The United States and Uganda have signed a $1.7 billion health financing pact under Washington's "America First" aid strategy, which prioritizes US-made goods in assistance programs. Uganda agreed to raise domestic health spending by $500 million to take on more fiscal responsibility, and the administration has struck similar deals with Kenya and Rwanda. Observers say the model makes aid more "transactional," raising questions about feasibility, local procurement and long-term sustainability.
US, Uganda Seal $1.7B Health Financing Pact Under "America First" Aid Plan
A scatter plot comparing GDP per capita to aid given per capita
Uganda and the United States have signed a $1.7 billion health financing agreement that forms part of Washington's "America First" approach to foreign aid. The deal aims to expand health funding while emphasizing the use of US-made goods and services within assistance programs.
Details of the Agreement
Under the pact, Uganda has pledged to increase its own health-sector spending by $500 million to "gradually assume greater financial responsibility," according to Washington. The Trump administration has pursued similar arrangements with Kenya and Rwanda, tying elements of foreign assistance to procurement and policy commitments that favor US suppliers.
Reactions and Analysis
Supporters say the model promotes accountability, protects American jobs and ensures that aid dollars are spent on vetted goods and services. Critics argue it could limit local procurement, introduce new strings to assistance, and place heavy policy and fiscal burdens on recipient governments.
Expert View: An analyst writing for Semafor described the new approach as making aid "wholly transactional," with recipient states expected to treat the US as a business partner. The commentator called the shift ambitious and said it could be "visionary. Or delusional."
As implementation proceeds, the deal will be watched for its impact on health outcomes in Uganda, the capacity of the Ugandan government to meet increased fiscal commitments, and the broader consequences for traditional aid relationships. The balance between economic and diplomatic objectives will determine whether this model is sustainable and effective.
