Today, the Trump administration, through the State Department, released its America First Global Health Strategy. This strategy has been long-awaited as the US global health community saw mass firings and the abrupt dismantling of USAID earlier this year. 

Comprising three pillars: safer, stronger, and more prosperous, the strategy emphasizes a commitment to global health outcomes, but through a vastly different approach than earlier administrations. The strategy relies heavily on bilateral agreements between the US and funded countries as well as a strong emphasis on the use of US-based technologies to help create health systems that recipient countries will be required to run and further fund themselves. The strategy also places a strong emphasis on the reasons the Trump administration created a direct funding model in the first place. This includes too much former Congressional funding for project managers and general overhead costs. The administration believes their strategy, on the other hand, will create better results with less waste and redundancy. 

Throughout the strategy report, attention is paid to disease outbreaks and pandemics and how the United States is making Americans safer, stronger and more prosperous by keeping diseases where they originate. Per the report, the United States has a “global surveillance system that can detect an outbreak in seven days”. Additionally, the strategy demands increased co-investment from recipient countries to gradually wean them off of US foreign assistance. 

In the meantime, though, the strategy will continue to fund 100% of frontline health workers and 100% of frontline commodity purchases for work directly with patients. This funding is vital to America’s continued surveillance of any outbreaks that can be first detected by frontline health workers in recipient countries.

The strategy does recognize the positive global health outcomes caused by PEPFAR. These include decreased mortality rates, better GDPs, and increased political stability in PEPFAR-funded countries. Additionally, there are 19 “military-to-military collaborations” in sub-Saharan countries. And yet, the report mentions that despite the strides of PEPFAR it is riddled with bloat and implementation partner redundancy. 

As its name suggests, the strategy portends America first by keeping America’s economy healthy for American workers. It does this by keeping infectious diseases and outbreaks at bay. It will also use American companies and products in its financial assistance program.

The report states that bilateral agreements between the US and recipient countries will be complete by December. Financial assistance will roll out in April 2026.

Upcoming: Next week, I will give my opinion on the America First Global Health Strategy.