Health and development experts are concerned that African governments are losing their collective bargaining power under the United States’ new “America First” global health strategy as they sit alone across the negotiating table from the world’s most powerful nation.
The U.S. State Department has sent roving teams to visit African countries to negotiate overarching bilateral health agreements, as opposed to leaning more heavily on funneling money through nongovernmental organizations to implement global health programing.
A template of the agreements obtained by Devex outlines points under negotiation such as how funding responsibilities will shift from the U.S. to partner governments annually and ensures those governments commit to “co-investment” from their own budgets as opposed to using funds from other donors or multilateral organizations. But more controversially, it also includes decades-long requirements for African countries to share sensitive data with the U.S.