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The "America First" health agreements initiated by President Trump signify a decisive shift from wasteful traditional aid toward accountability and national ownership, requiring African governments to co-invest substantial domestic resources while receiving predictable U.S. support. These partnerships strengthen disease surveillance, expand treatment access for HIV/AIDS and malaria, and build sustainable health systems that reduce long-term dependence on foreign assistance. Clear benchmarks and strict timelines ensure taxpayer dollars deliver measurable results.
Trump's bilateral health deals erode African sovereignty by locking countries into long-term commitments that grant the U.S. broad access to pathogen data and medical records, often without clear guarantees of equitable benefit sharing. The frameworks weaken Africa's collective leverage in global forums and risk repeating the COVID-19 pattern, where the continent was last in line for treatments derived from its own data. As U.S. companies secure lucrative contracts, African states quietly lose control over health priorities and digital infrastructure.