The Humanitarian Times

By Abdulkareem Haruna
DAKAR – Africa stands at a precarious juncture as the global health architecture undergoes a seismic reconfiguration, defined by the erosion of traditional multilateralism and the emergence of a hard-nosed, bilateral “America First” strategy.
Experts gathered at a recent webinar organized by the Network for Media, Promoting Health and Environment (RemapSEN) warned that the continent’s health sovereignty is increasingly at risk as it navigates a landscape where health is no longer solely a medical concern, but a central theatre for geopolitical influence.

The Erosion of Multilateralism          Stéphanie Chambiano, an associate lecturer in political science at the University of Paris I Panthéon-Sorbonne, painted a stark picture of the current order. The global health framework, historically anchored by the World Health Organization (WHO), is facing unprecedented instability.

The primary catalyst for this shift, according to experts, is the aggressive policy trajectory of the United States. Following the American decision to withdraw from the WHO—citing bureaucracy and alleged mismanagement during the COVID-19 pandemic—the global system has seen a ripple effect of instability. While the withdrawal represents a significant blow to the normative power of the UN, the subsequent vacuum has been filled by a new American paradigm: the “America First Global Health Strategy.”

The Rise of Bilateralism and Data Sovereignty

Unveiled in September 2025, the new US strategy marks a pivot away from the collective, multilateral response model toward a transactional, bilateral approach.
“The United States is not leaving global health, but restructuring its presence to prioritize American interests and values,” Chambiano noted.
Central to this pivot are Memorandum of Understanding (MOU) agreements signed with 32 countries globally. These agreements, which often tie funding to specific policy conditions—including restrictions on gender and reproductive health programs—have raised alarms among public health advocates.

A critical concern for African nations is the requirement for partner countries to share sensitive health data. Experts warn that this creates a strategic advantage for the US in monitoring potential future pandemics and gaining access to vital biological intelligence, while potentially infringing on the sovereignty of the host nations.

While many countries have signed on, the move has met resistance. Zimbabwe, Zambia, and Ghana have notably turned down these MOUs, citing concerns over data privacy and the need for more equitable negotiation frameworks.

Africa’s Fight for Agency

As the continent’s population is projected to double by 2100, the stakes for Africa are existential. With Africa currently producing only 3% of the vaccines it consumes, the drive for health self-reliance is no longer optional.

However, the path to influence is fraught with challenges. The proliferation of decision-making bodies—from the G7 to private entities like the Gates Foundation—has complicated the landscape, often sidelining traditional inter-state discussions at the WHO.
To counter these pressures, Africa is increasingly looking toward collective advocacy. The emergence of the Africa Centres for Disease Control and Prevention (Africa CDC) as a powerful diplomatic voice, coupled with the African Union’s (AU) permanent membership in the G20, represents a strategic shift.
“Africa must speak with one voice,” experts argued during the session. By leveraging South-South cooperation and aligning behind the AU’s “Health Strategy 2016-2030,” the continent is attempting to transition from a passive recipient of global health policy to an active architect of its own future.

The Path Forward

For African journalists and policymakers, the message from the RemapSEN forum was clear: global health is now a domain of high-stakes diplomacy. The challenge for African states will be to reconcile the need for external funding with the imperative of protecting national data, upholding human rights, and ensuring that the continent is not reduced to a mere pawn in the unfolding rivalry between global powers.

As the geopolitical tides shift, Africa’s ability to demand equity in international negotiations may well determine the health outcomes for generations to come.
*This report is based on insights shared during the RemapSEN webinar on “New Global Health Geopolitics: Stakes and Challenges for Africa.”