In September 2025, the America First Global Health Strategy (AFGHS) lays out a plan to use global health diplomacy and foreign assistance to make America “safer, stronger, and more prosperous,” while claiming it will end “inefficiencies, waste, and dependency.” At the same time, it marks a sharp departure from decades of bipartisan global health cooperation, with the administration’s fiscal year 2026 budget anticipating a 62% cut to foreign assistance for health.
With the launch of the AFGHS, global health is reframed as an explicit political strategy to pursue American national advantage. This shift reshapes priorities around ideology and domestic political alignment, rather than evidence-based need or global equity, sidelining routine and essential services in favor of narrowly defined outbreak preparedness. It also advances a model that “affirms national ownership only rhetorically,” while dictating how Global South countries should design their health strategies, set priorities, and implement programs, including through bilateral Memorandums of Understanding that place the United States “in the driver’s seat” of national health agendas.
The AFGHS also advances a fundamental realignment away from a rights-based agenda and toward a commercial one, positioning global health assistance as a vehicle to expand markets for American technologies. It frames Africa as “a continent of strategic importance to U.S. national interests,” citing “key minerals and rare earth elements” tied to military and commercial applications, and it shows how health assistance can become leverage in negotiations. In this context, “health sovereignty” is used as a façade that risks hollowing national health systems in the Global South, to the benefit of private capital interests, while weakening multilateral coordination and shared global health governance.