US withdrawal from the WHO signifies a strategic power shift, emphasising bilateral health agreements with African nations to secure health data and enhance unilateral influence. No prime-time address. No presidential speech.
No spectacular interviews. On Friday, 22 January 2026, the US quietly completed itswithdrawalfrom the World Health Organization (WHO). While most people might shrug at such news in an age of permanent outrage, there is more to the US departure from the WHO.
This was not just an impulsive retreat from global health. It was a calculated move, part of a far more ambitious power play set out in the USAmerica First Global Health Strategyfrom September 2025. A deeper look into the US decision reveals a geopolitical pivot in plain sight.
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In just six weeks, the US concluded bilateral health cooperation memoranda of understanding (MOUs) with 15 African countries, under which the US will provide funding to their health systems, ranging from $106-million to $2.1-billion. What is in it for the US? Not oil, not cobalt or lithium.
The MOUs in question secure health data, which results in power in the 21st century and a troubling picture for the future of the African countries in question. While the conventional narrative may categorise the latest move by the US as an abandonment of multilateralism, that is only half true and dangerously misleading. One of the goals of the America First Global Health Strategy is to “create a conducive environment for American businesses to deploy their innovative health products and services globally” and to advance “commercial diplomacy”.
While the cutting of aid to healthcare systems in Africa, including Pepfar funding, appeared as impulsive decisions to please the Maga base at the time, the latest moves reveal a crucial repositioning of the US in this context. Africa, with its growing population and expanding health market, is regarded as an opportunity to create a counterweight to China’s power on the continent. Bilateralism is not a retreat in this context.
It is an upgrade that comes with multiple advantages. Bilateral agreements allow Washington to exercise its power fully and set the rules without international standards, control data flows, bypass multilateral scrutiny and attach ideological conditions to funding. It follows the goal of maximising unilateral influence, disguised as technical cooperation to the health sector in Africa, while reshaping global health in the US image: transactional and ideological.
Most of the MOUs in question have not been publicly disclosed, which, by itself, constitutes a red flag. However, publicly available MOUs such as those concluded withKenya,LiberiaorMozambiquereveal a system of “cooperation” with provisions on data sharing, access to national disease surveillance systems, access to genomic sequencing and integration of US health-security platforms. This extraction of data, unlike natural resources, does not run out — it compounds.
It can feed AI systems, pharmaceutical pipelines, predictive analytics and national security models. Population data can reveal disease susceptibility, genomic diversity, reproductive health patterns, and outbreak vulnerability across entire societies. Welcome to extraction 2.0!
On top of that, MOUs like the one for Kenya clearly favour US companies when stating that: With such data, states with the necessary resources could model epidemics, shape pharmaceutical markets and anticipate demographic and biological trends across states. A leverage that can easily be translated into direct power over another state. Between 4 December 2025 and 14 January 2026, 15 African countries signed these MOUs: Botswana, Cameroon, Ivory Coast, Eswatini, Ethiopia, Kenya, Lesotho, Liberia, Madagascar, Malawi, Mozambique, Nigeria, Rwanda, Sierra Leone and Uganda.
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