African and Global Civil Society Call on African Heads of State and Government to Demand Fair Terms in U.S. Health Agreements

Nearly 50 Organizations Urge African-Led Alternatives that Uphold Equity, Rights, and Public Accountability

NAIROBI, KENYA — Nearly 50 civil society organizations, led by African public health and social justice networks, have issued an urgent letter calling on African heads of state and government to demand equity and sovereignty in new bilateral health agreements with the United States.

Last week, the U.S. signed bilateral agreements with Kenya, Rwanda, Liberia and Uganda and is pressing for additional signings in the coming weeks. Based on public information, the proposed MOUs and related agreements would give the U.S. extensive access to national health data systems and pathogen samples while providing no corresponding commitments on equity, benefit-sharing, technology transfer, pricing or long-term public health strengthening.

The letter urges governments to advance counterproposals grounded in national law, regional strategies, and public accountability, rather than accept one-sided terms. The groups urge African heads of state and government to:

• Avoid one-sided terms that condition health funding on data and pathogen access;
• Advance African counterproposals anchored in sovereignty, equity, and regional public-health priorities;
• Ensure full transparency and meaningful civil society participation; and
• Condition cooperation on enforceable commitments to equity, technology transfer, fair pricing, and benefit-sharing.

“These agreements risk entrenching unequal power dynamics and compromising sovereignty,” said Aggrey Aluso, Executive Director of the Resilience Action Network Africa (RANA). “Africa has committed to building its own health sovereignty; no government should accept terms that hand long-term control of our data and pathogens to a foreign government — and its contractors — without clear, enforceable obligations that protect our people, uphold our laws, and strengthen public institutions.”

The letter reflects a coordinated call by African and global civil-society partners, including Resilience Action Network Africa (RANA), People’s Health Movement Kenya, and Public Citizen, working with a broad coalition of organizations representing people living with HIV, women and youth, health workers, treatment activists, and access to medicines advocates across the continent and beyond.

“These deals ask countries to trade their power and a little of their dignity for less support than Trump took away early this year,” said Peter Maybarduk, Director of Public Citizen’s Access to Medicines Program. “African nations have stood together to negotiate better access to medical tools ever since COVID’s deadly vaccine inequity. Trump would undermine even that principled stand. Each time we think we’ve seen the bottom, the Trump administration finds a way to dig a deeper, darker role for the United States in global health.” 

Read the letter.