The United States today announced a major step forward in its America First Global Health Strategy with the rollout of multi-year Bilateral Agreements on Global Health Cooperation to be signed with dozens of partner countries in the coming weeks. These agreements mark a new chapter in U.S. global health engagement—one centered on shared responsibility, long-term sustainability, and strengthened partnerships with governments receiving U.S. health assistance.
Under the new framework, the United States and partner governments will commit to a unified vision for tackling priority global health challenges, ensuring that U.S. investments deliver maximum impact while expanding country ownership and preserving gains made over decades. The agreements aim to save millions of lives, halt the spread of infectious diseases, reinforce global health security, and help countries build more resilient health systems that can operate independently over time.
A core objective of the agreements is the gradual transition of U.S.-funded technical support and financial responsibilities to partner governments. By doing so, the United States will continue the legacy of more than $204 billion invested since 2001 to strengthen health systems and expand access to lifesaving services worldwide.
Each bilateral agreement will reaffirm commitment to achieving global health targets related to HIV/AIDS, tuberculosis, malaria, and polio, while placing strong emphasis on maternal and child health, disease surveillance, and readiness for infectious disease outbreaks. The agreements are grounded in key principles—including streamlined performance monitoring, reduced investment in non-frontline activities, full integration of U.S.-supported programs into national health systems, increased private-sector and faith-based engagement, and greater co-investment from partner governments in frontline workers and essential health commodities.
To drive long-term sustainability, the agreements introduce several innovative provisions:
- Transition of Health Commodities: Procurement responsibilities will shift from the U.S. government to partner governments over the duration of each agreement. The United States will, however, continue to fully fund frontline health workers and essential commodities in the next fiscal year, working with countries to incrementally increase their contributions.
- Frontline Health Workforce Integration: Health workers currently funded by the United States will be aligned with government-recognized cadres and gradually absorbed into partner government payrolls under a jointly defined, multi-year transition plan.
- Strengthened Data Systems: Investments will expand national health data systems to ensure long-term tracking of HIV/AIDS, TB, malaria, polio, and emerging disease threats at scale.
- Increased Domestic Health Financing: Partner governments will progressively increase their own health budgets to ensure they can sustain critical health services without long-term reliance on U.S. funding.
- Performance-Based Support: Continued U.S. financial assistance will be tied to measurable progress, with incentives for countries that exceed agreed health performance indicators.
These bilateral cooperation agreements reinforce the United States’ enduring commitment to global health, while ensuring that its investments are more efficient, accountable, and aligned with partner-country priorities. They strengthen what has worked well in previous global health programs and directly address areas in need of reform—reflecting the Trump Administration’s sustained focus on protecting American interests while supporting global stability.
Through these agreements, the America First Global Health Strategy continues to make the United States—and the world—safer, stronger, and more secure.
