Kenya, US seal US$2.5bn ‘America First’ health deal as Trump rewrites foreign aid

The United States has signed a US$2.5 billion health cooperation agreement with Kenya, the first in a planned series of “America First” global health deals that will channel funding to countries aligned with President Donald Trump’s foreign policy priorities.

Kenyan President William Ruto and US Secretary of State Marco Rubio signed the five-year agreement on Thursday, replacing a patchwork of earlier programmes that had been managed for decades by the US Agency for International Development (USAID). The Trump administration dismantled USAID as an independent agency earlier this year, prompting widespread criticism from global health groups after hundreds of programmes including maternal health, nutrition and HIV/AIDS initiatives lost funding.

Rubio said the new deal would “strengthen US leadership and excellence in global health while eliminating dependency, ideology, inefficiency and waste.” He also praised Kenya for its role in the international security force deployed to curb gang violence in Haiti.

Ruto welcomed the agreement and said Kenya would continue contributing to the Haiti mission as it transitions to a broader operation.

Under the deal, the United States will provide US$1.7 billion, with Kenya contributing US$850 million. The focus will be on tackling HIV/AIDS, malaria and tuberculosis, with a strong emphasis on faith-based health providers. All facilities enrolled in Kenya’s national health insurance system will be eligible for funding, US officials said.

Family planning services that comply with US abortion restrictions will also qualify. Negotiators Jeremy Lewin and Brad Smith said the agreement would not exclude LGBTQ people or sex workers.

Other African countries are expected to sign similar agreements before the end of the year, although Nigeria and South Africa are unlikely to be among them due to political differences with Trump, the officials said. Talks with Nigeria are continuing, despite what Lewin described as the president’s “very significant concerns” about the persecution of Christians there.

The dismantling of USAID has had broad repercussions across Africa, shutting down health and development programmes and leaving thousands of health workers without salaries previously financed by the United States.