Critical aid in exchange for health data

**SPEAKER_1** (0:00)
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**Kimberly Adams** (0:54)
The new Fed Chairman's first check-in with Congress.
From Marketplace in Washington, I'm Kimberly Adams. Federal Reserve officials are split on the direction interest rates should go. The Iran War is once again pushing up oil prices, and Americans are increasingly expecting inflation to remain high. That's the backdrop to Fed Chair Kevin Warsh's first appearance in front of Congress as the new head of the central bank later this morning. Marketplace's Nova Saffo has more.

**Nova Saffo** (1:23)
At the House Financial Services Committee today and the Senate Banking Committee tomorrow, Kevin Warsh is likely to face questions over a number of immediate and long-term concerns. Immediate ones include the direction of interest rates and where inflation might be headed. The minutes from the last meeting of the Fed's Interest Setting Committee showed sharp divisions with half supporting raising rates by the end of the year. Some policymakers were also worried about the impact of artificial intelligence. Longer term, Warsh has committed to reforming how the Fed does its work, including how it communicates with the public. Warsh wants the Fed to say less.
Last week, the Central Bank announced the names of 15 experts from outside the Fed who will lead task forces considering various reforms. The names include Obama-era appointees and former central bankers from Brazil, India and the UK.
I'm Novasafo for Marketplace.

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**Kimberly Adams** (3:26)
The way US aid is distributed to countries around the world has changed significantly since the beginning of President Trump's second term, with cuts to global food and health aid. The United States has withdrawn from international agreements and organizations that support health care in developing countries.
For the aid that is flowing, the terms are changing. According to reporting by ProPublica, a series of new agreements between the United States and various African countries is tying funding to access to those countries' health data. For more on this, I'm joined by the two reporters behind the investigation, Sharon Lerner and Anna Maria Berry-Jester. Good morning.

**Sharon Lerner** (4:05)
Thanks for having us.

**Anna Maria Berry-Jester** (4:06)
Thank you.

**Kimberly Adams** (4:07)
Anna Maria, can you tell me about these deals and how you discovered them?

**Anna Maria Berry-Jester** (4:12)
So last year, the Trump administration dismantled USAID, which was the largest provider of foreign aid in the world. It was the primary mechanism through which the US gave aid to other countries.
In September, they announced that they were doing something new in its place, this thing called the America First Global Health Strategy. As part of that, they would be signing agreements with individual countries to provide the aid that they previously provided, usually through NGOs and nonprofits. The agreements have been largely kept secret. The US has refused to release them publicly. We were able to see a handful of the agreements with the countries and also these sort of other agreements that go with them. So there's a data sharing agreement and a specimen sharing agreement with a lot of countries.

**Kimberly Adams** (4:58)
What kind of data are we talking about?

**Anna Maria Berry-Jester** (5:01)
We were able to see the data agreement with Uganda. And one of the things that several data privacy experts told us was fairly shocking to them is that it requires access to the United States. It gives direct logins to the nation's health care systems, like their data system. So we're talking about medical records, lab data, data collected by community health workers. And the agreements call for that data to be de-identified, meaning masking who exactly the data belongs to.