WASHINGTON — The Trump administration has signed the first in what are expected to be dozens of “America First” global health funding agreements that will prioritize combating infectious diseases in countries deemed to be aligned with the president’s broader foreign policy goals and positions.
The five-year, $2.5 billion agreement with Kenya was signed Thursday by Kenyan President William Ruto and Secretary of State Marco Rubio to replace a patchwork of previous health agreements that had traditionally been run by the U.S. Agency for International Development for decades until the Trump administration dismantled it earlier this year.
The elimination of USAID as a separate agency sparked widespread criticism and concern in the global health community as its immediate impact resulted in the defunding of multiple hundreds of programs focused on the developing world, including cuts to maternal and child care, nutrition and anti-HIV/AIDS programs.
Rubio said the agreement with Kenya “aims to strengthen U.S. leadership and excellence in global health while eliminating dependency, ideology, inefficiency, and waste from our foreign assistance architecture.” He also praised Kenya for its role in leading and contributing to the international stabilization force working to combat powerful gangs in Haiti.
Ruto lauded the agreement and said Kenya would continue to play a role in Haiti as the gang suppression force transitions to a broader operation.
Under the health deal with Kenya, the U.S. will contribute $1.7 billion of the total amount, with the Kenyan government covering the remaining $850 million. The agreement focuses on preventing and treating diseases such as HIV/AIDS, malaria and tuberculosis with an emphasis on faith-based medical providers, although all clinics and hospitals enrolled in Kenya’s health insurance system will be eligible to receive funding, according to U.S. officials.
“This cooperation framework is quite a departure from the past and will have a lasting impact on health for all,” said Ouma Oluga, Kenya’s principal secretary for medical services.
Family planning programs that comply with U.S. restrictions on the provision of abortion services will also be eligible, according to Jeremy Lewin and Brad Smith, two State Department officials involved in the negotiations. They said the agreement would not discriminate against gay and transgender people or sex workers.
A number of other African countries are expected to sign similar agreements with the U.S. by the end of the year, according to the officials, although two of the continent’s most populous nations — Nigeria and South Africa — are not expected to be among that group due to political differences with Trump, according to Lewin and Smith.
Dismantling USAID had repercussions across Africa, shutting down programs that fought disease and hunger and supported maternal health, and even some that tackled extremism and promoted democracy. It also put thousands of health workers out of jobs because their salaries were funded by U.S. aid.
Lee and Imray write for the Associated Press. Imray reported from Cape Town, South Africa.
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