By MOGOMOTSI MAGOME and MICHELLE GUMEDE
JOHANNESBURG (AP) — The U.S. authorities has signed well being offers with at the very least 9 African nations, a part of its new method to international well being funding, with agreements that mirror the Trump administration’s pursuits and priorities and are geared towards offering much less help and extra mutual advantages.
The agreements signed thus far, with Kenya, Nigeria and Rwanda amongst others, are the primary beneath the brand new international well being framework, which makes help depending on negotiations between the recipient nation and the U.S.
A number of the nations which have signed offers both have been hit by U.S. help cuts or have separate agreements with the Trump administration to just accept and host third-country deportees, though officers have denied any linkage.
The Trump administration says the brand new “America First” international well being funding agreements are supposed to improve self-sufficiency and get rid of what it says are ideology and waste from worldwide help. The offers substitute a patchwork of earlier well being agreements beneath the now-dismantled United States Company for Worldwide Growth.
U.S. help cuts have crippled well being methods throughout the creating world, together with in Africa, the place many nations relied on the funding for essential packages, together with these responding to outbreaks of illness.
The brand new method to international well being aligns with President Donald Trump’s sample of coping with different nations transactionally, utilizing direct talks with international governments to advertise his agenda overseas. It builds on his sharp flip from conventional U.S. international help, which supporters say furthered American pursuits by stabilizing different nations and economies and constructing alliances.
A special technique
The offers mark a pointy departure from how the U.S. has offered well being care funding over time and mirrors the Trump administration’s pursuits.
South Africa, which has misplaced most of its U.S. funding — together with $400 million in annual help — due partially to its disputes with the U.S., has not signed a well being deal, regardless of having one of many world’s highest HIV prevalence charges.
Nigeria, Africa’s most populous nation, reached a deal however with an emphasis on Christian-based well being services, though it has a slight majority Muslim inhabitants. Rwanda and Uganda, which every have deportation offers with the U.S., have introduced the well being pacts.
Cameroon, Eswatini, Lesotho, Liberia and Mozambique are also amongst those who have signed well being offers with the U.S.
In response to the Middle for World Growth, a Washington assume tank, the offers “mix U.S. funding reductions, formidable co-financing expectations, and a shift towards direct government-to-government help.”
The offers signify a discount in complete U.S. well being spending for every nation, the middle stated, with annual U.S. monetary help down 49% in contrast with 2024.
A faith-based deal in Nigeria, a lifeline for a number of others
Beneath its deal, Nigeria, a serious beneficiary of USAID funds, would get help that has a “robust emphasis” on Christian faith-based well being care suppliers.
The U.S. offered roughly $2.3 billion in well being help to Nigeria between 2021 and 2025, principally by USAID, official information reveals. The brand new five-year settlement will see U.S. help at over $2 billion, whereas Nigeria is anticipated to boost $2.9 billion to spice up its well being care packages.
The settlement “was negotiated in reference to reforms the Nigerian authorities has made to prioritize defending Christian populations from violence and consists of vital devoted funding to help Christian well being care services,” the State Division stated in an announcement.
The division stated “the president and secretary of state retain the appropriate to pause or terminate any packages which don’t align with the nationwide curiosity,” urging Nigeria to make sure “that it combats extremist non secular violence in opposition to weak Christian populations.”

For a number of different nations, the brand new offers might be a lifeline after U.S. help cuts crippled their well being care methods and left them racing to fill the gaps.
Beneath its deal, Mozambique will get U.S. help of over $1.8 billion for HIV and malaria packages. Lesotho, one of many poorest nations on this planet, clinched a deal value over $232 million.
Within the tiny kingdom of Eswatini, the U.S. dedicated to offer as much as $205 million to help public well being information methods, illness surveillance and outbreak response, whereas the nation agreed to extend home well being expenditures by $37 million.
No deal for South Africa after disputes
South Africa is noticeably absent from the listing of signatories following tensions with the Trump administration.
Trump has stated he’ll reduce all monetary help to South Africa over his extensively rejected claims that it’s violently persecuting its Afrikaner white minority.
The dismantling of USAID resulted within the lack of over $436 million in yearly financing for HIV remedy and prevention in South Africa, placing this system and 1000’s of jobs within the well being care trade in danger.
Well being compacts with nations that signed deportation offers
No less than 4 of the nations which have reached offers beforehand agreed to obtain third-country deportees from the U.S., a controversial immigration coverage that has been a trademark of the Trump administration.
The State Division has denied any linkage between the well being care compacts and agreements concerning accepting third-country asylum seekers or third-country deportees from the USA. Nevertheless, officers have stated that political issues unrelated to well being points could also be a part of the negotiations.
Rwanda, one of many nations with a deportation cope with the U.S., signed a $228 million well being pact requiring the U.S. to help it with $158 million.
Uganda, one other such nation, signed a well being deal value almost $2.3 billion during which the U.S. will present as much as $1.7 billion. Additionally Eswatini, which has began receiving flights with deported prisoners from the U.S.
Related Press writers Evelyne Musambi in Nairobi, Kenya, Dyepkazah Shibayan in Abuja, Nigeria, Mark Banchereau in Dakar, Senegal, and Matthew Lee in Washington contributed to this report.
