Welcome to Foreign Policy’s Africa Brief.
The highlights this week: Pushback mounts over the Trump administration’s health aid deals in Africa, Gaza’s Rafah crossing with Egypt is set to reopen, and the United Kingdom pauses legislation to ratify its Chagos Islands deal with Mauritius.
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As U.S. President Donald Trump’s administration has inked $11 billion in health agreements with more than 15 African countries in recent weeks, it is facing increased pushback on the continent, especially in Nigeria and Kenya.
In Nigeria, the bilateral deal—whereby the United States has committed $2.1 billion in health aid over five years—is drawing significant backlash across the political spectrum. This has centered on the agreement’s emphasis, in the U.S. State Department’s words, on “promoting Christian faith-based health care providers.”
“Healthcare is a core public good that must remain neutral, inclusive, and universally accessible,” Mallam Bolaji Abdullahi, a member of the African Democratic Congress, a Nigerian opposition party, said last week. Nigeria’s population is roughly split between the predominantly Christian south and predominantly Muslim north.
In December, Kenya’s High Court halted the implementation of a similar aid deal with the United States, pending a legal review over data privacy concerns and a lack of public and parliamentary consultation.
The five-year agreement would see Washington provide $1.6 billion in aid for treatments for HIV/AIDS and other infectious diseases in Kenya. In turn, Nairobi would commit $850 million to pay health workers and move toward becoming independent of aid.
The deal was temporarily suspended after more than 50 rights groups raised concerns that it could potentially give the U.S. government direct access to sensitive personal medical records, compared with the anonymized data used for the President’s Emergency Plan for AIDS Relief, which the new deal seeks to replace.
Civil society organizations and analysts also argue that the deal would give the United States undue leverage over the nation’s health policies. For instance, it commits Kenya to accepting U.S. Food and Drug Administration approvals and U.S. emergency use authorizations—which, critics argue, would weaken Kenyan regulatory institutions.
A $2.3 billion agreement faces similar pushback in Uganda, where politicians, including opposition leader Joel Ssenyonyi, have criticized the government for failing to seek parliamentary approval. “If this is such a good deal, it must be brought to Parliament for review,” Ssenyonyi said.
Washington has intended for these deals, which are part of Trump’s “America First” global health strategy, to serve as a kind of replacement to the now-dissolved U.S. Agency for International Development. Unlike USAID, however, the agreements require countries to provide matching funds and directly report health findings to the U.S. government instead of multilateral organizations, such as the World Health Organization.
The U.S. strategy explicitly prioritizes “commercial diplomacy” and leverages U.S. pharmaceuticals and medical firms to deliver treatments. It also combines health aid with commercial deals in minerals and rare earths. “U.S. health foreign assistance has the potential to be an important counterweight to China especially in Africa,” a September 2025 strategy document states.
Meanwhile, Guinea-Bissau suspended a controversial U.S.-funded vaccine program last week. The $1.6 million study, backed by U.S. Health Secretary Robert F. Kennedy Jr., has generated outrage among global health experts for potentially withholding the lifesaving hepatitis B vaccine from newborns in a high-risk region.
The Danish researchers leading the project have been cited by anti-vaccine activists and questioned by some public health experts for over-interpreting past findings. With this latest study, they were seeking to look at negative effects of the hepatitis B vaccine, including death and developmental issues.
The study was designed as a randomized controlled trial, in which 7,000 newborns would receive the hepatitis B vaccine at birth—as recommended by the World Health Organization—while 7,000 others would instead receive it at 6 weeks of age.
Global health experts, including the Africa Centres for Disease Control and Prevention (Africa CDC), have argued that the study is unnecessary because the vaccine has long been known to be safe. “We are led by the interests of our people in Africa,” Jean Kaseya, the director-general of Africa CDC, said. “We are not led by the small interests of individual people.”
Critics argue that the study is unethical because international law on human research requires that participants receive globally accepted standards of care. “Researchers are exploiting a scarcity situation to basically ram through this unethical study,” Boghuma Titanji, an infectious diseases physician at Emory University, told the New York Times.
Africa has one of the world’s highest burdens of hepatitis B infections due to lack of access to vaccines.
