Imagine it’s the mid-1990s and the U.S. has decided to pursue policies that would restrict trade and investment to Asia instead of promoting it. Would those markets still prosper? Would the U.S. have grown as strongly or had the same counterweight to China if the American government had abandoned Indonesia, Vietnam, Thailand, Malaysia, Singapore or other regional markets?
At the time, these countries represented the next frontier of economic opportunity for American companies seeking to establish manufacturing and financial hubs, sell to millions of new consumers and tap an emerging talent base. Much of the economic data from the past thirty years underscores the mutual economic benefits that came from favorable policies that promoted deeper diplomatic cooperation and corporate investment in Asia.
I had a front row seat on this economic rocket ride early in my career, spending more than four years right after college working in international marketing throughout Southeast Asia. We have seen a tectonic shift in global trade since then, mostly resulting in incalculable benefits to global trading partners, including the U.S., as market access has opened for an array of goods and services. In combination with health systems investments, countries like Indonesia, which were once leading recipients of development assistance, have seen their GDPs increase to the point where they are now considered middle-income countries and are providing economic assistance to other countries in public health programs like the ones supported by Gavi, the Vaccine Alliance.
This sort of massive transformation came about because the U.S. and other countries played the long game. It’s crucial to keep this in mind – and the hypothetical scenario of where we would be today if we had lopped off trade opportunities with Asia 30 years ago – because we are about to retreat from the next great frontier market of the 21st century: Africa.
The implications of such a move are reflected in economic and demographic data. Eleven out of the top 30 fastest-growing economies in the world last year were in Africa. A staggering 70 percent of the population is under 30 years old, a tsunami of innovators, entrepreneurs, researchers and everyday workers hungry to supercharge their futures. In health, education, financial services, technology, manufacturing and many other sectors, African markets are showcasing new models that can help emerging economies leapfrog in their economic development.
It’s a big reason why China, India, the Gulf States and many other countries are racing to establish economic partnerships with key African markets so they have an established presence as the region becomes more prosperous. But the United States is opting out.
Currently, plans developed by the Trump Administration to reorganize the State Department indicate an intention to scale back the American diplomatic presence substantially in Africa. This follows the dismantlement of USAID, de-funding of PEPFAR and other key public health programs, and the anticipated scuttling of the Africa Growth and Opportunity Act (AGOA), a vital trade agreement that allows for duty-free access to the U.S. for many African exports.
The result of these cuts could leave the U.S. government and companies sidelined from any meaningful diplomatic engagement and commercial gains as African markets race ahead with support from our greatest geopolitical rivals. Without robust engagement from American embassies, U.S. companies may be hobbled as they seek to create commercial partnerships, understand the competitive landscape of key African markets, negotiate regulatory barriers and navigate legal and operational threats that arise in any market.
Such a shutout may be felt acutely by American biopharmaceutical companies and health start-ups that include African markets in their clinical trials, partner with national governments and civil service organizations on early-market initiatives, attract talented scientists and build brand loyalty with more than a billion new health consumers. Policy and regulatory issues in Africa are routine problems that healthcare companies work with American embassies to solve, along with risk management.
Then there is the potential cost to domestic U.S. healthcare from cutting global health programs and diplomatic presence in Africa. USAID offices were often attached to American embassies and have been among the first to respond to the early detection of disease outbreaks. The U.S. spent $900 million in 2023 to fund laboratories and emergency preparedness and response in more than 30 countries, many in Africa. Those programs are now on hold, which increases the danger that outbreaks of polio, Ebola, Marburg, and mpox, as well as bird flu, could erupt. Without that frontline defense, the risks grow dramatically higher for existing and new diseases to reach Americans at home and overwhelm our health systems.
It’s become cliché to say “health there affects health everywhere,” but when more than 77 million people travel to the U.S. from foreign destinations in 2024, it’s obvious that humans are the greatest vector known to disease. America’s massive biomedical research capacity and our biopharma companies are at the vanguard of protecting our health. Abandoning our political and commercial connection to key countries in Africa reverses years of important progress.
We depend on access and cooperation with Africa’s emerging markets to help maintain our health defenses and build a next generation drug pipeline, but also to create a pathway to future economic growth. Without the vital support our companies receive through U.S. diplomatic assistance, that pathway could be closed off. Are we prepared to risk that?
