Africa eyes new sources of funding for health

African experts said that recent moves by Zimbabwe, Zambia and Kenya to reassess major health funding agreements with the United States could accelerate Africa's diversification of health financing partnerships, deepening South-South cooperation while reshaping engagement with global actors.

Though rooted in different domestic legal and fiscal contexts, experts said the three cases point to a shared pattern: governments are subjecting external health financing agreements to closer scrutiny, with growing emphasis on sovereignty, transparency and alignment with national development priorities.

The reassessment follows Zimbabwe's withdrawal from negotiations on a proposed $367 million US health funding arrangement, citing risks to data sovereignty. In Zambia, authorities rejected elements of a $1 billion bilateral health agreement with the US, raising concerns — among other issues — about provisions related to the sharing of sensitive health data in exchange for financial support. Meanwhile, Kenya's High Court suspended a similar health funding agreement the government had signed with the US after a consumer rights lobby filed a case citing concerns about the safety of Kenyans' health data.

Carlos Lopes, a professor at the Nelson Mandela School of Public Governance at the University of Cape Town, described the developments as evidence of "a maturing and more assertive African approach to global health financing partnerships", adding this could encourage diversification of health partnerships.

Such diversification, he said, reflects a broader effort to move from aid dependency toward partnerships negotiated on more equal footing, with greater emphasis on national ownership, predictable financing and long-term fiscal sustainability.

Melha Rout Biel, executive director of the Institute for Strategic and Policy Studies in South Sudan, said the moves demonstrate that African countries are no longer prepared to accept funding proposals that do not reflect their national or continental interests.

"It offers a new perspective on how Africa is viewing agreements with partners around the globe," Biel said. "It is a sign that Africa can no longer be taken for granted to accept any offer that does not meet her national or continental interest."

Continental effort

According to Biel, the recent decisions by the three countries are "not isolated national decisions" but part of a broader effort to ensure that partnerships are structured as "a win-win situation for the benefits of the two parties to such a deal and not one party dictates the deal".

Deniz Akkas, a political analyst based in Singapore, said the developments reflect deeper structural shifts in how African governments approach external financing.

While the decisions in Zimbabwe, Zambia and Kenya may reflect specific national contexts, Akkas said they "may mark the beginning of a broader continental posture: stricter vetting of external financing arrangements, clearer red lines around policy encroachment, and stronger emphasis on cofinancing and system strengthening."

"This does not weaken global health cooperation," he said. "If handled correctly, it strengthens it."

The developments come as the Africa Centres for Disease Control and Prevention publicly backed Zimbabwe and Zambia's positions, citing concerns over transparency, data governance and national sovereignty within the new US government health cooperation framework.

Jean Kaseya, director-general of the African Union's continental public health agency, said last month Africa CDC would support any country that chooses to withdraw from or renegotiate the framework.

He also raised concerns over pathogen data control and sharing, emphasizing the need for Africa to safeguard its public health information. "We want to hold our data in Africa. We want to own our future," Kaseya said.