US signs health pacts with nine African countries
U.S. officials announced a new framework for global health aid that has resulted in formal agreements with nine African governments. The agreements were signed in 2025 and are part of the Trump administration’s “America First” strategy, which ties U.S. funding to negotiated terms set by the recipient country rather than the previous USAID model.
Kenya, Nigeria, Rwanda, Uganda, Cameroon, Eswatini, Lesotho, Liberia, and Mozambique have all signed contracts that specify reduced U.S. financial support and increased domestic co‑financing. The deals total 49 percent less than U.S. assistance in 2024 and require the countries to raise additional resources for health programs.
Key features include a faith‑based focus in Nigeria, where the agreement emphasizes support for Christian health facilities, and a provision that allows U.S. officials to suspend funding if national interests are not aligned. South Africa has not signed a deal after disputes over its U.S. relations and has lost substantial HIV‑related funding.
In addition, some signatory countries have U.S. deportation agreements, but U.S. officials state the health compacts are independent of those arrangements, though political factors may influence negotiations.