Trump Administration Signs Health Agreement with Kenya
The Trump administration has finalized the first of several “America First” Global Health Fund agreements. This initiative aims to bolster responses to infectious diseases in countries that align with the president’s foreign policy objectives.
On Thursday, Kenyan President William Ruto and Secretary of State Marco Rubio signed a five-year, $2.5 billion agreement, which replaces a series of previous health agreements that had been managed by the U.S. Agency for International Development (USAID) until the Trump administration dissolved it earlier this year.
The move to eliminate USAID as an independent agency drew significant criticism in the global health sector, with immediate consequences, including the loss of funding for numerous programs in developing nations focused on maternal and child health, nutrition, and HIV/AIDS prevention.
During the signing, Rubio emphasized that this agreement with Kenya aims to enhance U.S. leadership in global health while addressing issues of dependency and inefficiency. He also commended Kenya’s contributions to the International Stabilization Force combating gang violence in Haiti.
Ruto expressed enthusiasm for the partnership and indicated that Kenya would maintain its involvement in Haiti as anti-gang operations expand.
Agreement Details
Under the terms of the agreement, the U.S. will contribute $1.7 billion, while Kenya will provide the remaining $850 million.
U.S. officials noted that the focus will be on faith-based health care providers and tackling diseases such as HIV/AIDS, malaria, and tuberculosis. However, any clinic or hospital participating in Kenya’s health insurance system can qualify for funding.
Kenya’s chief secretary for health services, Ouma Olga, stated, “This cooperation framework is very different from the past and will have a lasting impact on the health of all people.”
The agreement will also support family planning initiatives that comply with U.S. regulations on abortion services. Officials involved in negotiations reassured that there will be no discrimination against LGBTQ+ individuals or sex workers.
Other African nations are anticipated to enter into similar agreements with the U.S. by the year’s end, although Nigeria and South Africa, due to political differences with Trump, are not expected to be part of that group.
Ongoing discussions with Nigeria continue, despite the president’s serious concerns regarding the persecution of Christians there.
Officials foresee an escalation in efforts to address these issues once a health agreement with Nigeria is reached.
The disbandment of USAID led to significant repercussions in Africa, halting programs that addressed diseases and hunger, along with initiatives that supported maternal health and countered extremism. Many health workers lost their positions as U.S. funding ceased.
Potential Impacts on Health Programs
Experts warn that sub-Saharan Africa’s battle against HIV could face setbacks as the impact of USAID’s closure is felt. The President’s Emergency Plan for AIDS Relief (PEPFAR), initiated by the George W. Bush administration, has been credited with saving millions of lives but has faced funding cuts.
South Africa, home to the highest number of HIV infections globally, relied on U.S. aid—over $400 million annually—to provide essential antiretroviral drugs to those in treatment.
Without adequate support, the state of South Africa’s HIV program, one of the world’s largest, was severely affected, with funding from U.S. taxpayers dropping significantly due to the cuts.
In response to criticism over the potential loss of lives resulting from funding reductions, the Trump administration restored some aid, including $115 million to support South Africa’s HIV initiatives at least through March.
However, President Trump has indicated his intention to halt all financial assistance to South Africa, referring to discredited reports of violence against the country’s white Afrikaner population.
Nigeria’s health system is largely reliant on international aid, having received nearly $4 billion from USAID from 2020 to 2025. Unfortunately, chronic underfunding has weakened Nigeria’s health sector, with the federal government historically allocating only 4-5% of its budget to health care for its rapidly growing population.
The abrupt funding cuts have exacerbated an existing crisis at a time when many aid-supported programs have become crucial for millions.
