On December 24, 2025, the United States announced new health memoranda of understanding (MOUs) with four African partners—Madagascar, Sierra Leone, Botswana, and Ethiopia—totaling nearly $2.3 billion in combined commitments under the America First Global Health Strategy, launched this September.
The agreements outline clear benchmarks, strict timelines, and consequences for nonperformance, aiming to deliver measurable results against priority disease threats and reduce long-term dependence on US assistance. Of the total funding, approximately $1.4 billion will come from US assistance, with more than $900 million pledged in co-investment by the host countries.
In Ethiopia, the MOU targets HIV/AIDS, tuberculosis, malaria, polio eradication, maternal and child health, and infectious disease preparedness, including ongoing support for the Marburg virus response. Botswana’s deal focuses on modernizing electronic medical records and strengthening disease surveillance systems across the country.
Sierra Leone is set to receive over $30 million in the first quarter of 2026 to rapidly boost disease surveillance, laboratory capacity, health workforce training, and data infrastructure. Meanwhile, Madagascar’s partnership will concentrate on malaria control, maternal and child health, and global health security, while transitioning community health workforce management to national authorities.
These four new MOUs build on earlier agreements signed this month: Kenya led the pack on December 4, and Nigeria, Rwanda, Cameroon, Lesotho, and Liberia have also signed on. The US government plans to roll out multi-year bilateral health cooperation agreements with dozens more partner countries in early 2026.
By linking substantial financial commitments with accountability measures and local ownership, these MOUs aim to accelerate progress on critical health challenges, empower national health systems, and foster sustainable, data-driven solutions across the African continent.
Reference(s):
cgtn.com
