U.S. Signs Health Aid Deals With 16 African Countries as Pandemic Annex Talks Continue
The United States has signed agreements with 16 African countries to provide more than $11 billion in health aid, according to The New York Times, which reported the deals in January 2026.
The agreements are part of the America First Global Health Strategy, a plan the State Department released in September 2025. The plan says it prioritizes drugs, frontline health supplies and staff, and working directly with countries. Reuters reported that it also gives priority to recipients' self-reliance. The strategy says it will protect the American homeland by preventing infectious disease outbreaks from reaching U.S. shores.
Most of the deals take the form of bilateral agreements, meaning agreements between two governments. The State Department said in September 2025 that it aimed to complete these agreements with the countries receiving the vast majority of its health foreign assistance by December 31. The written agreements, known as memoranda of understanding (MOUs), are formal documents that set out each side's commitments. A December 2025 State Department release said these MOUs include modernizing electronic medical records and disease surveillance systems, which track the spread of illness. In April 2026, the United States and Cambodia agreed to a $36.1 million bilateral health MOU that includes $5 million in global health security funding.
Data sharing is one of the terms that has drawn attention. Reuters reported in November 2025 that the U.S. seeks pathogen samples and genomic sequencing data, which describe the genetic makeup of a germ, within five days of an outbreak in exchange for foreign health aid. Africa is central to the overall spending. The New York Times reported in February 2025 that about 85 percent of U.S. spending on global health went to programs in or for African countries.
Travel is a separate issue. In May 2026, the New York Times reported that the U.S. administration had blocked travelers from Congo and South Sudan as part of sweeping bans restricting visas from many African countries.
The bilateral deals run alongside a separate, multilateral effort. Countries agreed in April 2025 on a draft "pandemic treaty" meant to help the global community better prevent and respond to health crises. Health experts voiced concerns, as Reuters reported in December 2025, that the U.S. deals would bypass the World Health Organization and derail the negotiations. The WHO chief said he was "not worried" about the bilateral deals affecting the pandemic treaty.
The treaty's details are still being negotiated. In March 2026, WHO member states agreed to extend negotiations on the Pathogen Access and Benefit Sharing (PABS) annex, a technical add-on that sets out how pathogen samples and their benefits are shared. In a September 2026 WHO statement, the organization said that adopting the annex at the World Health Assembly, its decision-making meeting, in May 2027 is necessary before member states can begin national consideration.
