The Democratic Republic of Congo has signed a $1.2 billion, five-year health partnership with the United States, joining Uganda in embracing Washington’s new bilateral financing model, even as Zambia and Zimbabwe have rejected similar agreements over concerns about health data sovereignty and the terms attached to the funding.
Under the 2026–2031 agreement announced Thursday, Congo will receive $900 million in US government assistance, while committing $300 million in increased domestic health spending.
The partnership targets HIV/Aids, tuberculosis, malaria, maternal and child health, polio eradication, epidemiological surveillance, health workforce development, and emergency preparedness.
The deal follows the same template Washington has recently pursued across Africa — shifting from traditional donor channels to direct government-to-government arrangements that require greater domestic co-financing and structured data-sharing frameworks.
But the model has divided African governments.
Zambia last week rejected a proposed $1.012 billion agreement after a leaked draft memorandum revealed provisions granting extended US access to national health data and strict performance conditions tied to continued funding.
Civil society groups warned the terms risked exposing the country to external leverage over its health system.
Zimbabwe also pulled out of talks on a $367 million health pact, with officials describing the proposed arrangement as “asymmetrical.”
The government said the agreement required sharing biological samples and sensitive health data without guarantees of equitable access to any resulting vaccines or treatments.
Meanwhile, Uganda has already signed a separate $1.7 billion, five-year partnership under the same framework, describing it as a sovereign-guided cooperation model designed to strengthen national health systems while safeguarding domestic control over health information.
The divergent responses come as the United States restructures its global health financing strategy, moving away from traditional aid mechanisms toward bilateral compacts that emphasize domestic investment and direct accountability.
With DR Congo now joining Uganda, and Zambia and Zimbabwe stepping back, the debate over sovereignty, sustainability, and health security is reshaping Africa’s engagement with Washington’s new funding approach.
