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US Warns Against Non-Performance In $2.3bn Health Deals With Four African Nations

"Each MOU includes clear benchmarks, strict timelines, and consequences for nonperformance – ensuring U.S. assistance delivers results against priority disease threats and reduces long-term dependence on U.S. assistance," the State Department said in a statement.

December 24, 2025
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By Enyichukwu Enemanna

The U.S. has sealed new global health memorandums of understanding (MoUs) with four African nations, worth nearly $2.3 billion in funding, the State Department said on Tuesday.

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The MoUs which come with a warning against non-performance has Madagascar, Sierra Leone, Botswana, and Ethiopia as benefitting states.

The Donald Trump administration had in September unveiled its “America First Global Health Strategy”, a new approach to overseas aid that seeks to improve target countries’ self-reliance in managing their health sectors.

“Each MOU includes clear benchmarks, strict timelines, and consequences for nonperformance – ensuring U.S. assistance delivers results against priority disease threats and reduces long-term dependence on U.S. assistance,” the State Department said in a statement.

“Across the four MOUs, which total nearly $2.3 billion, the United States has committed almost $1.4 billion, with recipient countries co-investing more than $900 million of their own resources.”

The U.S. embassy in Ivory Coast’s commercial capital Abidjan said a signing of a five-year health cooperation memorandum between the two countries was scheduled for Thursday.

The MoU is aimed at strengthening disease detection and health worker capacity, the embassy said, adding that the State Department planned to provide up to 273 billion CFA francs ($491 million) in health support, while Ivory Coast commits to increasing its national funding to 252 billion CFA francs.

Earlier this month, the U.S. signed a five-year health cooperation agreement with Eswatini to provide up to $205 million for investments in health data collection, disease monitoring and response and HIV prevention and treatment.

Eswatini, in turn, will increase domestic health spending by $37 million during the five-year period.

The U.S. has also signed health cooperation agreements with Kenya, Rwanda, Uganda and Lesotho.

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