In Africa, around twenty countries have signed a bilateral agreement with the United States as part of “The Global Health Strategy – America First”. A program launched by the Trump administration to, officially, “ protect the national territory by preventing infectious disease outbreaks from reaching U.S. shores […] and save millions of lives and help countries reduce their dependence on foreign aid “. But some African states like Zambia or Zimbabwe have decided not to comply with American conditions.
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With our correspondent in Johannesburg, Claire Bargelès
After the restructuring and massive reduction of several American health programs, the countries which benefited from them are now being pushed to accept bilateral agreements with the Trump administration, in order to be able to unlock new aid.
On the African continent, many states have already agreed to play the game of this “America First” strategy, signing texts worth millions of euros. The United States has signed 5-year bilateral agreements with around twenty African countries, including, most recently, Burkina Faso, Guinea, Niger and the DRC.
According to Washington, the objective is, in the long term, to reduce dependence on international aid, and the States concerned undertake to co-finance programs, for example to fight malaria, HIV or maternal and infant mortality.
Also readDRC: a cooperation agreement signed with the United States in the field of health
« A simple negotiating tool for a rapacious administration »
It is also the global context that pushes these countries to accept American conditions, because funding is becoming scarce. France should, for example, reduce by 58% the amount it has so far dedicated to the Global Fund to Fight AIDS, Tuberculosis and Malaria.
But for Asia Russell, director of the Health Gap organization which fights for better access to treatments against HIV and AIDS, it is very worrying to see such texts being signed without consultation. “ These bilateral agreements are very different from the way the Pepfar program [le President’s Emergency Plan for AIDS Relief, plan d’aide d’urgence à la lutte contre le sida à l’étranger lancé en 2003 par les États-Unis, NDLR] worked, she explains. It was based on scientific evidence, in complete transparency, with national governments interacting with HIV carriers and the US government, to evaluate the progress of the programs and determine where billions of dollars should be invested, in which clinics and in which area. »
She laments: “ When health becomes a simple negotiating tool for a rapacious administration that wants, in exchange, to exploit sovereign resources, such as minerals, it can lead to disastrous results. Programs may not meet the needs of people who are at risk of dying if they do not have access to treatment or effective means of prevention. »
Little transparency
In fact, the clauses and amounts vary, depending on the negotiations that have been carried out. But overall, there is relatively little transparency, particularly when it comes to sharing health data, which can give Americans an advantage in health surveillance.
This is what pushed Zimbabwe to refuse to sign such an agreement, deemed ” asymmetric » by the government spokesperson.
Zambia is asking for a renegotiation, while certain elements seem to indicate that compensation would be requested in the mining sector. As for Kenya, it was the courts which temporarily blocked the application of the signed text, in order to verify that it complies with local laws.
Also readHow Donald Trump’s “America first” is setting the United States back on the international stage
