{"id":284154,"date":"2025-11-26T10:06:12","date_gmt":"2025-11-26T10:06:12","guid":{"rendered":"https:\/\/www.newsbeep.com\/uk\/284154\/"},"modified":"2025-11-26T10:06:12","modified_gmt":"2025-11-26T10:06:12","slug":"the-us-has-released-an-america-first-global-health-strategy-health-experts-warn-it-is-risky","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/uk\/284154\/","title":{"rendered":"The US has released an \u2018America First Global Health Strategy.\u2019 Health experts warn it is risky"},"content":{"rendered":"

\n Health experts are warning that the Trump administration\u2019s new \u201cAmerica First Global Health Strategy\u201d could further damage public health systems already reeling from billions of dollars in foreign aid cuts following the destruction of the US Agency for International Development (USAID)<\/a>, and while some say the new system could bring benefits, there is agreement it marks a radical change in approach from decades of US policy.\n <\/p>\n

\n Under the new strategy<\/a>, touted as an ambitious overhaul of the way the US provides health assistance throughout the world, American aid will be funneled through a new system of one-on-one agreements with individual countries, rather than distributed through international aid partners and organizations.\n <\/p>\n

\n The stated goal is to have recipient countries further develop their own health systems \u2013 and the US decrease its assistance spending.\n <\/p>\n

\n The strategy calls for bilateral agreements to be completed by December 31 for countries that receive the vast majority of US health foreign assistance. A senior State Department official said they are preparing to finalize some of those compacts by early December, and that countries are \u201creally excited about what this opportunity presents.\u201d\n <\/p>\n

\n On Tuesday, as part of the strategy, the State Department announced an agreement to provide \u201cup to $150 million\u201d to an American drone company \u201cto expand access to life-saving medical supplies, including blood and medicines,\u201d in five African nations.\n <\/p>\n

\n The strategy\u2019s core argument is that US global health aid was often duplicative and inefficient, with significant overhead costs, including money spent on technical assistance and program management. It also criticizes high overhead costs, including high CEO pay, for some of the contracting companies called \u201cimplementing partners\u201d that carry out US foreign aid projects.\n <\/p>\n

\n However, some experts note that some of those activities are crucial to global health work.\n <\/p>\n

\n \u201cWhile we all want as much money as possible to be going to direct services for people, the truth is, a hospital is more than just a doctor and the medications. A doctor needs to be trained. There\u2019s a medical school. There are people who have to keep the hospital clean,\u201d one senior aid worker explained. \u201cAll those costs, while they can get out of control, are legitimate.\u201d\n <\/p>\n

\n The senior aid worker added that there is a risk that government health ministries alone \u201cdon\u2019t get to the last mile\u201d or \u201cdon\u2019t get to the most poor and vulnerable people,\u201d which are often taken care of by private sector providers or independent charity providers.\n <\/p>\n

\n Jeremy Konyndyk, the president of Refugees International, told CNN: \u201cA lot of the things that they deride as non-essential are essential, because they are the things that make the essential functions work.\u201d\n <\/p>\n

\n There are also questions of how quickly the agreements can be effective amid the fallout from the sudden, significant cuts to US foreign assistance earlier this year, which caused scores of public health organizations and nonprofits to decrease or eliminate services.\n <\/p>\n

\n Rachel Bonnifield, the director of the global health policy program at the Center for Global Development think tank, said that \u201cwhat they are outlining is a really good transition and sustainability plan for countries that are relatively higher levels of maturity and wealth, but probably will not be viable in the short term for the poorest countries and most fragile.\u201d\n <\/p>\n

\n \u201cPart of what\u2019s frustrating about this strategy is that, while I think it is the right thing to do, they have made it much harder for themselves \u2026 in just cutting off tremendous numbers of awards and foreign assistance programs without warning,\u201d Bonnifield told CNN shortly after the policy was released in September.\n <\/p>\n

\n Konyndyk, who worked for USAID under the Biden and Obama administrations, noted that \u201cit would be one thing if they had said, we want to get the US out of the business of X, Y and Z, and we\u2019re going to do this in a collaborative and phased way over the four years of the administration. I wouldn\u2019t have agreed with that, with them doing that, but that would at least be a semi-responsible way to do the thing that they claim they want to do.\u201d\n <\/p>\n

\n \u201cThis is just pushing Humpty Dumpty off the wall and leaving the country to pick up the pieces,\u201d he said.\n <\/p>\n

\n Bonnifield said she is sympathetic to the arguments that it\u2019s important to work via countries\u2019 Ministries of Health and to tackle issues with duplication and lack of country ownership \u2013 all things that experts have previously noted \u2013 but it is \u201ca high-risk strategy.\u201d\n <\/p>\n

\n \u201cThere is a risk that the money goes to a country, and the money is stolen, or they do their best, but they fail to deliver the health services and people die as a result,\u201d she said. \u201cIt\u2019s not quite clear what, if anything, they are currently planning to do to mitigate that risk.\u201d\n <\/p>\n

