After dismantling USAID and pulling out of the WHO, the Trump administration is back with a new offer for African nations: hundreds of millions in health aid, but with strings attached that look more like a corporate sponsorship than a humanitarian gesture. The deals require recipient countries to increase their own health spending, prioritize US pharmaceutical companies, and in some cases, hand over sensitive patient data and biological samples. Kenya signed a $2.5bn deal in December, but activists delayed it in court. Zambia balked at linking health funding to a critical minerals agreement. Ghana and Zimbabwe rejected the terms over data privacy concerns, with Ghana's Data Protection Commission noting that once data leaves Ghana, they have no control over it. South Africa, meanwhile, is losing HIV/AIDS funding over a dispute about Afrikaner rights - a move critics say is based on discredited claims of 'white genocide.' The new approach is a shift from multilateral cooperation through the WHO to bilateral deals tied to US strategic and commercial interests. But as the Ebola outbreak in DR Congo shows, the cuts have weakened frontline response - Care lost a third of its staff, and 10 critical days were lost in the response. The US insists the new model is more efficient and aligned with American interests, but with only 32 countries signed up and several African nations refusing, the jury is still out.