The US State Department is facing scrutiny from eight Democratic senators over its demands for direct access to foreign health data systems as a condition for global health aid. The senators, including Minority Leader Chuck Schumer, have expressed concerns that these demands are unprecedented and could set a dangerous precedent that undermines data privacy.
The controversy stems from agreements the US has struck with African countries, which require these nations to provide the US with logins or other secure access mechanisms to their health data systems. These agreements, which have not been made public, raise serious questions about data privacy, security, and the potential for misuse.
Senators demand answers on data privacy
In a letter to Secretary of State Marco Rubio, the senators, led by Raphael Warnock of Georgia, requested a briefing and written responses to a list of questions by the end of August. They expressed concern that the requirement to access foreign health data might reverberate beyond the countries where the aid agreements were struck and set international precedents that ultimately harm Americans.
The senators noted that the demands for data appear to be at odds with the Trump administration’s National Cyber Strategy, which emphasizes the right to privacy for Americans and their data. They wrote, “These new demands set an alarming precedent that is seemingly contrary to the Administration’s longstanding support for the privacy of U.S. citizens’ data.”
The letter also laid out the details of a data-sharing agreement between the US and Uganda, which demands that Uganda provide the US with direct access to its health data systems. The senators highlighted that while global health programs have historically included data-sharing components, they have never required direct access to privileged electronic systems for US government representatives.
The implications of direct access to health data
The shift in the approach to health data is part of the America First Global Health Strategy, which aims to make America more prosperous and promote American health innovations. However, privacy experts warn that if health data is mishandled under these agreements, it could have serious consequences. Revealing healthcare histories, including sensitive information about abortions, mental health conditions, or sexually transmitted diseases, can lead to discrimination and violence, particularly in Africa.
In the age of artificial intelligence, health data has become especially valuable. The agreements reviewed by ProPublica provide no guarantee that Africans subject to them will have a say in how their data is used or whether they would receive any potential financial benefits. The senators also asked what privacy rights foreign citizens will have over data that is transferred to the US and how those rights will be enforced in the case of a data breach or another unethical use of their personal information.
The background and context of the agreements
After the Trump administration dismantled the US Agency for International Development and drastically reduced funding for international health work done by the Centers for Disease Control and Prevention, Congress required the executive branch to continue providing foreign aid. The State Department has since faced the challenge of finding new ways to get the funding to countries, ensure that it was being spent wisely, and address potential pandemics.
The effort to establish these new aid arrangements was led by Brad Smith, an entrepreneur who founded three healthcare companies. The US agreement with Uganda provides up to $1.7 billion in aid for HIV, tuberculosis, and malaria, among other diseases. As a condition, the deal calls for the sharing of aggregated data with all personally identifiable information removed. However, experts have noted that it is possible to reverse-engineer data that has been anonymized.
The State Department declined to answer specific questions about the senators’ letter, stating that it does not respond to questions about congressional correspondence. In a statement, a State Department spokesperson defended the data requirements in the health agreements, stating that neither the US government nor any private American companies receive or review any personally identifiable information under these data-sharing agreements.
