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Why Trump’s “America First” Health pacts aren’t as tame as they seem.
Borders are a helluva thing. Especially on maps. Arbitrary, yet manifest in every way that we live our lives. Recently, a few colleagues and I toured the David Rumsey Map Center in Stanford University’s Green Library, where I saw for the first time a cartographer’s impression of Africa from the year 1808. It was incredible, seeing places I live in and have been to but with different names, and how different the borders of nations within Africa were from the map that we know today.
141 years ago, in the city of Berlin, the start of many, many lessons taught to Africans about Otto von Bismarck, the Prussian leader, began. He was the convenor of the Berlin Conference of 1884–85, euphemistically called “the scramble for Africa.” Scramble — a word as soft as eggs, but so vague that it concealed the violence that was underway on the continent. No small irony that a Germany unified only 15 years earlier was already leading the charge to carve up a far-away land. That’s the benefit of power and the ability to write one’s own history.
You can lean on the scales when there is a need to add weight to some part of your history, but paint broadly over the things that require specificity but aren’t in your interest to define in clear terms. This is how I feel about the Health Co-operation Framework signed between Kenya and the United States on the 4th of December, 2025.
The agreement reads like a glass of water. Functional, doing all the things it needs to do yet not really exciting enough to awaken any suspicion. It envisions Kenya and the US jointly funding the building of state-of-the-art disease surveillance systems, the sharing of Kenyan citizens’ health data under the strictures of Kenyan law, and the efficiencies of funding healthcare through public institutions rather than non-governmental organisations. All of this seems reasonable — Kenya does need to simplify how it funds its healthcare, and some NGOs had long become a crutch upon which our healthcare systems leaned. We do have brand-new laws to meet the challenges that the digital age brings. And yes, a lot of our funding can benefit from being tied to a clock (a good measure of it already is) to prevent mission creep. Still, something doesn’t smell right. It is something of a small miracle that another document that points to the source of the stink exists. The United States National Security Strategy, drafted in November but published on the very same day that Kenya signed its co-operation agreement, is worth reading as well, because it lays bare the foundational logic of the co-operation agreement’s benign language.
Specifically, in the section of the strategy discussing the United States’ relationship with its partners in Europe, it goes into a lament about Europe’s degraded capacity to defend itself — citing the spectre of violence in the Russia-Ukraine war, lambasting European nations’ efforts to end the war as little more than empty rhetoric, and an unmerited entitlement by NATO nations to the United States bankrolling any serious efforts to bring Russia to heel. Trump has said this before; but in the document, he goes further:
“Over the long term, it is more than plausible that within a few decades at the latest, certain NATO members will become majority non-European. As such, it is an open question whether they will view their place in the world, or their alliance with the United States, in the same way as those who signed the NATO charter.”
He didn’t have to spell it out, but it is the closest that any strategy document that I’ve seen has come to mirroring the warnings of racists of yore about the creation of “mongrel nations” out of racial mixing. Trump is saying that Europe can only be a trusted partner if it is white as the driven snow. This has set off a firestorm of commentary about the vile, racist, and hostile nature of the United States’ current regime. I doubt that any black or brown person who has read the strategy document or seen the reactions to it is in the least bit surprised by Trump; the surprising bit is the shock and horror with which his document has been received by Europe. Trump has simply said, through this document, what others have tried to deodorize in more innocuous language. Here’s one quote from the year 2022 reflecting the very same sentiments. These words were spoken by the European Union’s then High Representative for Foreign Policy and Security, Josep Borrell:
“Europe is a garden. We have built a garden… The rest of the world is not exactly a garden. Most of the rest of the world is a jungle, and the jungle could invade the garden.”
Borrell would later try to walk back the statement, saying that he was referring to Europe’s stable institutions in comparison to other (black and brown) parts of the world where instability and conflict reign. But institutions don’t invade one another — people do. All Trump has done is rip the mask of politeness from Europe and force them to contend with the ugly truth behind their political correctness if the US can be Europe’s partner going forward.
Simply because Europe’s future is blacker and browner than it is white.
Frantz Fanon was right — in this version of the world, the black (and brown) body always represents something radicalizing. As long as you are not white, you represent an inherent threat. So, by the same logic, if black and brown people can’t be trusted as partners in helping secure the world, how can the US be a trusted, fair-minded partner in honouring its pledge to keep Kenyan health data safe? Can Africa separate America’s stated suspicion of black and brown people in one context from its approach to Africa in another? These racial statements aren’t in one of his rambling speeches or tweets. They are the official framework for the “new America.” New boss — meet old boss.
