Kenya has signed a historic five-year health agreement with the US, the first such pact since Donald Trump’s administration overhauled its foreign aid programme.
The $2.5bn (£1.9bn) deal is aimed at combating infectious diseases in Kenya, with similar agreements expected to be rolled out in other African countries aligned with Trump’s broader foreign policy goals.
The government-to-government deal aims to boost transparency and accountability but has raised fears it could give the US real-time access to critical health databases, including sensitive patient information.
Kenya’s Health Minister Aden Duale sought to allay such fears, saying “only de-identified, aggregated data” would be shared.
On his first day in office in January, Trump announced a freeze on foreign aid as part of a government spending review, dismantled the US Agency for International Development (USAID) and cut billions in aid to poorer countries.
This has led to a drastic reduction in the availability of some drugs in developing countries.
In September, the Trump administration introduced an “America First Global Health Strategy”, making aid dependent on negotiations that officials said would cut waste and advance US priorities.
Under the deal with Kenya, the US will contribute $1.7bn, with the Kenyan government covering $850m and gradually taking on more responsibility.
The deal targets the prevention and treatment of HIV/Aids, malaria, and tuberculosis, maternal care, polio eradication and infectious disease outbreak response and preparedness.
Signing the agreement with Kenya’s President William Ruto, US Secretary of State Marco Rubio described it as a “landmark agreement,” and referred to Kenya as a “longstanding American ally”.
He praised Kenya for its role in leading and contributing to the UN-backed mission working to combat powerful gangs 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 explained that the US wanted its foreign aid to go directly to governments, rather than through aid agencies and charities.
“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 president said the money would be used to work towards the country’s priorities, such as buying modern equipment for hospitals and boosting the health workforce.
“I assure you that every shilling and every dollar will be spent efficiently, effectively, and accountably,” Ruto added.
However, some Kenyans are demanding the disclosure of the full agreement, with fears that it would allow the US to view personal medical records such as the HIV status, TB treatment history, and vaccination data of Kenyan patients.
“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 voiced similar concerns, urging the Kenyan government to release the full agreement so “we can read it for ourselves”.
Minister Duale has dismissed such fears, insisting that Kenya’s health data remained secure and fully protected by Kenyan laws.
“Your health data is a national strategic asset,” Duale added.
US officials are yet to comment on the data concerns.
A number of other African countries are expected to sign similar agreements by the end of the year, according to US officials.
