The United States has restructured its global health aid delivery under the "America First" policy, shifting away from broad international programs toward direct, targeted agreements with recipient nations. This change, following the restructuring of USAID, requires partner countries to gradually cover increasing shares of their own health program costs, eventually assuming full financial responsibility. The new model prioritizes bilateral arrangements over multilateral support, aiming to reduce dependency on U.S. funding while aligning aid with national interests.
Reporting by Fred de Sam Lazaro highlights how Kenya and Uganda are implementing these revised terms, offering early perspectives on the strategy’s real-world effects. These nations have signed formal agreements under the new framework, adapting their health initiatives to meet stricter conditions. The evolving approach reflects a broader transformation in American foreign assistance, influencing how global health programs are funded, managed, and sustained across regions.