The United States' America First Global Health Strategy, launched in September 2025, has encountered significant backlash and accusations of being exploitative, particularly from African and Latin American nations. This strategy marks a departure from traditional health assistance models, aiming to provide direct financial support from the US government to recipient governments over five years, thereby reducing dependency on non-governmental organizations (NGOs) previously used to channel aid.

Twenty African nations and four Latin American states have reportedly signed memoranda of understanding (MOUs) under this new strategy. The shift away from NGOs, which previously received health grants via the US Agency for International Development (USAID) and the decimated US President's Emergency Fund for AIDS Relief, was driven by the Trump administration's belief that NGOs were siphoning off excessive overheads. However, despite the substantial US investments, these new agreements represent an average 40% decrease in health finance compared to what recipient countries received from the US over the preceding five years. A core condition of these MOUs is that recipient countries commit to gradually taking over the financing of their health functions; failure to do so could result in the withdrawal of future US funding.

Specific examples highlight the financial commitments involved. The MOU with Kenya, for instance, stipulates a US investment of approximately US$1.63 billion, requiring Kenya to increase its health spending by KES115 billion (about US$890 million) over the five-year period. Nigeria has the largest deal, set to receive US$2.1 billion, but must contribute a substantial US$3 billion itself.

Secretary of State Marco Rubio articulated the primary benefit for the US as enhanced security. America's direct health engagement and access to foreign countries' health data are intended to facilitate earlier detection of disease outbreaks, enabling countermeasures before they reach the US. For example, the Kenyan MOU aims to ensure the country acquires the ability to detect infectious disease outbreaks with epidemic or pandemic potential within seven days of emergence and to notify the US within one day. Another key objective is to provide US health companies with a competitive advantage by granting them pathogen data to develop vaccines and treatments ahead of rivals.

While the deals incorporate ostensibly worthy goals like promoting financial self-sufficiency and reducing aid dependency, several African countries have labeled them as