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On Thursday, 4 December, President William Ruto signed a US$2.5 billion five-year US-Kenya health cooperation framework on behalf of the government of Kenya. The framework is the first to be signed of the dozens of “America First” bilateral health agreements that are planned following the Trump administration’s dismantling of USAID. Under this pact, funding will focus on supporting digital frameworks within the country to ensure that infrastructure such as billing systems work for all health facilities, and on building the essential benefits package to address the needs of HIV, TB and malaria patients.
Negotiations between Kenya and the United States to establish the Strategic Trade and Investment Partnership (STIP) have been ongoing for the past three years. Opposition to STIP inside Kenya has forced data companies to seek legal cover from the US government for their operations in Kenya; Western corporations have been involved in questionable experimentation in Kenya’s health sector under the cover of USAID for over four decades.
Kenya has been the scene of repeated scandals associated with aid in the health sector. These controversies became so prominent that John le Carré’s novel, The Constant Gardener – and its subsequent film adaptation – depicts the fictional murder of an activist in Kenya investigating a pharmaceutical scandal. In real life, The New England Journal of Medicine has published critical editorials on the ethics of experimentation in Kenya and East Africa. One key editorial, “The Ethics of Clinical Research in the Third World”, was authored by Dr Marcia Angell, then the executive editor. Angell strongly criticized trials conducted in Kenya, Uganda, and Tanzania, arguing that, by using placebos when an effective AZT treatment to prevent tuberculosis in HIV patients (the ACTG 076 regimen) was already the standard of care in the United States and Europe, they represented a “retreat from ethical principles” and a “double standard”.
Since that editorial nearly thirty years ago, USAID has also been implicated in numerous scandals within the health sector, to the point that they attracted the attention of the Inspector General of the US government. The US Secretary of State alluded to these scandals in the health NGOs sector during the signing of the health cooperation framework, stating:
“This makes no sense. So why are we hiring American and international NGOs to go into other countries and run health care systems that are parallel to – and sometimes in conflict with – the health care systems of the host country? If we’re trying to help countries, help the country; don’t help the NGO to go in and find a new line of business. And so that’s the model we’re breaking. We’re not doing this anymore. We are not going to spend billions of dollars funding the NGO industrial complex while close and important partners like Kenya either have no role to play or have very little influence over how health care money is being spent. Bottom line: if you want to help a country, work with that country, not with a third party that imposes things on that country.”
Big tech in Kenya
Other scandals regarding the distribution of HIV commodities have come to light in more recent years. Under the Trump administration, the liberal arm of empire, as manifest in entities such as USAID have been jettisoned in favour of direct relationships with organizations such as Palantir and Oracle, which have been tiptoeing inside the Kenyan health system for some years now. Palantir, which has been described as the “scariest” of America’s tech giants, got its start working with US soldiers in Iraq and Afghanistan but now supplies software to police departments, other public agencies, and corporate clients.
Palantir is already active in the health sector in Britain, Israel, and Saudi Arabia, and is seeking to gain a strong foothold in Africa. Kenya has been an attractive base for foreign capital inside East Africa as, for the past fifty years, the financial institutions have been organized to drain capital from Africa. Fin Tech is seeking to bring the colonial model up to date.
Data and capital accumulation
Data is the currency of the fast-growing global digital economy, and tech companies have invested billions in connective technology infrastructure based on their for-profit business models, which monetize data. Like any society’s natural resources, the personal data of citizens belongs to them, and they have a right to privacy. Data used by the government, from military secrets to promoting the nation’s best tourist locations, must be stewarded properly by elected officials. The Kenyan government’s recent announcement of a “deal” with the US government that involves sharing the health care data of Kenyan citizens in return for financial resources raises numerous questions.
Firstly, the Kenyan government claims that all shared data will be anonymized and will be governed by Kenyan law. What is the current quality and standard of Kenyan law in protecting the privacy rights of Kenyan citizens?
