National Drug Authority staff in a laboratory. The writer warns that Africa, with its already fragile health systems and vast economic disparities, cannot afford to replicate the American healthcare system, which is privatised. PHOTO/FILE
The recent meeting between African health leaders and the Trump administration’s officials has exposed an alarming shift in US.-Africa health relations. By framing healthcare as a business rather than a social service, the US is pushing Africa toward a model that has already failed millions of Americans while enriching a handful of billionaires. African leaders must tread carefully and resist the temptation of privatised healthcare, learning from both the US’ disastrous system and the structural adjustment policies that previously devastated African economies and public services. If Africa follows the US model, the consequences will be devastating. The US healthcare system is a cautionary tale—one of the most expensive in the world, yet riddled with inefficiencies, inaccessibility, inequality and worse healthcare outcomes.
American hospitals, insurance companies, and pharmaceutical giants prioritise profits over people’s well-being. The result? Millions of Americans cannot afford medical care, live in medical financial hardship, leading to preventable deaths, medical bankruptcies, and worsening health outcomes. A system controlled by private interests does not prioritize universal access or public health—it prioritises financial gains. Africa, with its already fragile health systems and vast economic disparities, cannot afford to replicate this disaster. Anyone on the African continent will agree that the private sector is already dominating health care provision with devasting implications. If healthcare continues to be a profit-driven industry, it will create a system where only the wealthy have access to quality care while the majority are left to suffer. Health is not a luxury—it is a fundamental human right.
A painful reminder
This is not the first time Africa has been led down a path that benefits the West at its own expense. In the 1980s and 1990s, the International Monetary Fund (IMF) and World Bank imposed Structural Adjustment Programs (SAPs) on African nations under the guise of economic reform. These policies forced governments to cut social spending, privatize essential services, and open up their economies to foreign exploitation. The result was disastrous: weakened institutions, collapsed public services, worsening poverty, and a cycle of dependency that continues to this day. The push for “health as a business” is a modern-day version of the same extractive policies. It encourages Africa to shift away from publicly funded healthcare and instead rely on private investors. This is not about improving Africa’s healthcare systems; it is about creating profitable markets for corporations, given the capital investments needed, this space will inevitably be dominated by foreign companies.
At the same time that the Trump administration is pushing a business approach to health, it is also cutting critical health funding to Africa. The abrupt termination of U.S. aid programs has left a $224 million funding gap for the Africa CDC, jeopardizing initiatives in maternal health, HIV, malaria, and emergency preparedness. The Lancet recently warned that these cuts could lead to up to 10.75 million new HIV infections and nearly 3 million HIV-related deaths by 2030. As with SAPs, I believe these reductions are not accidental; they are part of a larger strategy to force African nations to turn to private financing. But without strong government intervention, private sector dominance will not ensure equitable access to healthcare. Instead, it will lead to a fragmented system where services are dictated by profitability, not need.
Dangers of corporate capture
Investing in the local manufacturing of medical supplies—such as medicines, vaccines, equipment, and health technologies—is an urgent and commendable goal for African nations. It represents a step toward health sovereignty, job creation, and reduced dependency on foreign supply chains. However, while these efforts may involve private sector players, African governments must resist being arm-twisted or captured by corporate interests. It is imperative to establish legislative frameworks that balance the pursuit of profit with the protection of public interest. If left unchecked, the private sector could exploit health systems much like Western pharmaceutical firms did during Covid-19—using public funds to develop life-saving products, only to privatize the benefits and price them out of reach. Africa must not allow the same mistakes to be repeated on its soil.
Rather than embracing a failed, profit-driven model, African leaders must fortify public health institutions and uphold healthcare as a fundamental right—not a commodity. The continent cannot continue to rely on Western donors whose priorities shift with political tides. Instead, Africa must focus on building resilient, self-sustaining health systems through regional collaboration, increased domestic financing, and innovative, equitable funding models that maintain public oversight. The Africa CDC is already leading this strategic shift, advocating for sustainable approaches such as expanding domestic tax bases, implementing earmarked levies, and pursuing carefully structured public-private partnerships that serve the public interest—not corporate agendas.
The writer, Dr Moses Tetui is an assistant research professor at the University of Waterloo, Ontario, Canada.
