2025-2026 US Bilateral Health Agreements

In late 2025 the United States launched bilateral negotiations for health aid as part of the “America First” Global Health Strategy.The agreements were negotiated after the elimination of the US Agency for International Development (USAID) in early 2025 and raise concerns that health aid is being inappropriately leveraged to extract terms beneficial to the US in negotiations around natural resources and access to sensitive health data from recipient countries.

The agreements with Ethiopia, Kenya, Mozambique, Nigeria, and Uganda were briefly posted to the State Department’s Freedom of Information Act Library on March 13, 2026, under the Case-Zablocki Act, which requires timely public disclosure of concluded international agreements. However, days later they were removed after the New York Times reported that the US had explicitly linked a $1 billion health package to access to Zambia’s minerals. Rwanda and Liberia’s agreements were never officially released and became publicly available only through leaks. The original agreements can be found below, and will be updated as other verified agreements become available.

A detailed human rights assessment of the text of the agreements can be found on this page.