Data, co-financing and minerals drive America First diplomacy.

America is wheeling and dealing in African mining countries – yet not for the “critical” minerals that drive U.S. interest in Africa these days. Instead, the public health of around 150 million Africans is at stake.

In late February 2026, U.S. diplomats locked down three more public health aid deals under Donald Trump’s America First Global Health Strategy. The largest memorandum of understanding was signed with the Democratic Republic of Congo, for USD 1.2 billion over five years – 300 million to be paid by the DRC government. The deal calls for creating a national disease-outbreak response, strengthening community health workers and scaling up neonatal rapid diagnostic tools in the sprawling country of about 113 million people.

These health MOUs show that America has sorted its prized African partners into two buckets: those with valuable minerals and those such as Kenya and Ethiopia that have little to offer in extractive profits yet are strategic, friendly, fast-growing economies (courted by China) and can’t be ignored. Twenty African countries have signed MOUs, amounting to almost USD 20 billion – 38 percent committed by the countries.

DRC and Rwanda

The DRC is Africa’s largest producer of copper, holds at least half the world’s cobalt and is loaded with other shiny treasure including lithium and gold. Under a Trump-brokered peace agreement with Rwanda last year that’s intended to quell an insurgency in eastern Congo, American investors got preferential access to DRC mining and prospecting deals.

That agreement is shaky. The U.S. Treasury Department’s sanctions office imposed financial penalties on Rwanda’s military and four senior officials in March 2026, accusing them of “blatant violations” of the peace deal by aiding the M23 militia in capturing territory and mining areas in eastern Congo, actions that have killed and displaced civilians.

The United States also cited M23’s takeover of Uvira, a town on Lake Tanganyika near the DRC-Burundi border, shortly after the peace accord signing as evidence of widening violence in violation of the peace drive. Rwanda said the sanctions unjustly target its military and misrepresent the conflict situation.

Kenya health data dispute

In Kenya, some fear the true gold extracted from its health deal with America might be data. Kenya’s high court has suspended the USD 2.5 billion agreement with the United States over legal challenges brought by the Consumer Federation of Kenya and a Kenyan senator. The federation said the deal violates Kenyan data protection laws and would give the United States access to extensive public health information. The senator said the Kenyan government has made an unfunded commitment of USD 850 million that sidesteps legislative oversight.K

Under the Kenya agreement, signed in Washington in December by Secretary of State Marco Rubio with Kenyan President William Ruto present, the United States will spend up to USD 1.6 billion during the next five years on public health in Kenya to go with the Kenyan contribution.

After three months of talks, Kenya agreed to assume more responsibility for its public health care. Purchases of commodities – typically drugs, testing kits and other supplies – will shift to Kenyan control over five years. Frontline health workers now paid with U.S. funding will move to the Kenyan government payroll. And Kenya has pledged to scale up its health data system “to ensure key programmatic data” for HIV/AIDS, tuberculosis, malaria, polio and disease outbreaks “can be tracked at scale over the long-term,” according to a U.S. statement.

“This gesture of goodwill by President Trump on behalf of the American taxpayers reinforces our ongoing mobilization of domestic resources by Kenyans and actors and stakeholders in Kenya to the health sector,” Ruto said at the signing ceremony. “And I assure you that every shilling and every dollar will be spent efficiently, effectively and accountably.”

The data controversy seems to have caught the attention of the U.S. Congress. In the 2026 appropriations for diplomacy and international assistance finalized in January 2026, lawmakers asked the State Department for a strategy to transition U.S. spending and programs on HIV/AIDS to host-country ownership, including “a plan to safeguard personally identifiable information of patients within electronic medical records, laboratory systems, and surveillance systems required by new country agreements.”

What’s at Stake: In the aftermath of Trump’s shutdown of the U.S. Agency for International Development, which operated in dozens of African countries, the United States is trying to reassert its influence in public health as it works to secure industrial minerals. American investments totaling more than USD 100 billion in Africa in the past two decades, mainly to ease the impact of AIDS and curb the spread of HIV – yet also to reduce child mortality and build up technical skills – have translated into substantial influence in many countries.

Many of the recent deals have come in economies where the U.S. is seeking minerals needed for clean energy, artificial intelligence and military uses. While copper, cobalt and lithium often grab attention, more esoteric minerals mined in Africa, such as gallium, germanium and niobium, also are sought for U.S. and allied supply chains.

Guinea iron ore trove

In West Africa, Guinea signed a five-year, USD 142 million deal that the U.S. said, “establishes a clear transition toward Guinea’s independent health system management by 2030.” Medical labs meeting international standards and stepped-up malaria surveillance are what’s promised. Guinea will contribute about USD 51 million, and America 91 million.

Guinea hosts Africa’s largest mining investment, the Simandou iron ore project controlled by Rio Tinto, which says there’s about 1.5 billion tons of high-grade ore under mountains in southeastern Guinea. Rio Tinto is also involved with the government in building rail and port facilities to export this mother lode.

Nearby Burkina Faso (gold, lithium, manganese) inked a similar deal with America to fight AIDS and malaria and boost response to disease outbreaks. The U.S. committed to invest up to USD 147 million in the next five years, while Burkina Faso – led by fashionista Captain Ibrahim Traoré – intends to boost its spending by USD 107 million in what the State Department called a show of “significant national ownership of its health system.”

This deal has larger significance, as the U.S. statement hinted, saying the agreement “reinforces regional health security in the Sahel.” Burkina Faso is the epicenter of Islamist militant violence in the vast Sahel, an arid belt across north-central Africa, so any effort to bolster stability is a positive step – and might signal further U.S. involvement.

Action Options: The health deals keep America engaged across Africa and might open doors for U.S. companies. The U.S. Congress is requiring the State Department to submit a strategy for expanding market access for U.S. pharmaceuticals and medical devices and equipment. The products would be related to child survival, HIV/AIDS, malaria, tuberculosis and “global health security” in low- and middle-income countries. Lawmakers want the plan to reduce regulatory, procurement and distribution barriers for American products.

(Feature photo: Kenya’s President William Ruto watches the deal signing in Washington in December 2025 by Cabinet Secretary for Foreign Affairs Musalia Mudavadi and U.S. Secretary of State Marco Rubio, via Kenya Presidency on X.)