Malawi is racing against time to strike a balance between securing a five-year $740 million (K1.3 trillion) United States (US) health financing deal and protecting rights to privacy on health data and pathogen information.
Information The Nation has sourced indicates that the deal has a December 31 2025 deadline.
Ministry of Health and Sanitation Principal Secretary Dan Namarika conceded in an interview yesterday that the discussions with US authorities have been back and forth because they border on privacy and sovereignty.
He said while the current US administration has come openly on data, even in previous deals Washington was getting a lot of data and that he previously raised such concerns.
Said Namarika: “This new thinking is basically an open book to say no longer free aid, we have a motive behind. Now we have to defend ourselves to say, what is it that we can do to protect our people? That’s the discussion!”
He said in the past, the World Health Organisation WHO) was providing technical support and helped with data protection as well as pathogen issues.
However, with the US no longer funding WHO, the situation was being discussed by individual countries.
On December 10 2025, 57 African Civil Society Organisations (CSOs) wrote their respective Presidents, including Malawi, warning that pathogen information and granting access to data systems will remain in place for up to 25 years if they sign the deals.
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The data systems include those covering national health warehouses, health management information, surveillance and outbreak response, health commodity inventory management, lab management, pharmacy management and electronic medical records.
Data shared by CSOs in the health sector show that assistance to Malawi will drop from an annual average of $245 million per year. With the new five-year deal, $180 million will be disbursed in 2026 with $164 million in 2027 and $148 million in 2028.
The years 2029 and 2030 are projected to have $132 million and $116 million, respectively.
Reacting to the developments, Centre for Human Rights and Rehabilitation executive director Michael Kaiyatsa, who is part of the 57 CSOs that signed the petition, said the deal entails that sensitive personal information such as HIV status, tuberculosis treatment history and vaccination records could potentially be accessed by a foreign government.
He said: “Allowing personal medical data to be viewed or managed outside the country creates a serious risk of breaching constitutional protections of privacy and confidentiality.
“Government must clearly explain what data will be shared, who will have access to it, and how personal medical records will be protected. Malawi must retain full control over its health data and systems.”
The US aid will directly be injected into the government system and not CSOs, an arrangement Kaiyatsa said would undermine transparency, accountability and independent voices, removing a critical layer of checks and balances.
Kamuzu University of Health Sciences professor of public health and epidemiology Adamson Muula in an interview yesterday expressed reservations with the arrangement to share personal health data to third parties without prior consent.
He said: “For many people, sharing personal data would be problematic. In the US, they have what they call HIPAA and if you read it, you’ll see that personal data is protected from third party users, and how one can use that.”
On the privacy law, Catholic University of Malawi dean of law Professor Clement Ng’ong’ola urged caution, stating that while constitutional rights can be abridged, it was not that simple.
Section 44 (1) of the Constitution provides that “no restrictions or limitations may be placed on the exercise of any rights and freedoms provided for in this Constitution other than those prescribed by law, which are reasonable, recognised by international human rights standards and necessary in an open and democratic society”.
Ng’ong’ola said the Malawi Government might actually find it difficult to go for a bilateral agreement with the US because what the Trump administration is advocating may not be consistent with international human rights standards.
Malawi Civil Society Advocacy Forum chairperson Gift Trapence, in a separate interview, called for openness on the engagement and negotiations processes.
“CSOs are demanding meaningful participation of partners in the HIV response during the MoUs development and also in the development of implementation plans,” he said.
International Coalition on Health Financing Advocacy chairperson Maziko Matemba called on the US to provide Malawi more room for engaging its citizens and stakeholders.
The new deal under the America First Global Health Strategy has already faced struggles in Kenya where a court suspended implementation of the $2.5 billion health aid deal over data privacy concerns.