Wednesday, Jan. 28, to Sunday, Feb. 1: U.S. Deputy Secretary of State Christopher Landau and U.S. Africa Command leader Gen. Dagvin Anderson visit Ethiopia, Kenya, and Djibouti in a tour that began on Saturday.
Thursday, Jan. 29: The European Union and Moroccan officials meet to discuss trade relations.
Saturday, Jan. 31: The United Nations Office for West Africa’s mandate is due for renewal.
Rafah reopening. Gaza’s Rafah crossing with Egypt is expected to open sometime this week as part of the U.S.-backed Board of Peace framework. Israeli Prime Minister Benjamin Netanyahu said that his government had agreed to a “limited reopening” for “pedestrian passage only, subject to a full Israeli inspection mechanism.”
The crossing—Gaza’s only border point with a country other than Israel—has been almost entirely closed since the Israeli military took control of it in May 2024.
Many details of the plan remain unclear, including what it will mean for the flow of humanitarian aid. Israel intends on allowing more people to leave Gaza than enter—a proposal long rejected by Egypt for fear of mass displacement into its territory.
Wish list. After accepting third-country deportees from the United States in July, South Sudan sent a list of requests to Washington that included U.S. support for the prosecution of an opposition leader and the lifting of sanctions for a senior official accused of graft, The Associated Press reports.
It’s unclear whether the requests were granted, or how much Washington paid South Sudan to receive deported migrants. Last fall, the Trump administration sent $7.5 million to Equatorial Guinea to accept third-country nationals.
Archipelago in limbo. Last Friday, the U.K. government halted legislation required to finalize its deal to hand the Chagos Islands back to Mauritius.
Britain detached Chagos from Mauritius three years before the latter’s independence in 1968, governing it as the British Indian Ocean Territory. The government of Prime Minister Keir Starmer announced that it would relinquish control of the archipelago—which hosts a vital joint U.K.-U.S. military base in the Indian Ocean—in 2024, a few years after the International Court of Justice found that its separation from Mauritius broke international law.
Under this arrangement, the United Kingdom would then lease the base for around $4.7 billion for a 99-year period.
On Friday, Britain’s main opposition party, the Conservatives, put forward an amendment calling for the bill, which would turn the Chagos Islands agreement into law, to be paused in the House of Lords “in light of the changing geopolitical circumstances.” Earlier that week, Trump had claimed that the deal was an “act of great stupidity” and of “total weakness” by Britain.
The U.K. government has said the bill will return to the House of Lords at an unspecified date.
The Kenyan government is planning to allocate up to around $774,000 annually for social media influencers, bloggers, and content creators to “positively” promote the government’s image in the wake of widespread anti-government protests among young Kenyans.
Nairobi has allegedly turned to digital platforms before to further its agenda. A November report by Amnesty International accused the government of paying influencers to suppress protest hashtags and amplify pro-government messages on social media between June 2024 and July 2025, at the height of Generation Z-led demonstrations.
- In Davos, a Tale of Two Speechesby Ravi Agrawal
- What Spheres of Influence Are—and Aren’t by Stephen M. Walt
- ‘A Rupture in the World Order’by Jennifer Williams
Malawi’s rare earths. In Finance Uncovered, Jack McBrams and Caroline Henshaw report on how a critical minerals extraction project in Malawi ended up being owned by Chinese state companies.
“Malawi’s government was oblivious as ownership of this crucial resource changed hands twice in two years, in an apparent breach of the law,” they write. “This game of corporate pass the parcel means millions of tonnes of heavy sands, a major source of critical minerals, are now ultimately controlled by regional state authorities in China.”
AFCON attendance. Although Senegal’s recent victory against Morocco drew a full crowd, half-empty stadiums are a regular feature at the Africa Cup of Nations (AFCON) due to intra-African flights being among the most expensive in the world, Gerard Akindes argues in Africa Is a Country.
“AFCON remains a major media event, as evidenced by its rising TV rights,” Akindes writes. But “participation in the sporting spectacle depend on mobility infrastructure, such as affordable air travel and fast, safe road and rail networks.”
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