The United States government has signed new bilateral health agreements with at least nine African nations, formalizing a strategic shift in its approach to global health funding. The agreements, finalized under the Trump administration, are designed to move from a traditional donor-recipient model to partnerships focused on sustainability and mutual cooperation, according to U.S. officials and documents outlining the policy.
The memorandums of understanding were signed with countries including Kenya, Rwanda, Nigeria, Malawi, and Uganda. According to the Associated Press, which first reported on the agreements, the deals codify a U.S. policy aimed at helping partner nations build self-sufficient health systems. This approach aligns with the administration’s broader foreign policy goal, termed the “journey to self-reliance,” which emphasizes trade and investment over direct foreign aid.
Details of the agreements indicate a long-term strategy for countries to eventually manage and fund their own public health initiatives, including programs previously supported heavily by U.S. aid, such as the President’s Emergency Plan for AIDS Relief (PEPFAR). U.S. officials stated that the goal is to create more sustainable health sectors that are not dependent on perpetual foreign assistance.
In a statement from the period, the U.S. Department of State described the new model as a “partnership” that would advance public health and strengthen the national security of both the United States and the partner nations. The framework of these agreements also incorporates existing U.S. government policies. This includes the “Protecting Life in Global Health Policy,” which restricts U.S. funding for foreign non-governmental organizations that provide or promote abortion as a method of family planning.
The agreements were the culmination of a policy shift articulated in the 2017 “U.S. Strategy Toward Africa.” That strategy prioritized fostering economic growth, trade, and investment on the continent. The new health MOUs reflect this by framing health aid as a component of a larger economic and strategic partnership rather than as standalone humanitarian assistance.
While specific financial details for each country’s agreement were not made public, the overarching structure signals a change in how U.S. global health funds are administered. The focus is on technical support, capacity building, and joint planning to ensure that partner countries can maintain and expand upon public health gains with increasing domestic resources over time. The participating African governments also committed to increasing their own domestic health spending as part of the agreements.
