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Criticism of a $2.5 billion health cooperation agreement between Washington and Nairobi is growing in Kenya over data privacy concerns, sparking calls for other African countries signing deals with the US to demand “fair terms.”
The Trump administration’s America First Global Health Strategy — a successor to USAID, which previously funded vital health programs across Africa — is in line with its more business-led approach to the continent. Kenya became the first country to sign a new health agreement with Washington this month, and several African countries including Rwanda, Uganda, Liberia, Lesotho, and Eswatini have signed similar deals since.
But following two separate challenges by a local senator and the Consumers Federation of Kenya lobby group, a Kenyan court last week suspended the implementation of the US-Kenya MoU “insofar as it provides for or facilitates the transfer, sharing or dissemination of medical, epidemiological or sensitive personal health data.”
A key sticking point is a provision that allows the sharing of sensitive health data and information on pathogens for up to 25 years, even after the termination of any agreements. The US would also gain extensive access to Kenyan health management systems and electronic medical records, fueling concerns on data protection and conformity with local laws.
Kenyan opposition MP Caleb Amisi, of the Orange Democratic Movement (ODM) party, told Semafor that the Memorandum of Understanding signed by President William Ruto “was going against the confines of the constitution.”
Amisi accused Kenya’s government of deliberately side-stepping public participation to push the agreement through. “The government has bureaucratic institutions from the legal department, health and data protection, but they’ve gone ahead to make an agreement without considering due process,” he said.
Kenya’s President William Ruto has accused nonprofits previously involved in US health programs of spreading misinformation about the deal but has not provided any evidence to support his claims. “If anybody is annoyed, they should take their anger to another place,” he said, suggesting critics take up their concerns with Washington. Kenya’s Health Ministry did not immediately respond to queries from Semafor.
The courts have given Kenya’s government until Jan. 16 to file its response, with the matter scheduled to return to court on Feb. 12.
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The new US global health strategy emphasizes priorities for Washington such as preventing disease outbreaks before they reach America. It also commits partner countries to increasing their health spending.
Fifty civil society organizations from around the continent last week published a letter calling on African governments to demand “fair terms” with Washington. They warned that “these agreements would give the US undue leverage over your governments, including to decrease or cancel health assistance for perceived noncompliance, and undermine your national health and personal security.”
Nairobi-based lawyer Liz Lenjo told Semafor that the Kenyan government had failed to obtain the consent of its citizens to share their health data, raising significant legal and ethical questions. “Anything that concerns citizens should be an open book. If the data is to be shared with a third party [the US], another layer of consent arises,” Lenjo said. “At this point, the ideal thing is for the government to halt any further engagement with the US on Kenya’s data, and start the process afresh following the right procedure.”
Martin’s view
Several African countries have for years struggled to adequately fund their health systems, resulting in poor rankings on global health metrics such as infant mortality and life expectancy. Aid from external donors has become a significant part of many countries’ health systems, as was made clear by the impact of USAID’s closure in countries including South Africa and Kenya. It therefore makes sense that many African leaders would be open to directly receiving increased external funding for the sector from the US.
The interests of these leaders and the Trump administration converge on cutting out nonprofits that have long been central to supporting US-funded health programs in Africa. African leaders who are keen on exerting greater control over massive health budgets are likely to ignore the potential downsides of any agreements.
The lack of a formal public participation process in Kenya on the sharing of sensitive health data, for instance, suggests that the government itself is keen on the MoU’s successful implementation. Several other African leaders, particularly in countries with less stringent data protection laws, are unlikely to face meaningful pushback despite widespread criticism of the agreements from across the continent.
Room for Disagreement
The United States Embassy in Nairobi sought to assure Kenyans that their data will be protected in the agreement, explaining that they would access aggregated data as opposed to personally identifiable data.
“We are just putting on paper the many policies we have had for years, so any data sharing will be aggregated data, in other words, not personally identifiable data,” said Susan Burns, head of the diplomatic mission at the US embassy in Nairobi.
The US government will invest $1.6 billion in Kenyan health institutions as part of the deal, which also commits the Kenyan government to increasing its health spending by $6.5 million over five years.
Notable
- Local public health officials in Kenya expressed frustration over the lack of consultation on the deal signed with the US. According to Defrontera, leaders were “cut out of the negotiations for a sector they legally run.”