Human Rights Watch has raised serious concerns over new US global health aid agreements that it says place harmful conditions on lifesaving medical assistance, including requirements for surveillance access, pathogen data sharing, and compliance enforcement mechanisms that may undermine privacy and human rights.
According to a report released on 8 June 2026, the United States has signed bilateral health agreements with several African countries, including Ethiopia, Kenya, Mozambique, Nigeria, Rwanda, Liberia, and Uganda. The agreements reportedly condition health funding on broad access to national health data systems and biological samples, raising concerns about data privacy, equity in medical research, and control over health resources.
Human Rights Watch warned that the agreements could give external actors extensive access to sensitive patient health information, with limited safeguards or clear protections for confidentiality. The organization also highlighted provisions requiring countries to share pathogen samples and related data, potentially influencing how future diagnostics, vaccines, and treatments are developed and distributed.
The agreements also include provisions linked to compliance with US legal requirements, including monitoring for abortion-related restrictions under the Helms Amendment. Critics argue that such requirements may lead to expanded surveillance of healthcare systems and create pressure on governments to allow inspections and reporting that could affect the delivery of reproductive health services.
Human Rights Watch noted that failure to comply with data-sharing and surveillance conditions could result in the withdrawal of funding, potentially disrupting access to essential medicines and healthcare services in countries already dependent on external aid. The organization warned that such conditions could undermine long-standing global health programs, including HIV treatment and prevention efforts.
Civil society groups in affected countries have expressed opposition to the agreements, arguing that they risk weakening national sovereignty over health systems and failing to protect vulnerable populations. Some organizations have also raised concerns that the agreements do not ensure equitable access to medical products developed using shared biological samples and data.
The report further states that the agreements were negotiated following a broader restructuring of US foreign health assistance, including reductions in funding and the closure of key development programs. Critics say the shift has created pressure on countries to accept terms that prioritize external access to data and resources over local public health needs.
Human Rights Watch is calling for greater transparency in the agreements, stronger protections for patient privacy, and the involvement of civil society and multilateral health organizations in future negotiations. It argues that global health assistance should strengthen healthcare systems without compromising human rights or restricting equitable access to medical innovations.
