The United States has signed a five-year bilateral health memorandum of understanding (MoU) with Nigeria aimed at strengthening the country’s healthcare system, with a significant focus on Christian faith-based medical institutions.

In a statement released on Tuesday, the US Department of State said the agreement is designed to expand access to essential preventive and curative health services, including interventions for HIV, tuberculosis, malaria, maternal and child health, and polio.

According to the US Department of State, the Memorandum of Understanding signed on Saturday, the US government intends to commit nearly $2.1 billion over the five-year period, while Nigeria is expected to increase its domestic health spending by close to $3 billion during the same timeframe.

The US described Nigeria’s financial commitment as the largest co-investment made by any country under the America First Global Health Strategy. The agreement was announced by Principal Deputy Spokesperson, Thomas Pigott, and is part of the America First Global Health Strategy.

The agreement places particular emphasis on faith-based healthcare providers, especially Christian-run clinics and hospitals, which the statement said play a critical role in Nigeria’s healthcare delivery system. According to US government estimates, Nigeria’s more than 900 faith-based health facilities currently serve over 30 percent of the population.

The State Department, in a statement signed on Saturday, said Nigeria’s financial commitment represents “the largest co-investment any country has made to date under the America First Global Health Strategy.” The statement noted that investments in these facilities are “uniquely positioned to complement public-sector healthcare services” and strengthen the country’s overall health infrastructure.

The MoU was negotiated against the backdrop of ongoing reforms by the Nigerian government, which the US said are aimed at protecting Christian communities from violence. The agreement also links continued US health assistance to Nigeria’s progress in addressing religiously motivated attacks.

“The Trump Administration expects Nigeria to continue to make progress ensuring that it combats extremist religious violence against vulnerable Christian populations,” the statement from the department read.

The US government added that the agreement remains subject to broader American foreign policy priorities, noting that the president and secretary of state retain the authority to pause or terminate programmes that do not align with US national interests.

“As with all foreign assistance, the President and Secretary of State retain the right to pause or terminate any programs which do not align with the national interest,” the statement added.

The Department of State also said the United States plans to sign similar multi-year bilateral health cooperation agreements with dozens of other countries receiving US health assistance in the coming weeks.

The MOU was signed amid heightened US scrutiny of Nigeria, including recent travel restrictions imposed by the Donald Trump administration, which cited national security and visa overstay concerns.

The America First Global Health Strategy, released in September 2025, applies to countries receiving US health assistance and shifts US global health policy toward bilateral agreements, increased partner-country co-investment, and expanded efforts to combat HIV, tuberculosis, malaria, and other priority diseases while strengthening national health systems.