The Trump administration is forging bilateral offers with nations hit by widespread cuts to US international help.
Revealed On 30 Dec 2025
The administration of United States President Donald Trump has signed a deal committing $480m in public well being help to the Ivory Coast.
The settlement, signed within the West African nation’s capital, Abidjan, on Tuesday, is the newest flip within the Trump administration’s America First International Well being Technique.
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The plan envisions forging bilateral agreements with dozens of nations to obtain US well being help within the wake of the administration’s gutting of the US Company for Worldwide Growth (USAID).
The Trump administration has maintained that US international help coverage has been inefficient and wasteful, saying that the bilateral agreements will create extra accountability, oversight and eventual self-sufficiency.
Consultants have questioned the efficacy of the method and raised alarm over its transactional nature.
On the signing ceremony on Tuesday, the US ambassador to the Ivory Coast, Jessica Davis Ba, mentioned the US authorities is shifting “past the standard help method towards a mannequin centered on commerce, innovation, and shared prosperity”.
“In the present day, our bilateral cooperation is coming into a brand new part. We’re implementing the America First International Well being Technique,” the ambassador mentioned.
As a part of the settlement, the Ivory Coast dedicated to finally offering as much as $292m to well being funding by 2030, Ivorian Prime Minister Robert Beugre Mambe mentioned.
The deal is the most important of the greater than a dozen different preparations the Trump administration has reached to this point beneath the brand new technique.
Cuts to USAID
Deep USAID cuts earlier this 12 months have disrupted public well being companies the world over, with Africa significantly hard-hit.
That has sparked issues in regards to the potential enhance of the spread of HIV on the continent, declines in maternal and child healthcare, spikes in Malaria circumstances, and decreased early detection of recent infectious illnesses.
Whereas the Ivory Coast deal and different new bilateral agreements search to handle these areas, public well being specialists have been cautious in regards to the administration’s method.
An evaluation by the Heart for International Growth earlier this month mentioned that the brand new technique outlines a number of probably helpful modifications to international well being help supply.
Nonetheless, these modifications “carry super dangers to service supply and hard-won public well being positive factors”, senior analyst Jocilyn Estes and coverage fellow Janeen Madan Keller wrote.
The pair recognized a number of potential areas of threat, together with public well being priorities probably being formed by “transactional pressures”, questions over oversight, and an absence of readability on how companies will probably be protected if a associate nation is unable to satisfy its commitments.
The specialists additional questioned what the technique would imply for help in areas the place there isn’t a “credible or secure authorities”.
“Operationalising a reconfigured method to US world well being help – significantly direct authorities help – at this scale and pace is unprecedented”, they wrote, including that “every potential level of failure dangers lives”.
