Ebere Okereke, senior technical adviser at the Tony Blair Institute for Global Change, has cautioned that the newly released America First Global Health Strategy risks undermining Africa’s health sovereignty.

Ms Okereke, via her official LinkedIn page on Wednesday, said that the strategy prioritised American national interests over broader global health goals.

She said that the strategy pledged continued U.S. support for HIV, malaria, tuberculosis, and pandemic preparedness but reframed global health aid as a tool to make America “safer, stronger, and more prosperous”.

She said that it also identified Africa as a priority region, citing outbreak risks, population growth, and strategic minerals.

According to her, the framing of the strategy is problematic because it blames African countries for inefficiency and dependency without acknowledging the donor-driven structures that have created these issues.

“Inefficiency and dependency are not simply African failings; they are the result of parallel structures created and controlled by donors.

“For years, the U.S. channelled funds through its NGOs, retained control over procurement, and prioritised vertical programmes. To now accuse Africa of dependency distorts the historical reality,” she said.

Ms Okereke said that proposed bilateral agreements are tied to strict performance benchmarks and mandatory cofinancing.

She stated that U.S.-driven surveillance systems could enhance external oversight while undermining African-led initiatives, such as the African Medicines Agency and the Partnership for African Vaccine Manufacturing.

“This strategy risks eroding Africa’s health sovereignty by embedding U.S. staff in ministries, controlling access to surveillance data, and privileging American commodities over local production. Health aid is being reframed from saving lives to securing influence in the U.S.-China rivalry,” she said.

She urged African leaders to respond strategically by negotiating collectively through the African Union and Africa CDC, accelerating domestic health financing, and protecting local manufacturing capacity.

“The U.S. strategy should be a wake-up call. Africa must seize this moment, move beyond rhetoric about sovereignty, and ensure that external partnerships align with continental priorities, ” she said.

(NAN)