The United States (US) has signed new health funding agreements with at least nine African countries under a restructured global health framework aligned with the Trump administration's "America First" agenda.

The deals reduce overall US aid, require greater financial contributions from recipient governments, and emphasize negotiated, transactional partnerships over traditional assistance delivered through USAID, which has been dismantled. Countries such as Kenya, Nigeria, Rwanda, Lesotho and Eswatini have signed on, with some agreements linked to specific US priorities, including faith-based health care support and migration co-operation. However, questions have been raised about the political and economic implications of these agreements.

To provide more insight on these developments, political analyst, governance and social activist Diamone Siulapwa from Zambia.