 countries willing to step forward and do just half of what Kenya has done already, it would be an extraordinary achievement,” said Rubio.
The Secretary of State said the United States preferred to channel assistance through governments rather than intermediary organisations.
“We are not going to spend billions of dollars funding the NGO industrial complex while close and important partners like Kenya either have no role to play or have very little influence over how health care money is being spent,” he said.
Kenya’s leader said the funds would support national goals, including acquiring up-to-date hospital technology and expanding the country’s medical workforce.
“I assure you that every shilling and every dollar will be spent efficiently, effectively, and accountably,” Ruto added.
Despite this, some Kenyans are calling for full transparency, arguing that the document should be made public to clarify whether the US will have access to personal health information such as HIV status, tuberculosis history, and vaccination records.
“What specific data categories are being shared? Are genomic data, disease patterns, mental health data, insurance claims, hospital records, or biometrics included? If not, why is that not explicitly written?” lawyer Willis Otieno posted on X.
Well-known whistle-blower Nelson Amenya expressed the same reservations, urging the authorities to publish the pact so “we can read it for ourselves”.
Minister Duale dismissed the allegations, insisting Kenya’s medical information remains safeguarded under domestic law.
“Your health data is a national strategic asset,” Duale added.
Officials from the United States have not yet responded publicly to the concerns raised about data privacy.
According to US representatives, several other African governments are expected to sign comparable agreements before the year concludes.
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