US - America First Global Health Strategy (U.S. Department of State, September 18, 2025)

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America First Global Health Strategy

Fact Sheet

Office of the Spokesperson

September 18, 2025

Today, the U.S. Department of State released its America First Global Health Strategy.

• The strategy lays out a positive and forward-looking vision for United States leadership in global health built around three pillars.
• The strategy prioritizes the interests of Americans and making America safer, stronger, and more prosperous.
• The strategy will also save millions of lives around the world and assist other countries in developing resilient and durable health systems.

This strategy builds on the successes of past global health programs. Over the last 25 years, the United States global health programs have:

• Prevented thousands of infectious disease outbreaks from reaching American shores.
• Saved over 26 million lives through the President’s Emergency Plan for AIDS Relief (PEPFAR) and millions of additional lives through other global health programs.
• Prevented 7.8 million babies from being born with HIV / AIDS.

However, our global health programs have become inefficient and wasteful and created a culture of dependency among recipient countries.

• Today, less than 40% of health foreign assistance goes to frontline supplies and health care workers.
  • ~25% of funds are used to purchase commodities (e.g., diagnostics, drugs)
  • ~15% of funds are used to employ over 270,000 frontline healthcare workers (e.g., mostly nurses and community health workers)
• The remaining 60% of funds are spent on technical assistance, program management, and other forms of overhead costs.
• Over the past 25 years, our health programs have created a culture of dependency among many recipient countries.

SAFER: We will keep America safe by monitoring and helping quickly contain infectious disease outbreaks before they reach U.S. shores.

• We will keep Americans safe by continuing to support a global surveillance system that can rapidly detect an outbreak.
• When there is an outbreak, we will be prepared to work with local governments to respond promptly.
• When necessary, we will be prepared to surge resources to ensure the outbreak is contained, travelers are appropriately screened, and – to the maximum extent possible – the outbreak does not reach American shores or harm Americans living abroad.

STRONGER: We will strengthen bilateral relationships with key countries by entering multi-year bilateral agreements that advance American interests, save lives, and enable economic growth:

• Our global health foreign assistance program is not just aid – it is a strategic mechanism to further our bilateral interests around the world. Moving forward, we will utilize our health foreign assistance to advance U.S. priorities and move countries toward resilient and durable local health systems.
• We will do this by entering multi-year bilateral agreements with recipient countries that lay out clear goals and action plans.
  • Frontline Commodities & Healthcare Workers: Bilateral agreements will ensure that 100% of funding for all frontline commodity purchases and all frontline healthcare workers is maintained.
  • Data Systems: Bilateral agreements will ensure there are data systems in place to monitor epidemiology data, service delivery data, and supply chain data.
  • Technical Assistance, Program Management and Overhead: Bilateral agreements will work to rapidly transition U.S. technical assistance from supporting individual clinical sites to supporting governments in taking over key functions. This will include more direct government-to-government assistance as well as leveraging the private sector and faith-based organizations.
  • Co-Investment: Bilateral agreements will require recipient governments to co-invest in these efforts and include performance benchmarks that must be met in order to release future U.S. health foreign assistance funding.
• We aim to complete bilateral agreements with recipient countries receiving the vast majority of U.S. health foreign assistance by December 31, 2025 with the goal of beginning to implement these new agreements by April 2026.

MORE PROSPEROUS. We will make America more prosperous by promoting American health innovation around the world and protecting our economy from infectious disease outbreaks and promoting American Health Innovation Around the World:

Infectious disease outbreaks can quickly become epidemics that can lead to significant economic disruption. By helping contain outbreaks where they originate, we will protect the U.S. economy from health-related disruptions.

We will promote American health innovation globally by procuring and distributing goods from American companies through our foreign assistance programs and leveraging our bilateral relationships to promote American health innovation and products around the world.

Read full strategy
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https://www.state.gov/releases/offi...2025/09/america-first-global-health-strategy/