The United States government has released its new America First Global Health Strategy, a document that sets out how Washington will engage in worldwide health initiatives in the coming years.
Editorial Note: This article was originally published on January 13, 2026, and has been refreshed to incorporate the latest information as of November 6, 2026, ensuring that new developments in the strategy and its implementation are reflected.
These agreements, formally known as memoranda of understanding (MOUs), create five-year plans that describe how the United States will work with each partner to strengthen that country’s health system. The purpose of the plans is to help nations move toward more resilient and lasting health infrastructure.
The memoranda cover the 2026-2030 period, outlining specific milestones, funding allocations, and joint governance mechanisms that both parties will use to monitor progress toward more durable health systems.
Central to the approach is the transition of country programs from U.S. assistance to long-term national ownership. Each partner nation has pledged to raise its own domestic health spending, or to co-invest in health, over the next five years. The government began signing the first MOUs in late 2025, and the signing process continues.
Co-investment ratios differ among partners, with each country committing a share that reflects its fiscal capacity and health priorities, creating a spectrum of contributions across Africa, Latin America, the Caribbean, and Asia.
U.S. Commitment and Country Co-Investment
The overall commitment across the agreements is notable, with a co-investment share that reaches 39 percent of total funding. Nations in Africa, Latin America, the Caribbean, and Asia have already signed MOUs, each with its own co-investment ratio.
All figures in this section are drawn from data compiled up to October 8, 2026, and the source documents sometimes do not specify whether the reported country co-financing represents only new contributions or the total health spending—including existing allocations—throughout the MOU term.
According to the report, the United States has signed MOUs with 36 countries. The combined effect of those agreements represents a change of negative $8.1 billion, a decline of 34 percent in five-year global health funding for the participating nations. Historical funding totals include appropriated and planned amounts for fiscal years 2021-2023, as well as requested amounts for fiscal years 2024-2025 for the Global Health Programs (GHP) account.
The tracker that follows the agreements draws on press releases issued by the State Department, U.S. embassies, and partner ministries of health, together with the actual MOU documents. When a public MOU was available, funding data were taken directly from that text; the only exceptions are Malawi and Zambia, whose figures come from State Department statements.
The tracker’s methodology follows KFF’s protocol of cross-checking press releases with the actual MOU appendices, and it flags any inconsistencies between the narrative statements and the tabulated financial tables.
MOU Details and Funding
Global health MOUs for Bolivia, Botswana, Panama, and South Sudan cover a three-year span. In the cases of Botswana and South Sudan, the prior funding figures represent planned global health financing for fiscal years 2023-2025. Limited data prevent a direct comparison for Bolivia and Panama.
The Philippines opted for a “Strategic Objective Agreement” rather than a formal MOU. An overall funding amount is known, but co-financing specifics have not yet been released. Similar gaps exist for Vietnam, although the United States announced that it would provide $98.75 million for that country’s agreement.
State Department information indicates that Vietnam’s annual health expenditure is projected to rise from $23.3 billion to $33.8 billion over the five-year period, an increase of roughly $10.5 billion.
While the United States has earmarked the announced amount for Vietnam, the precise contribution that Vietnam itself will add remains undisclosed, reflecting the broader uncertainty about whether country contributions are reported as incremental or cumulative.
Program areas were identified through keyword searches, and each country agreement was classified as addressing global health security when it explicitly mentioned GHS or described outbreak preparedness and response activities. The six categories that appear across the MOUs are Surveillance & Outbreak Response, Laboratory Systems, Commodities, Health Workforce, Data Systems, and Strategic Investments.
