The changes introduced by the administration of US President Donald Trump in the health cooperation policy with Africa are sparking debates on their implications for the continent’s health systems and international cooperation.
After dissolving the US Agency for International Development (USAID), exiting the World Health Organization (WHO), and reducing foreign aid for health, the Trump administration is finalizing a new series of bilateral agreements that are supposed to guide the next phase of US international health engagement.
Amid this dwindling aid context, the US has signed a series of bilateral health agreements with African countries since the end of 2025. Portrayed as a transition to more “responsible” and “sustainable” partnerships, these memorandums of understanding are part of the new “America First Global Health” strategy.
According to the most widely reported data by various African and international media outlets, at least 17 African countries have already signed these agreements. The consolidated list includes Kenya, Nigeria, Rwanda, Uganda, Liberia, Lesotho, Eswatini, Mozambique, Cameroon, Ivory Coast, Burkina Faso, Niger, DR Congo, Madagascar, Sierra Leone, Botswana, and Ethiopia. The participation of countries like Burundi, Malawi, Guinea, Senegal, and Angola is still unclear. Zambia and Zimbabwe, however, reportedly declined or withdrew their participation due to perceived excessive conditions.
Context: US under Trump administration shifting its international health engagement towards a more bilateral approach with Africa.
Fact Check: The participation status of Zambia and Zimbabwe in the new health agreements is still uncertain due to perceived unreasonable conditions.
Context: Think Global Health report reveals various financial challenges.
Fact Check: Think Global Health report highlights financial challenges faced by African countries due to reduced global health funding.
Context: African countries face varying levels of financial commitment under new health agreements.
Fact Check: African countries like Nigeria and Botswana have agreed to finance a significant portion of the planned expenses under the new health agreements.
Context: Africa’s historical health funding commitments reviewed.
Fact Check: Think Global Health analysis shows African countries’ health financing levels falling short of long-standing targets set in Abuja Declaration.
