U.S. Signs Health Agreements With Seven African Nations Requiring Data Sharing After USAID Shutdown Cut $800 Million in Aid
The agreements tie health funding to surveillance access and pathogen sample sharing after USAID's early 2025 shutdown cut over $800 million in aid to seven African countries.
hrw.orgHuman Rights Watch released an assessment on June 8, 2026, of seven bilateral health agreements signed in late 2025 between the United States and Ethiopia, Kenya, Mozambique, Nigeria, Rwanda, Liberia, and Uganda. U.S. Agency for International Development in early 2025.
That shutdown cut more than $800 million in health aid to the seven countries. The pacts require recipient governments to grant the United States broad surveillance over their health systems.
U.S. law that bans foreign assistance for abortion services. Failure to supply the required surveillance data could trigger withdrawal of all funding under the agreements, with as little as 180 days' notice.
Five of the agreements—with Rwanda, Ethiopia, Uganda, Nigeria, and Mozambique—contain specimen-sharing provisions. These provisions obligate the countries to provide the United States with biological samples and data on pathogens with epidemic potential as a condition of continued health funding.
A draft template of the specimen-sharing terms, published by journalist Emily Bass, states there is no guarantee that the countries will receive equitable access to diagnostics, vaccines, or treatments developed from their own biological resources.
U.S. State Department's Freedom of Information Act Library on March 13, 2026, then removed days later. Rwanda's and Liberia's agreements were never officially released and became public only through leaks.
More than 60 civil society organizations wrote to African heads of state in December 2025 to raise concerns about the draft terms. LGBT rights groups in Kenya and Uganda said the agreements do not adequately address the needs of marginalized populations who face criminalization and discrimination when seeking public health services.
U.S. Agreement. On March 30 a coalition of Zambian civil society groups urged their government not to sign. Ghana withdrew from negotiations in April, citing the broad data-access demands. Zimbabwe withdrew from negotiations entirely.
Human Rights Watch also noted that the United States has reportedly signed 31 additional agreements whose details have not been publicly disclosed. U.S. government to publish all agreements immediately and to disclose any ongoing negotiations linking health assistance to access to natural resources.
