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U.S. Expands 'America First' Health Pacts to 24 Countries With $20.2 Billion Portfolio

The bilateral model pairs U.S. financing with country co-investment and data-sharing terms that have drawn sovereignty and legal concerns from African institutions and governments.

Overview

  • Washington signed new health MOUs with Guatemala, Guinea, and El Salvador, including nearly $60 million for Guatemala, over $91 million for Guinea within a $142 million package, and up to $31.9 million for El Salvador with $7.9 million for global health security.
  • With these additions, the State Department reports 24 bilateral MOUs totaling more than $20.2 billion in combined U.S. assistance and partner-country co-investment.
  • The U.S. and Democratic Republic of the Congo concluded a five-year, $1.2 billion partnership, with up to $900 million from the United States and $300 million from Kinshasa for HIV, TB, malaria, surveillance, laboratories, and professionalized community health workers.
  • Additional agreements detail up to $46.7 million for the Dominican Republic and a $179.3 million package with Niger that includes $107.4 million in U.S. funds, 7-1-7 outbreak targets, and integrated digital health and lab systems.
  • Africa CDC flagged “huge concerns” over data and pathogen-sharing provisions as Zimbabwe exited talks, Zambia sought renegotiation, and a Kenyan court suspended an earlier U.S. health funding deal pending a data privacy challenge.