Washington, D.C., USA, 2025-09-20

The U.S. Department of State has unveiled its new “America First Global Health Strategy,” a comprehensive foreign policy framework that redefines the country’s approach to international health assistance. The strategy, built on three pillars—”Safer, Stronger, and More Prosperous”—emphasizes protecting American interests and homeland security while leveraging health foreign assistance to advance U.S. priorities. While the plan aims to save millions of lives globally, it marks a significant shift away from previous administrations’ open-ended aid models toward a system of bilateral, time-limited agreements that require co-investment from recipient nations. This new approach has been met with a mix of support and criticism, with proponents hailing it as a more efficient and strategic use of resources and critics warning that it could undermine global health security.

The Three Pillars of the “America First” Strategy

The new strategy is designed to make global health foreign assistance a more direct tool of U.S. foreign policy.

 * Safer: The plan prioritizes protecting Americans by strengthening a global surveillance system that can rapidly detect infectious disease outbreaks before they reach U.S. shores. It also outlines a plan for a rapid, 72-hour response to any infectious disease outbreak that threatens Americans at home or abroad.

 * Stronger: The strategy moves away from a traditional aid model toward a system of “strategic partnerships.” It will replace open-ended assistance with multi-year bilateral agreements that include clear goals and performance benchmarks. These agreements are designed to help recipient countries become more self-reliant and ultimately assume full ownership of their health programs.

 * More Prosperous: The strategy explicitly links global health to U.S. economic interests. It will promote American health innovation by ensuring that U.S. foreign assistance programs procure and distribute goods from American companies. The plan also seeks to leverage bilateral relationships to promote the export of American health products and innovations around the world.

The new strategy will be implemented through government-to-government assistance, and it pledges to maintain funding for frontline healthcare workers and the purchase of life-saving commodities like diagnostics and drugs. However, it also requires recipient governments to co-invest in these efforts and to demonstrate progress toward self-reliance.

A Change in Focus and Funding

The new approach has raised concerns among some in the global health community about its potential impact on existing programs and its focus. While the strategy covers key diseases like HIV/AIDS, tuberculosis, and malaria, critics point out that it does not explicitly mention other areas that were prioritized under past administrations, such as maternal and child health and vaccine-preventable diseases.

 * PEPFAR Under Review: The strategy also outlines changes to the President’s Emergency Plan for AIDS Relief (PEPFAR), a landmark program that has saved millions of lives in Africa. The new plan will focus on a “commodity-centric” model, which prioritizes the purchasing and distribution of drugs and treatments while reducing funding for programmatic overheads.

 * Potential for Reduced Funding: The strategy signals a potential for deep cuts to overall global health funding. The president’s fiscal year 2026 budget proposal recommends approximately $4 billion for global health, a significant decrease from the roughly $10 billion spent in 2024.

A Divided Response

The “America First Global Health Strategy” has been met with a mixed response both at home and abroad. Proponents argue that the strategy is a much-needed reform that will make U.S. foreign assistance more efficient and effective. They claim that previous models were inefficient and led to over-reliance on U.S. aid.

On the other hand, critics warn that the new approach could be detrimental to global health security. They argue that a focus on self-reliance could put a greater burden on low- and middle-income countries and that tying assistance to U.S. economic interests could undermine the collaborative spirit needed to fight global pandemics. The strategy now faces a critical test as the State Department aims to complete bilateral agreements with recipient countries by the end of this year, a deadline that will determine the future of U.S. global health engagement.