The US has signed four new global health memorandums of understanding with Madagascar, Sierra Leone, Botswana and Ethiopia, committing nearly $2.3 billion in combined funding, the State Department said.
The agreements come under the Trump administration’s “America First Global Health Strategy”, unveiled in September, which aims to reduce long term reliance on US aid by strengthening national health systems and increasing local investment.
According to the State Department, each memorandum includes clear benchmarks, strict timelines and consequences if agreed targets are not met. Officials said the approach is designed to ensure US assistance delivers measurable results against priority disease threats.
Across the four agreements, the US has pledged almost $1.4 billion, while partner countries are expected to co invest more than $900 million from their own resources.
In a related move, the US embassy in Abidjan said a five year health cooperation agreement with Ivory Coast is scheduled to be signed on Thursday. The deal is intended to improve disease surveillance and expand health worker capacity.
Under the agreement, the State Department plans to provide up to 273 billion CFA francs, about $491 million, in health support, while Ivory Coast has committed to raising its national health spending to 252 billion CFA francs.
Earlier this month, the US signed a five year health cooperation agreement with Eswatini, pledging up to $205 million for investments in health data systems, disease monitoring, and HIV prevention and treatment. Eswatini has agreed to increase its domestic health spending by $37 million over the same period.
The US has also signed similar health cooperation agreements with Kenya, Rwanda, Uganda and Lesotho, expanding its broader push to reshape overseas health assistance across Africa.