By Lawrence Williams
The United States has signed three major bilateral health agreements with Kenya, Rwanda and Liberia, committing to provide about $1.8 billion investment support for the recipient countries, marking the start of a new global strategy to help countries build stronger, more self-reliant health systems. The deals are the first under the America First Global Health Strategy announced by the U.S. government.
The new approach is designed to change how U.S. health aid works. Instead of giving most of the money to international NGOs, the U.S. says it will now work directly with partner governments so that more funds reach local hospitals, clinics, health workers, and patients.
Kenya became the first country to sign the agreement last Thursday, which brings $1.6 billion in U.S. health support over five years to the host country, while contributing $850 million of its own resources. The partnership will help upgrade hospitals, improve disease surveillance, train health workers, and support Kenya’s push for universal health coverage.
U.S. Secretary of State Marco Rubio said past aid models often created parallel systems that weakened countries’ own health structures. The new agreement, he said, ensures that “if we want to help a country, we work with that country,” not outside organizations.
Kenyan President William Ruto said the partnership will help millions by improving access to affordable healthcare and strengthening emergency response systems. He added that all funds will be used “efficiently and accountably.”
A day later, the U.S. signed its second bilateral health agreement with Rwanda, committing up to $158 million to combat HIV/AIDS, malaria, and other infectious diseases. Rwanda, which has already achieved global HIV/AIDS control targets, will provide up to $70 million in counterpart funding to enable it take full ownership of its HIV response by the fourth year of the deal.
The agreement also includes investments in advanced health technology, such as drone delivery of medical supplies and new disease outbreak surveillance tools.
On Tuesday this week, the U.S. announced up to $125 million in new health assistance to Liberia over the next five years, following the signing of a bilateral memorandum of understanding (MOU) aimed at strengthening key areas including HIV/AIDS, malaria, maternal and child health, and global health security.
Under the agreement, Liberia will increase its domestic health spending by nearly $51 million, a step toward gradually assuming greater financial and operational responsibility for its own health systems. The combined $176 million investment is expected to accelerate Liberia’s transition toward long-term self-reliance while improving national health outcomes.
The U.S. Department of State praised Liberia’s “remarkable progress” in recent years, noting major gains in HIV control, a more than 30 percent decline in malaria cases, and stronger laboratory and disease-surveillance capacity. These achievements, U.S. officials said, position the country to take greater ownership of its health sector and reduce the redundancies and inefficiencies associated with NGO-driven models.
The U.S. says many more bilateral agreements will be signed in the coming weeks with countries across Africa, Asia, and Latin America. These new partnerships aim to make global health assistance more transparent, more efficient, and better aligned with countries’ long-term health needs.
