Archive · 19 Jan 2026
US Ties Health Aid to African Funding Pledges
The United States is making new deals with African countries to give them health aid money.
But there's a catch: these countries have to promise to spend more of their own money on health care.
The US says this will help countries take control of their own health systems.
Some countries are happy because they might get more control.
But others are worried because they don't have enough money to meet these promises.
The US is also giving less money than before, which could make it harder for people to get the health care they need.
Some people are also concerned that the new deals might make it harder for women and marginalized groups to get health care.
The US has signed agreements with 16 African countries to provide over $11 billion in health aid over the next five years.
The new deals require African governments to increase their health budgets, with funding cuts ranging from 20% to 69% in some countries.
The US is shifting from funding NGOs to direct government-to-government transfers, aiming to increase transparency and reduce reliance on foreign aid.
Some countries and analysts welcome the shift for increasing autonomy, while others express concerns about unattainable conditions and reduced access to care for marginalized communities.
The deals have been negotiated under time pressure and with limited transparency, raising concerns about fairness and potential restrictions on abortion access and data sharing.
- Who
- US State Department and African governments
- What
- Negotiating health aid agreements with funding conditions
- When
- Over the past month and ongoing negotiations
- Where
- African countries, with negotiations in Asia and Latin America as well
- Why
- To reimagine the foreign aid system and make health systems stronger and less reliant on international largess
- Funding Period
- 5 years
- Total Aid
- $11 billion
- Countries Signed
- 16 African countries
- Funding Cuts
- Rwanda: 69%, Madagascar: 61%, Liberia: 42%, Eswatini: 34%
- Nigeria's Required Increase
- $3 billion
- US Funding to Nigeria
- $2 billion
- Zambia's Funding Cut
- More than 50%
- Malawi's Funding Cut
- 35%
- Kenya's Funding Cut
- 20%