Africa Must Guard Against Biomedical Extractivism in Global Health Deals

Late in February, Zimbabwe withdrew from a proposed $367 million United States health funding agreement after objecting to provisions requiring broad American access to sensitive national health data.

The five-year programme was framed as support for efforts against HIV/AIDS, tuberculosis, malaria, and epidemic preparedness. But the terms demanded extensive sharing of epidemiological surveillance data and pathogen samples without binding guarantees that Zimbabwe would receive equitable access to medical technologies developed from them.

Harare described the proposal as an “unequal exchange”, warning that the country risked supplying the “raw materials for scientific discovery” while the resulting benefits remained concentrated in the United States and global pharmaceutical companies.

Critics increasingly describe this pattern as biomedical extractivism, a form of scientific exploitation that mirrors the logic of colonial resource extraction. Zimbabwe is not alone in raising concerns.

In Lusaka, officials and civil society organisations have questioned a proposed United States–Zambia health partnership valued at more than $1 billion over five years. The draft agreement reportedly requires Zambia to contribute roughly $340 million in domestic co-financing while granting Washington far-reaching access to national health data and pathogen-sharing arrangements.

One controversial clause would allow the agreement to be terminated if Zambia fails to conclude a separate bilateral minerals compact with Washington covering resources such as copper and cobalt. Meanwhile, in Kenya, the High Court suspended a similar $2.5 billion health agreement last December after a legal challenge argued that it could expose sensitive health data without sufficient safeguards under the country’s Data Protection Act.

Taken together, these disputes point to a broader pattern unfolding across the continent.

They come as Washington expands a network of bilateral health agreements under its “America First Global Health Strategy”. According to the Kaiser Family Foundation, the United States has signed more than 20 memoranda of understanding with African governments, with implementation timelines ranging from 2026 to 2030 and commitments totaling approximately $20 billion.

Although presented as partnerships, a significant share of the funding is expected to come from African governments themselves, increasing fiscal pressure while deepening structural dependence. At least 17 African countries have already concluded similar agreements, many with fragile health budgets and limited negotiating leverage. These programmes finance important work against HIV/AIDS, tuberculosis, Ebola, and malaria while strengthening surveillance systems, laboratory capacity, and outbreak preparedness. But they also shift bargaining power sharply towards Washington.

In Nigeria, for example, some funding provisions reportedly require Abuja to commit to prioritising the protection of Christian populations from violence, demonstrating how political conditions can be embedded within public health cooperation. At the centre of the controversy lies what the United States expects in return: health data and pathogen samples.

In the age of biotechnology and pandemic preparedness, such information fuels the global bioeconomy, driving vaccine development, pharmaceutical patents, and artificial-intelligence-assisted drug discovery. Biological data has become as strategically valuable as oil, minerals, or rare earths.

Without safeguards, African public health systems risk becoming upstream suppliers of biological information while downstream benefits intellectual property, pharmaceutical manufacturing, and commercial profits remain concentrated in wealthier countries. These anxieties are not abstract. They are shaped by a long and troubling history in which medicine in Africa has often intersected with imperial power.

During the colonial era, European administrations used medical campaigns not only for disease control but also as instruments of surveillance and coercive governance. One of the most notorious examples occurred during sleeping sickness control programmes in French Equatorial Africa between 1921 and 1956, when entire villages were assembled for compulsory medical examinations and injected with experimental treatments such as atoxyl, a drug later linked to blindness and death.

Modern controversies have only deepened scepticism. In 1996, during a meningitis outbreak in Kano in northern Nigeria, the pharmaceutical company Pfizer tested an experimental antibiotic called Trovan on children at a field hospital. Nigerian investigators later concluded the trial lacked proper regulatory approval, and a government inquiry described it as an illegal study of an unregistered drug. Pfizer ultimately reached a $75 million settlement with Kano State in 2009 while continuing to deny wrongdoing.

Today, the stakes are even higher. Public health systems generate laboratory results, genomic sequencing, epidemiological records, and biological samples during outbreaks. The global biotechnology industry is valued at more than $1.5 trillion and is projected to reach nearly $4 trillion by 2030. In other words, biological data is among the most valuable scientific resources of the 21st century.

Ethicists have long argued that international medical research must ensure fair benefit-sharing. In a widely cited 2004 study, bioethicist Ezekiel Emanuel and colleagues argued that ethical research in developing countries requires collaborative partnerships with local institutions and equitable distribution of resulting benefits.

Yet that principle is often absent from current bilateral health arrangements. The lessons of the COVID-19 pandemic remain fresh. Scientists around the world relied on rapid sharing of viral samples and genomic data to track the virus's spread and develop vaccines. But when vaccines became available, many African countries found themselves at the back of the queue while wealthier states stockpiled supplies.

The World Health Organization attempted to address these inequalities through the 2025 Pandemic Agreement, which proposes linking pathogen sharing with fairer access to resulting technologies. Bilateral deals risk undermining those multilateral efforts. By negotiating directly with individual countries, powerful states can secure privileged access to pathogen data without being bound by broader frameworks designed to ensure equitable benefit-sharing.

The issue is not whether health data should be shared. Global cooperation is essential for pandemic preparedness.

The real question is whether countries providing that data receive fair and transparent access to the vaccines, diagnostics, and treatments developed from it. African governments, therefore, face a delicate balancing act: protecting life-saving health programmes while defending data sovereignty and reciprocal partnerships. One solution may lie in collective negotiation through institutions such as the African Union and the Africa Centres for Disease Control and Prevention rather than fragmented bilateral agreements.

Formally voluntary negotiations between a global superpower and financially constrained health systems rarely occur on equal terms. Washington has already begun winding down health funding in Zimbabwe, following the collapse of the talks, a reminder of the pressures facing countries that resist such arrangements. History offers a cautionary lesson. In the nineteenth century, colonial powers advanced through divide-and-rule tactics, isolating African societies one by one. Avoiding a new era of scientific extraction will require unity. If African countries share their data and pathogen samples, they must receive equal and transparent access to the knowledge, technologies, and medicines that result. African bodies should never be treated as raw material for someone else’s scientific progress.

US Africa health agreements