US Global Health Strategy Advances by Leaps and Bounds in Africa
On 22 and 23 December 2025, the USA signed four additional new Global Health MoUs with Botswana, Madagascar, Sierra Leone, and Ethiopia, with a focus on quantifiable results. The agreements are in line with #AmericaFirst Global Health Strategy, which aims put the national interests of America at the forefront in the fight against the most prevalent diseases around the world, with a particular focus on Africa.
In Botswana, the US signed a bilateral agreement to reinforce the fight against HIV/AIDS and enhance health service delivery to communities around Botswana. As per the agreement, US will provide USD 106 million in assistance, while Botswana will contribute more than USD 380 million. Thus, the MoU promotes self-reliance, health reforms, and supports the 95-95-95 targets for HIV control. The partnership will see the US help Botswana modernize its electronic medical records and disease surveillance systems, including networking infrastructure that leverages new satellite-based technologies.
In Ethiopia, the US inked a bilateral MoU totaling USD 1.466 billion, with the US investing USD 1.016 billion and Ethiopia adding USD 450 million. The priority programs target HIV/AIDS, Tuberculosis, Malaria, polio eradication, and maternal and child health. The MoU extends support for the Marburg Virus Response and maintains continuity for US health assistance to Ethiopia, as the US has invested more than USD 5 billion over the past decades.
In Madagascar, the focus is on malaria as well as maternal and child care. Thus, the target is to improve access to antenatal care from 40% to 75% by 2030. It also aims to provide treatment on a prompt basis with facilities on the frontline. The US will put in USD 134 million, while Madagascar will plough in USD 41 million.
“With the signing of this Memorandum of Understanding, we reaffirm our shared commitment to building resilient, durable health systems that protect our citizens and advance our mutual interests… This agreement sets clear goals, requires co-investment, and establishes performance benchmarks to ensure tangible results.”
US Charge d’Affaires Rabia Qureshi
In Sierra Leone, the US will front-load more than USD 30 million in 2026 to foster disease surveillance, laboratory capacity, health workforce, and data systems. On the other hand, Sierra Leone is expected to steadily increase its contribution year over year. By 2030, the target is to reduce malaria deaths by 75% and extend HIV diagnoses so that 98% of HIV-positive people are aware of their status and can receive appropriate treatment.
The new Global Health Strategy (#GHS) places great emphasis on accountability through measurable goals. It represents a shift in US foreign policy with the doctrine of trade, not aid. Now, the US favors direct #G2G agreements and no longer goes through #NGO. It is an opportunity to showcase the leadership of the USA in the healthcare and technology sectors. At the same time, it seeks to empower by encouraging recipient countries to up their game.