Secondly, most jurisdictions with strong data privacy laws only allow the personal data of their citizens held by the government or private companies to be transmitted across borders to other jurisdictions that also have strong data privacy laws. Does the US have strong data privacy laws? In the US there are currently no countrywide federal data privacy regulations in place. What recourse and rights do Kenyans have should there be breaches in the US involving their health data?
Thirdly, many jurisdictions are developing regulatory frameworks that create classification levels of the data held by governments, ranging from “top secret” to readily available public information. For example, the Government of the recently Philippines created a government data classification regulatory framework. Should the government of Kenya develop a robust government data classification regulatory framework before deals are made with foreign governments that include the sharing of such data?
Fourthly, before such deals are signed with foreign governments, most forward-thinking governments develop transparent processes involving a wide range of public and private sector participants to provide input on proposed international agreements. For example, the Government of Singapore recently announced that it is open to receiving inputs from the public before it signs a new international green economy deal with foreign jurisdictions, and it also sought comments from the public before agreeing to allow a new foreign nation to join one of its existing international digital economy and data agreements. Did the Kenyan government provide Kenyan public and private sector stakeholders with the opportunity to transmit their views on this deal with the American government?
Kenyan citizens can hope that this health data-sharing deal with the USG will produce tangible benefits for Kenya. After all, the value of the deal is based on the health data of Kenyan citizens. However, in the absence of affirmative answers to the above questions, hope is all we have that the health data of Kenyans will not become the latest iteration of how the country’s resources – coffee, tea, and flowers – are extracted for the primary benefit of others.
Digital colonialism
Often referred to as “Silicon Savannah”, Kenya has emerged as a hub for imperial penetration with collaboration between tech firms, the military and financial institutions. While these companies tout their contributions to infrastructure development, job creation, and digital service expansion, their operations have generated significant criticism across multiple dimensions. Labour practices represent one of the most contentious issues. Outsourced workers – particularly those engaged in content moderation and AI data annotation – are frequently subjected to exploitative conditions, earning wages as low as US$1.50–US$2 per hour despite exposure to psychologically harmful material. Reports indicate widespread mental health challenges, including post-traumatic stress disorder and depression, compounded by inadequate support systems and precarious employment contracts. Attempts to unionize have often been met with retaliation, including dismissals and abrupt contract terminations, raising concerns about systemic labour rights violations.
In addition to labour concerns, data privacy and consumer protection have become critical areas of scrutiny. Unregulated digital lending platforms have engaged in invasive practices such as harvesting personal contact data and publicly shaming defaulters, in contravention of Kenya’s data protection laws. Broader critiques target the opaque collection and monetization of user data by tech platforms, fuelling fears of surveillance capitalism and eroding public trust in digital ecosystems. These issues intersect with accusations of foreign control over the local digital infrastructure, often framed as “digital colonialism”. Key national platforms, including eCitizen and cloud-based health systems, have been managed through opaque agreements with foreign-linked entities, raising concerns about sovereignty, corruption, and dependency. Furthermore, the extraction and monetization of local knowledge – such as agricultural and transactional data – by foreign firms with minimal benefit to local communities underscores the structural inequities present in Kenya’s digital economy.
Concerned citizens in Kenya have sought to address these challenges with mixed outcomes. Landmark lawsuits against Meta and its subcontractors over labour conditions have tested the jurisdictional reach of Kenyan courts, while proposed legislative amendments aimed at shielding outsourcing firms from liability have drawn criticism for undermining worker protections. Concurrently, Kenya’s Competition Authority has advanced antitrust measures to curb monopolistic practices, algorithmic collusion, and data hoarding by dominant platforms. These developments highlight the continuation of Kenya’s role as an outpost to imperial penetration and exploitation. Young doctors and tech workers are increasingly strengthening their organizational capabilities to safeguard ethical standards, labour rights, and national sovereignty in an increasingly digitized economy.
