Aid for Data Is Not Partnership -By Fransiscus Nanga Roka

Today, the most insidious health deal in Africa is perhaps not even about drugs. It may be about control.

If the bilateral health agreements that the United States has signed with a number of African states put essential medical support in exchange for access to private health data and samples of pathogens, then this is not humanitarian leadership. It’s a leverage masquerading as humanitarian assistance.

Of millions of Africans whose access to programs linked to HIV, TB and malaria care is dependent. Their medical privacy, the biological sovereignty of their countries and that public health cooperation must not be a vector for one-way extraction. In front of negotiators and in courtrooms from Kenya, to Zambia and further afield. Now because the longer you have data, much of it the damage will outlive any single administration (especially if its contractually obliged for 25 years as reported). The imbalance is evident: One side has the drugs and dollars, the other is asked to cower data, samples and maybe strategic concessions. By way of bilateral MOUs that look to undermine stronger multilateral mechanisms and dilute fairer global governance frameworks, much further than what has been attempted within the ambit of the WHO for pathogen access/benefit-sharing.

And this is why critics say it is digital colonialism and they are not wrong.

We have seen this story before in Africa: raw materials leave cheap, value returns expensive, and the citizens of extraction are told to be grateful. Only this time the commodities are no longer just copper, cobalt, or lithium. They are genomic sequences, disease surveillance systems, and our most private details of human life: from reproductive histories to sexually transmitted infections, mental health records, and community-level patterns of outbreaks.

Now that is not a technical detail. It is the scandal.

But these contracts could lead to stigma, discrimination and even violence against already vulnerable communities unless accompanied by stringent rules on anonymization, consent standards that cannot be waived according to a higher purpose like scientific research, mandatory geolocation of samples or data storage in countries where the sample was taken, benefit sharing only benefitting indigenous groups living in developed nations. In our part of the world, a health file in ill hands is not just some data, it is in fact a weapon.

This legal backlash is not obstructionist, therefore. It is rational self-defense. It’s good that Kenyan civil society is challenging these arrangements through the lens of constitutional privacy rights and data protection law. Zimbabwe’s omission and Zambia’s reticence should not simply be dismissed as the diplomatically awkward ripples of international climate; rather they represent a wake-up call that sovereignty does not come at a price, least of all one linked to medical dependency.

Nor would it take a genius to recognize the strategic folly of this kind of approach on Washingtons part. Coercive health diplomacy might help in getting signatures, but it all comes at a cost of trust. Trust is the first pandemic infrastructure that you are trained with.

Three lines of urgent defense

These three suggestions must be implemented with urgency because the underlying problem is not limited to public health collaboration anymore. It is the transformation of medical dependence into political weaponization, of private health records into their strategic assets, and of sharing every related pathogen to a *get it one way extractionsystem. First, a continental red line must be drawn by African governments to ensure that no health agreement survives without reciprocal benefit-sharing, independent oversight, and, if necessary, judicial review. That is not obstructionism. It is self-defense. In short, African countries should insist on securing binding returns for any data or biological materials which can provide scientific insight commercial advantage pharmaceutical innovation or geopolitical leverage to a foreign partner: technology transfer co-ownership of research outputs comparison fair access to resultant medicines and enforceable means of redress. In the absence of these guarantees, “partnership” is a euphemism for extraction, and “aid” becomes a diplomatic veneer for asymmetry.

Secondly, all transfers of pathogen samples and population health data should be subject to stringent legal restrictions: time limits, purpose limits, local governance and full public disclosure of contractual terms. Foreign governments and institutions must not have unfettered access forever to intimate health intelligence data fit for kings; treating an entire nation of biological detail as a strategic dossier, delivered to their depths server rooms. The aim of broader health data should be for closely defined purposes. Anything less leads to mission creep, commercial exploitation and surveillance disguised as something else. It is also non-negotiable for local governance: national ethics bodies, domestic data-protection authorities and public institutions at the source country must all retain decisional powers over consent, storage, access and secondary use. And secrecy is indefensible. Contracts including information regarding our DNA, outbreak responses and reproductive histories and epidemiological records can not be buried behind double-talk of diplomacy. And lending in this context is not administrative convenience; it is the mechanism through which inequitable power flees.

Third, put negotiations back to multilateral rules, as on the one hand this is a collective role of weaker states, even for countries tough-bargaining amongst themselves, and thus in multilateral settings there we all have at least some degree of bargaining power like through the African Union or even through each domestic court but be sure with well-established or restrictive roles. Power does not balance in a model made only of two actors — it accumulates. Richer states set the agenda, while poor ones are forced to choose between treating their sick population now or giving away power in perpetuity. That is not consent. That’s just coercion by way of the paperwork. So essentially, this is not a matter of procedural preference for a multilateral framework. It is the last credible obstacle to attempting to turn global health into a marketplace of despair.

If the price of medicine is permanent control over a nation white lab coat the most appropriate use in conjunction with biological future it is not charity. This is extraction with a stethoscope.

Fransiscus Nanga Roka

Faculty of Law University 17 August 1945 Surabaya and Managing Partner Law Firm Victorious Indonesia