The United States has disclosed that its $2 billion health partnership agreement with Nigeria includes provisions for health data monitoring and enhanced disease surveillance aimed at improving responses to disease outbreaks and strengthening health systems.
Details of the arrangement are contained in the America First Global Health Strategy document, a memorandum of understanding signed between the United States and at least 20 African countries, including Nigeria.
The agreement, which spans five years from April 2026 to December 2030, was signed between both countries in December 2025. Under the arrangement, the US government is expected to provide nearly $2 billion in grant funding, while Nigeria is to mobilise close to $3 billion for health sector development during the same period.
When the agreement was first announced, attention focused largely on funding support for Christian faith-based healthcare providers. However, recent disclosures have sparked debate over the scope of data-sharing provisions and their implications for national health sovereignty.
According to the health strategy document, the United States plans to work with participating countries to establish a comprehensive performance monitoring system capable of tracking data across four key areas: service delivery, epidemiology, supply chains, and co-investment.
Nigeria’s Federal Ministry of Health said both countries intend to negotiate a regulated data-sharing framework that will allow the exchange of information relating to the long-term performance of the agreement while complying with applicable laws on data protection, privacy, ownership, access rights, and hosting requirements.
The ministry, however, did not specify the categories of data that would be shared under the arrangement.
Concerns have also emerged over provisions reportedly contained in an earlier version of the memorandum. According to reports, the draft agreement included references to granting the United States access to pathogen samples and pathogen sequence data for up to 25 years.
The reported provisions would have allowed the US government to share such materials with up to ten non-government American entities involved in the development of diagnostics and other medical countermeasures. Similar requirements were said to have appeared in agreements involving Nigeria, Rwanda, Ethiopia, Uganda, and Mozambique.
Reports further indicate that countries failing to comply with certain requirements could risk losing access to funding attached to the agreement.
The issue has attracted international attention following a March report by The New York Times, which alleged that a separate US health agreement with Zambia was linked to broader negotiations involving access to critical mineral resources. The report claimed that continued health assistance was used as leverage during discussions between both countries.
Meanwhile, Human Rights Watch stated that agreements signed with several African countries, including Nigeria, Ethiopia, Kenya, Mozambique, Rwanda, Liberia, and Uganda, require governments to provide broad access to information needed to monitor compliance with the Helms Amendment, a United States law that prohibits foreign assistance from being used to fund or promote abortion as a method of family planning.
According to the rights organisation, failure to provide such access could result in modifications to planned assistance or the termination of agreements altogether.
Human Rights Watch noted that for countries such as Nigeria, where the agreement is valued at approximately $1.8 billion, any disruption in funding could affect support for HIV, tuberculosis, malaria programmes, maternal and child healthcare services, laboratory systems, medical commodities, and health workforce development.
The organisation also claimed that the agreement signed with Uganda includes provisions allowing American officials to conduct unannounced inspections of health facilities and clinics.
Neither the US government nor Nigerian authorities have publicly released the full country-specific agreement, leaving several details of the arrangement yet to be independently verified.