\n The senior State Department official said that national governments are \u201cnot telling us that they can\u2019t make it work.\u201d\n <\/p>\n

\n The official argued if they hadn\u2019t \u201caggressively\u201d moved NGOs \u201cout of the process, we never would have been able to build a different health care system.\u201d They also said they\u2019ve included safeguards to prevent misuse or theft of funds.\n <\/p>\n

\n Another senior aid worker, who works at an implementing partner, expressed concerns that the tight timeline for negotiating bilateral agreements is backing many countries into a corner.\n <\/p>\n

\n \u201cI think that the majority of countries that don\u2019t have the ability to fund their own response will agree to what they have to agree to, to keep going,\u201d they said.\n <\/p>\n

\n Health policy experts have also criticized the new policy for having a scope that is too narrow, as it focuses mainly on HIV \/ AIDS, malaria, tuberculosis and infectious disease outbreaks.\n <\/p>\n

\n There are \u201cseveral important omissions\u201d in the new strategy, said Bonnifield, of the Center for Global Development. \u201cThere is minimal discussion of immunization, for example, or reproductive health \u2026 those are loudly absent.\u201d\n <\/p>\n

\n A statement from the Modernizing Foreign Assistance Network (MFAN), a bipartisan advocacy group, said: \u201cWe caution that the strategy endorses a highly selective definition of \u2018global health\u2019 and lacks a focus on other global health priorities, such as maternal and child health, nutrition, and neglected tropical diseases.\u201d\n <\/p>\n

\n MFAN recently released a report<\/a> warning that the State Department, which took over US foreign assistance after USAID was shuttered, \u201ccurrently lacks sufficient staffing and systems to effectively manage its global health and international development portfolio.\u201d\n <\/p>\n

\n The senior State Department official said they expected to sign some of the bilateral compacts in early December. They noted that negotiation teams had visited 20 countries in the preceding days. They also said diplomats had been engaging on the ground in another 50 countries.\n <\/p>\n

\n In addition to the bilateral agreements, the official said the strategy also includes \u201cglobally managed programs, particularly in the global health security space, responding to epidemics\u201d and partnerships with organizations like the Global Fund.\n <\/p>\n

\n They did not say which countries were close to finalizing agreements but said they aimed \u201cto reach nearly all of the traditional health recipient countries, absent ones like South Africa, where there\u2019s obviously a unique political dynamic.\u201d The Trump administration has an extremely tense relationship with South Africa and has made unfounded accusations about genocide being committed there against White Afrikaners.\n <\/p>\n

\n \u201cWhat we\u2019ve heard in a lot of these negotiations, as we go out there, the countries are really excited to be brought to the table, and for them to be taking over private responsibility for their healthcare system,\u201d they said.\n <\/p>\n

\n The senior State Department official said they had run successful pilot programs in Kenya, Zambia, and Nigeria.\n <\/p>\n

\n The bilateral agreements will last for five years, but the specifics of the deals would be different based on each country, the official said. Some elements, such as data sharing, might be longer.\n <\/p>\n

\n \u201cWe\u2019re going to structure it like a modern private-sector contract,\u201d the senior State Department official told CNN in a recent interview.\n <\/p>\n

\n They want to \u201chelp incentivize countries to move towards the type of healthcare system that will allow them to develop and also deepen connections to the United States and create opportunities for US businesses,\u201d they said.\n <\/p>\n

\n Tuesday\u2019s announcement of the \u201cup to $150 million\u201d for the drone company underscored the emphasis on creating opportunities for American businesses.\n <\/p>\n

\n The data sharing element has raised some concerns among aid officials. A source told CNN that the standard compact asks countries to share their epidemiological data for 25 years, but some countries have negotiated fewer years of data transmission.\n <\/p>\n

\n \u201cIt\u2019s not a data-sharing agreement. It\u2019s a data-giving agreement,\u201d one senior aid worker said, expressing concerns that the information could be used to give a non-competitive advantage to American pharmaceutical companies, with new drugs and vaccinations not guaranteed to benefit countries most in need.\n <\/p>\n

\n \u201cIt\u2019s a lot more transactional than we\u2019ve been before,\u201d a senior government official working in global health told CNN. \u201cFor many years, we\u2019ve criticized China for giving foreign aid that\u2019s very transactional, very self-serving, traps countries into agreements that go beyond the amount of support they get, and this feels like we\u2019re leaning into that kind of a posture.\u201d\n <\/p>\n","protected":false},"excerpt":{"rendered":"Health experts are warning that the Trump administration\u2019s new \u201cAmerica First Global Health Strategy\u201d could further damage public…\n","protected":false},"author":2,"featured_media":284155,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[43],"tags":[102,2960,56,54,55],"class_list":{"0":"post-284154","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-healthcare","8":"tag-health","9":"tag-healthcare","10":"tag-uk","11":"tag-united-kingdom","12":"tag-unitedkingdom"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/284154","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/comments?post=284154"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/284154\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media\/284155"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media?parent=284154"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/categories?post=284154"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/tags?post=284154"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}