Questions on Kenya's 25-year Health Pact with the United States

On Thursday, December 3, President William Ruto, on behalf of the government of Kenya, signed the United States and Kenya five-year, $2.5 billion health cooperation framework. This framework was the first to be announced as part of dozens of planned "America First" bilateral health agreements following the Trump administration's dismantling of USAID. The funding under this pact will focus on supporting digital framework within the country to make sure things like the billing system works for all health facilities and building the essential benefits package to identify the needs of HIV, TB and malaria patients.^[1]

For the past three years, there have been unfinished negotiations between Kenya and the United States to establish the Strategic Trade and Investment Partnership (STIP). Opposition inside Kenya to this STIP has forced the data companies to seek the legal cover of the US government for their operations in Kenya. For more than four decades, under the cover of the USAID, western corporations have been involved in questionable experimentation in the health sector of Kenya. 

Kenya has been the scene of repeated scandals associated with ‘aid’ in the health sector. These controversies became so prominent that books, dissertations, theses and scholarly articles revealed the depth of the exploitation and experimentation in Kenya. John le Carré’s novel, The Constant Gardener—and its subsequent film adaptation—depicted the fictional murder of an activist in Kenya investigating a pharmaceutical scandal. In real life, The New England Journal of Medicine published critical editorials on the ethics of experimentation in Kenya and East Africa. One key editorial, “The Ethics of Clinical Research in the Third World” (September 18, 1997), was authored by Dr. Marcia Angell, then the executive editor. She strongly criticized trials conducted in Kenya, Uganda, and Tanzania, arguing that they represented a “retreat from ethical principles” and a “double standard” by using placebos when an effective AZT treatment (the ACTG 076 regimen) was already the standard of care in the United States and Europe.

Since that editorial nearly thirty years ago, USAID has also been implicated in numerous scandals within the health sector, to the point that they attracted the attention of the Inspector General of the U.S. government. During the signing of the Health Framework of Cooperation, the U.S. Secretary of State alluded to these scandals in the health and NGO sectors, stating:

“This makes no sense. So why are we hiring American and international NGOs to go into other countries and run health care systems that are parallel to—and sometimes in conflict with—the health care systems of the host country? If we’re trying to help countries, help the country; don’t help the NGO to go in and find a new line of business. And so that’s the model we’re breaking. We’re not doing this anymore. We are not going to spend billions of dollars funding the NGO industrial complex while close and important partners like Kenya either have no role to play or have very little influence over how health care money is being spent. Bottom line: if you want to help a country, work with that country, not with a third party that imposes things on that country.” (Department of State 2025)

Big tech in Kenya

In addition, different scandals regarding the distribution of HIV supplies have come to light in more recent years. In the Donald Trump administration, the liberal arm of empire, as manifest in entities such as the USAID, has been jettisoned in favor of direct relationship with organizations such as Palantir and Oracle, who have been tiptoeing inside the Kenyan health system for many years. In the words of the BBC, Palantir has been “sometimes described as the ‘scariest’ of America's tech giants - it got its start working with US soldiers in Iraq and Afghanistan, but now supplies software to police departments, other public agencies and corporate clients.”^[2]

Palantir is already active in the health sector in Britain, Israel and Saudi Arabia and is seeking to gain a strong foothold in Africa. Kenya has been an attractive base for foreign capital inside East Africa since, for the past fifty years, the financial institutions have been organized to drain capital from Africa. Fin Tech wants to bring the colonial model up to date.

Data and capital accumulation

Data is the currency of the fast-growing global digital economy and tech companies have invested billions in connective technology infrastructure based on their for-profit business models which monetize data. Like any society’s natural resources, the personal data of citizens belongs to citizens, and they have rights to privacy. Data used by the government, from military secrets to promoting the nation’s best tourist locations, must be stewarded properly by our elected officials. The Kenyan government’s recent announcement of a “deal” with the USG involving the sharing of healthcare data of Kenyan citizens in return for financial resources raises numerous questions.

• The government claims all shared data will be anonymized and governed by Kenyan law, but what is the current quality and standards of Kenyan law in protecting the privacy rights of Kenyan citizens? 

• Most jurisdictions with strong data privacy laws allow the personal data of their citizens held by the government or private companies to be transmitted across borders, only to other jurisdictions which also have strong data privacy laws. Does the USA have strong data privacy laws?  In the US, there are currently no countrywide federal data privacy regulations in place. What recourse and rights do Kenyans have if there are breaches involving their health data in the US? 

• Many jurisdictions are developing regulatory frameworks which create classification levels of data held by governments, ranging from “top secret” to readily available public information.  For example, the Government of the Philippines recently created a government data classification regulatory framework. Should the government of Kenya develop a robust government data classification regulatory framework, including health data of Kenyan citizens, before making deals with foreign governments, including sharing such data?