The strategy document is unequivocal in how the US will be approaching Africa going forward — trade, not aid, and strategic investments, beginning with the energy and minerals sector that can provide good returns on investment. You can see that same logic in the text of the Kenya–US agreement. To be sure, Africa doesn’t need more paternalism embedded in its dealings with the rest of the world. But there’s a larger context that Kenya and other African nations ought to consider when weighing whether to partner with the United States. The US is in perhaps the most important race against other world nations, notably China, to develop the most powerful artificial intelligence and thus control the future economy. However, training data for various models is becoming more and more scarce, specifically healthcare data. The phrase “data poverty” could not be more apt when discussing just how under-represented Africa is in terms of healthcare training datasets. Herein lies the opportunity, underneath all the banal language in the agreement.
The co-operation framework’s stated objective is “to detect, prevent, and respond to emerging and existing infectious disease threats affecting both Kenya and the United States.” African health data isn’t just important for African health; it is even more important for another stated objective in the US strategy document — profit. There are hundreds of possibilities in which the health data, used as training data, can produce medicines, medical innovations, and data about the African genome that are worth a fortune to companies that have already built the engines they need to break down this data. And it is precisely here that the data-sharing agreement becomes its most vague.
Article 3(f) says benefits accruing from the insights gained from the data “shall require entering into other subsidiary agreements” without defining what constitutes a benefit, who initiates negotiation, or what enforcement mechanisms exist. Article 5(g) explicitly states this “does not constitute an international agreement” — meaning no international arbitration, no binding enforcement. This is more insidious than simple extraction. It’s extraction disguised as partnership, where protective language exists but enforcement mechanisms don’t.
Africa does face the legitimate risk of not benefitting from the development of healthcare solutions based on its own data — but this should be looked at as an opportunity for Africa to gather and manage its own datasets, collaborating internally, or at least with partners whose expertise doesn’t come at the expense of our dignity. We need not run at the pace of the US and others towards a finish line where the spoils will likely be shared between and among nations for whom we are just a resource — trusted when there’s a task to be managed or profit to be made — but not when our babies rise to power in their capitals.
Yet Kenya itself, the first African country to sign this agreement, can’t escape scrutiny here. The contradiction becomes clearer when we look inward. Kenya’s National Intelligence Research University (NIRU) recently launched a hackathon, asking citizens to submit AI innovations across five thematic areas: cybersecurity and data protection, security and safety, sustainable development and economic innovation, governance and public policy, and homegrown generative AI. The government trusts the public to build tools that will be used to surveil that same public but doesn’t trust them to build the future of Kenya’s healthcare systems. Instead, Kenya follows the US lead, signing onto a healthcare data agreement whose benefit-sharing provisions remain deliberately vague. The government demands more specificity from citizen hackers building surveillance tools than it secured from the United States in an agreement governing Kenya’s genomic sovereignty.
But why must it be so? This age isn’t just one of great change and the trepidation that comes with tidal shifts. Opportunities abound in our collective re-imagination of what our health systems, our economies, even our cultures can be. Interestingly, it isn’t the big, powerful nations that are leading the way; rather, it is economies that have been at the margins of great power, like us, that we can learn from, and even share with. Estonia is perhaps one of the best examples of how this can happen. The country has created a digital health system that is based on principles akin to radical transparency; every Estonian has rights of access to every bit of their healthcare data. Agency over large datasets need not only be in the hands of governments. If anything, it is the principle that governments build together with their citizens that is pushing Estonia’s digital healthcare system to the front of the pack. Closer home, Botswana is raising capital to buy diamond mining company De Beers, shifting leverage back towards the sovereign, as opposed to giving away its national assets. They are changing the story that our shared history said could not be changed. None of these examples are perfect examples, but they are countries whose domestic and foreign policies put the destiny of their nation in the hands of their own people. Examples of better ways to approach this new age abound, if only we care to look.
So, we return to Berlin in 1884 — to the euphemistic scramble for Africa. The sequence of conquest that emerged from the conference was broadly the same; they began a civilising mission, using their religions to soften the ground for the next phase — trade. Royal charters would then emerge, where agreements were signed between leaders of kingdoms and communities and companies with mandates from their own countries. All this while, I imagine that Africans felt that they had the agency to deal with their new partners as equals, or that the contact we had with them was in “our interest.” Then came the conquest, control, and colonialism. None of those agreements drawn prior mattered. After colonialism came independence, then proxy control. All this started with maps. Their language is banal, but their power is immense: they build worlds.
We live inside those boundaries that were drawn all of those years ago. Between 35 and 40% of those boundaries are straight lines — the shortest distance between the world the colonialist wanted to build and the resources he got from us. Today, maps are being redrawn around data. The US, China, and other rich nations’ strategies prioritize profit emerging out of the algorithmic and AI empires they are building. The AI race runs on data. African data is sovereign territory. Our leaders risk surrendering it under the guise of cooperation, mistaking benign language for benign intent (or enabling it). We may not yet be in the map rooms where the future is being drawn, though strategy demands that we should be. How I wish our leaders would imagine straight and curved lines of our own making, drafted in map rooms we control.
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This article was first published on John-Allan Namu’s Medium
