US Demands for Health Data Spark Privacy Fears in Africa

The United States has imposed stringent conditions on aid to Uganda and other African nations, requiring access to citizens' health data as part of new agreements. Frank Ssekamwa, a Ugandan attorney and digital rights expert, highlights the dilemma faced by his country: accept terms that expose millions of Ugandans’ personal information to potential breaches or forfeit over $1 billion in aid aimed at combating HIV, malaria, tuberculosis, and other deadly diseases. On December 10th, Uganda chose the former out of necessity.

Across Africa, similar negotiations have unfolded as part of the Trump administration's "America First Global Health Strategy," which seeks to leverage health crises abroad for U.S. national interests. The strategy conditions aid on data access, a stark departure from previous practices where USAID provided billions in aid with fewer restrictions. Countries like Zambia and Zimbabwe have outright rejected initial deals due to these stringent requirements.

ProPublica’s analysis of nine such agreements reveals extensive demands by the U.S., raising significant privacy concerns among digital rights experts. These contracts lack clear limitations on data collection and usage, increasing risks for misuse or exploitation of personal health information. In Uganda's case, the agreement grants direct real-time access to nine national health databases for seven years, including systems storing all health records, lab results, and electronic medical records.

Critics argue that such agreements could expose sensitive health data to unauthorized use or commercialization. Stephanie Psaki, former U.S. coordinator for global health security under President Biden, emphasized the unprecedented nature of these demands, noting the U.S. would never accept similar terms in reverse. Despite these concerns, Uganda agreed to receive up to $1.7 billion over five years for healthcare initiatives, though this amount is less than previous aid levels and will decrease annually.