• Most forward-thinking governments develop transparent processes involving a wide range of public and private sector participants to provide input on proposed international agreements with foreign governments, before such deals with a foreign government are signed. For example, the Government of Singapore recently announced that it is open to receiving inputs from the public before it signs a new international green economy deal with foreign jurisdictions, and it also sought comments from the public before agreeing to allow a new foreign nation to join one of its existing international digital economy and data agreements.  Did the Kenyan government provide Kenyan public and private sector stakeholders with an opportunity to transmit their views on this deal with the American government?       

Kenyan citizens and some parliamentarians are already questioning whether this health data sharing deal with the USG will produce tangible benefits for Kenya. After all, the value of the deal is based on the health data of Kenyan citizens. However, in the absence of affirmative answers to the above questions hope is all we have that our data won’t become the latest iteration of how Kenya’s coffee, tea and flowers are extracted for the primary benefit of others. 

Digital colonialism

Danielle Colemenn defined digital colonialism as:

“a modern-day “Scramble for Africa” where largescale tech companies extract, analyze, and own user data for profit and market influence with nominal benefit to the data source. Under the guise of altruism, large scale tech companies can use their power and resources to access untapped data on the continent. Scant data protection laws and infrastructure ownership by western tech companies open the door for exploitation of data as a resource for-profit and a myriad of uses including predictive analytics.”  (Coleman 2019)

Kenya, often referred to as “Silicon Savannah,” has emerged as a hub for imperial penetration with collaboration between tech firms, the military and financial institutions.  While these companies have proclaimed their contribution to infrastructure development, job creation, and digital service expansion, their operations have generated significant criticism across multiple dimensions. Labor practices represent one of the most contentious issues. Outsourced workers—particularly those engaged in content moderation and AI data annotation—are frequently subjected to extreme exploitative conditions, earning wages as low as $1.50–$2 per hour despite exposure to psychologically harmful material. Reports indicate widespread mental health challenges, including post-traumatic stress disorder and depression, compounded by inadequate support systems and precarious employment contracts. Attempts to unionize have often been met with retaliation, including dismissals and abrupt contract terminations, raising concerns about systemic labor rights violations.

In addition to labor concerns, data privacy and consumer protection have become critical areas of scrutiny. Unregulated digital lending platforms have engaged in invasive practices such as harvesting personal contact data and publicly shaming defaulters, contravening Kenya’s data protection laws. Broader critiques target the opaque collection and monetization of user data by tech platforms, fueling fears of surveillance capitalism and eroding public trust in digital ecosystems. These issues intersect with accusations of foreign control over local digital infrastructure, often framed as “digital colonialism.” Key national platforms, including eCitizen and cloud-based health systems, have been managed through opaque agreements with foreign-linked entities, raising alarms about sovereignty, corruption, and dependency. Furthermore, the extraction and monetization of local knowledge—such as agricultural and transactional data—by foreign firms with minimal benefit to local communities underscores structural inequities in Kenya’s digital economy.

Concerned citizens in Kenya have sought to address these challenges, though with mixed outcomes. Landmark lawsuits against Meta and its subcontractors over labor conditions have tested the jurisdictional reach of Kenyan courts, while proposed legislative amendments aimed at shielding outsourcing firms from liability have drawn criticism for undermining worker protections. Concurrently, Kenya’s Competition Authority has advanced antitrust measures to curb monopolistic practices, algorithmic collusion, and data hoarding by dominant platforms. These developments highlight the continuation of Kenya’s role as an outpost to imperial penetration and exploitation. 

Young doctors and tech workers are increasingly strengthening their organizational capabilities to safeguard ethical standards, labor rights, and national sovereignty in an increasingly digitized economy. Harriet Washington alerted us in the book, Medical Apartheid to the existence of genetic perdition. This refers to the perceived damnation or ruin of the Black community's health and social standing by falsely attributing health outcomes to intrinsic, unchangeable biological flaws. The chapter on “Race, Technology, and Medicine” is particularly relevant for the activists of the Consumer Federation of Kenya (COFEK) who are calling for parliamentary oversight, public consultation and transparent fiscal impact assessment. COFEK’s success in getting the Kenyan High Court to suspend the implementation of the health pact pending court determination of the legality and privacy issues in the pact is a step towards achieving transparency and public oversight over the deal.[3]

Horace G. Campbell is a peace and social Justice activist. He is also Professor of African American Studies and Political Science at Syracuse University and Chairperson of the Global Pan African Movement, North American Chapter.  He is the author of Global NATO and the Catastrophic Failure in Libya, Monthly Review Press, 2013. 

Endnotes