Editorial Note: This resource will be updated as needed to reflect additional developments.
A significant shift in U.S.global health strategy unfolded on September 18, 2025, with the release of the America First Global Health Strategy. This new framework outlines the United States’ evolving approach to international health initiatives. Central to this strategy is the implementation of bilateral health cooperation agreements – formally known as Memorandums of Understanding (MOUs) – with nations receiving U.S. global health assistance. These MOUs, spanning a five-year period from 2026 to 2030, are designed to foster more resilient and enduring health systems in partner countries.
I’ve found that a key element of these agreements is a deliberate transition towards country ownership of health programs. The U.S. is encouraging partner nations to increase thier own domestic health spending, effectively co-investing in their health infrastructure as U.S. assistance gradually decreases.The U.S. began initiating these agreements in late 2025, with ongoing implementation expected throughout the current year. Understanding these changes is crucial for anyone involved in global health, whether you’re a policymaker, practitioner, or simply someone interested in the future of international development.
This resource offers a extensive overview of the MOUs signed to date. The data presented here is based on publicly released press statements from the State Department. It’s crucial to note that detailed specifics within the MOUs – such as program areas, financial allocations, and data-sharing protocols – are not yet fully accessible to the public (see Methods for further details). We will continue to update this tracker as new agreements are finalized and more data becomes available.
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