The US unveiled the America First Global Health Strategy on 18 September. The strategy says global health should advance American safety, prosperity and influence, and it criticises existing programmes as "inefficient and wasteful and created a culture of dependency among recipient countries." It prioritises containing infectious disease outbreaks before they reach US soil, strengthening bilateral relationships, and promoting American health innovation worldwide. The plan also requires low- and middle-income countries (LMICs) to co-invest and meet performance benchmarks before some funds are released.
Experts describe both risks and opportunities. Jirair Ratevosian said there is "an opportunity and a risk," noting the strategy could accelerate US strengths such as long-acting prevention, cure research and AI-driven surveillance. He warned that being "too America-centric" could sideline LMIC researchers and miss the realities of their epidemics. The article uses HIV research as an example: PEPFAR has saved more than 26 million lives since 2003, and lenacapavir trials in Uganda and South Africa helped secure its global approval.
Beatriz Grinsztejn raised questions about US funding and the future of HIV prevention, and she warned that the proposed "sunset" of UNAIDS by the end of 2026 underlines the need to protect HIV as a global priority. Earlier dismantling of USAID and 90-day funding freezes harmed research, and the PRO Initiative mobilised US$110 million to keep more than 80 high-impact projects alive. Experts say such stopgaps cannot replace long-term US assistance.
Difficult words
- strategy — A plan to achieve a goal or objective.
- concern — A feeling of worry about something.
- collaboration — Working together to achieve a common goal.
- funding — Money provided for a specific purpose.
- innovations — New ideas or methods to improve something.
- prioritizing — Deciding what is most important.
- benchmark — Standards or points of reference for measuring.benchmarks
- health systems — Organizations that provide medical care and services.
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Discussion questions
- How can collaboration improve health outcomes in LMICs?
- What are the potential risks of depending on US resources?
- In what ways can LMICs maintain their independence in health strategies?
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