What Trump’s new ‘America First’ Global Health Strategy means for Africa
The U.S. State Department has formally released its “America First Global Health Strategy”, a sweeping blueprint that reorients U.S. health aid around the principle of putting American interests first.
The plan builds on decades of U.S. investment in global health, from the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), which has saved an estimated 26 million lives, to programs that have prevented 7.8 million HIV-positive births. But the State Department argues that the current model has become inefficient and even fostered “a culture of dependency” among recipient nations.
The strategy rests on three pillars: “making America safer, stronger, and more prosperous by prioritising U.S. interests; protecting Americans by preventing global outbreaks from reaching U.S. shores; saving lives abroad while helping partner countries build 'resilient and durable' health systems.”
According to the fact sheet from the Department of State, only 40% of foreign health aid currently reaches frontline workers and supplies. Roughly 25% funds commodities such as diagnostics and drugs, 15% supports 270,000 health workers, while 60% goes to overhead and technical assistance.
“We will keep America safe by monitoring and helping quickly contain infectious disease outbreaks before they reach U.S. shores,” the document states, adding that the U.S. will continue supporting a global surveillance system and be prepared to “surge resources” when outbreaks emerge abroad.
How is Africa affected?
Africa has benefited for decades from U.S.-backed health programs targeting HIV/AIDS, malaria, tuberculosis, and emerging diseases.
The strategy suggests that while Africa will remain “a focus,” U.S. health investments may increasingly shift toward the Western Hemisphere, raising doubts about whether African countries with the greatest need will continue receiving robust support.
“Africa is going to continue to be a focus, but we’re going to invest more in the Western Hemisphere,” a senior official told Semafor.
Officials say the new model will channel more resources into direct, results-driven bilateral agreements and cut waste.
This story is written and edited by the Global South World team, you can contact us here.
