The Trump administration has unveiled a new global health strategy, titled ‘America First Global Health Strategy,’ which marks a significant shift in how the United States approaches international health aid. Released on Thursday, the strategy emphasizes direct collaboration with recipient countries, prioritizing frontline health supplies, staff, and country-to-country agreements over traditional contractor-based models. This move comes after months of uncertainty following sweeping cuts to foreign aid earlier this year.
The plan requires recipient nations to co-invest in global health goals, particularly in combating diseases such as HIV/AIDS, malaria, tuberculosis, and polio. It also outlines a transition from aid dependency to self-reliance over the next few years. Notably, the strategy does not address several areas previously prioritized, including maternal and child health, cholera, and vaccine-preventable diseases like measles.
Secretary of State Marco Rubio highlighted the need to retain effective aspects of U.S. health foreign assistance while addressing inefficiencies. The strategy, however, lacks specific budget details, leaving questions about its financial feasibility. This announcement follows the dismantling of the United States Agency for International Development (USAID), which was integrated into the State Department as part of President Trump’s broader plan to reduce foreign aid.
The strategy also proposes changes to the President’s Emergency Plan for AIDS Relief (PEPFAR), a program previously lauded for its success. The new approach aims to allocate more funding directly to purchasing drugs and supporting health workers, reducing programmatic overheads that previously consumed up to 60% of funds. Additionally, the U.S. plans to promote its health innovations and products globally.
Critics, however, argue that an effective response to infectious diseases requires more than just products. Asia Russell, director of Health GAP, an HIV advocacy group, emphasized the importance of outreach to ensure patients access healthcare systems. She expressed concern that the U.S. is retreating from its leadership role in global health, particularly in the fight against HIV/AIDS.
The strategy also commits to a 72-hour U.S. response to disease outbreaks threatening Americans but notably omits any mention of climate change, which experts link to the increasing frequency of global outbreaks. Senior administration officials indicated that the U.S. will use next week’s U.N. General Assembly meetings in New York to engage in bilateral discussions with countries, aiming to finalize transition plans by March 2025.