PREVIEWWashington is pushing health contracts including tough conditions on big pharma, sexual health and data accessPresident Donald J Trump’s administration is reshaping development policy again with 13 bilateral pacts with African states so far as part of the ‘American First Global Health Strategy’. The latest deals are with Ethiopia, Madagascar, Botswana, and Côte d'Ivoire and worth a cumulative US$2.8 billion, taking the overall total to $16bn. The most lucrative are with Nigeria and Kenya, worth $2.1bn and $1.5bn respectively. The latest agreements follow the blueprint of prioritising programmes offering treatment and prevention of HIV/AIDS and TB and malaria, as well as infectious diseases (Dispatches, 15/12/25, Trump’s USAID 2.0 takes shape). Organisations such as the Red Cross are reporting that funding for sexual and reproductive health programmes has been dramatically reduced (AC Vol 66 No 6, Targeted by Trump – Africa and Europe draw closer).

Source: The North Africa Journal January 05, 2026 17:35 UTC