JOHANNESBURG (AP) — The U.S. has recently struck health agreements with nine African nations. This move is part of a new strategy for global health funding, shifting focus from traditional aid to a more transactional approach. Countries like Kenya, Nigeria, and Rwanda are among those involved, reflecting the Trump administration’s goals of mutual benefits over mere aid.
These new deals replace older arrangements under the now-defunct USAID, adjusting the way health funding will flow. The administration claims this approach aims to foster self-sufficiency and cut down on what it considers wasteful spending in international assistance.
However, this change comes on the heels of significant cuts to U.S. aid, which has affected many health systems worldwide. For instance, in Africa, funding cuts have hampered responses to disease outbreaks and crippled crucial health programs. According to the Center for Global Development, U.S. health spending for recipient countries is projected to drop by nearly 49% by 2024.
In Nigeria, a major recipient of U.S. aid, the new agreement emphasizes partnerships with Christian-based health providers. This deal could provide over $2 billion in support while Nigeria raises its own $2.9 billion to strengthen its health programs. Interestingly, the U.S. has tied some funding to Nigeria’s efforts to protect Christian communities from violence.
In contrast, South Africa, despite its high HIV prevalence, is not part of these agreements. After disputes with the U.S., it lost over $400 million in annual support, jeopardizing its health programs.
Countries like Mozambique and Lesotho have also secured deals to help replace lost funding. Mozambique, for example, will receive more than $1.8 billion for programs addressing HIV and malaria.
Interestingly, four of the countries that signed these health agreements also have agreements with the U.S. to host third-country deportees, raising questions about the motivations behind the deals. The State Department has denied any direct connection between health funding and immigration policies.
This shift in U.S. health diplomacy marks a significant pivot from how aid has traditionally been extended, focusing more on direct negotiations and expected returns. In an increasingly complex global landscape, such agreements may shape the future of international health collaborations.
For a more in-depth look, you can read about the broader implications of U.S. foreign aid on health systems in this Center for Global Development report.
