Trump launches $11B foreign health plan to replace USAID, shift focus to direct aid

US President Donald Trump's administration has launched a new $11 billion global health initiative aimed at replacing the US Agency for International Development (USAID) with a system that delivers aid directly to foreign governments and health institutions, media reports said Wednesday.

The five-year initiative, known as the "America First Global Health Strategy," seeks to realign US foreign health assistance to advance strategic and business interests while overhauling how aid is distributed, particularly in Africa, according to Axios.

Under the plan, the US will commit $11.1 billion to participating countries, which have pledged $12.2 billion in matching funds and agreed to meet specific performance benchmarks tied to continued support.

The strategy bypasses non-governmental organizations that previously operated under USAID and instead channels funding directly to governments, hospitals, and pharmaceutical suppliers.

So far, the State Department has signed 15 agreements and plans to expand the program to 50 countries within months, according to the report.

Secretary of State Marco Rubio said the new model ends reliance on what he described as the "NGO industrial complex," which he said absorbed 70% of US funding through intermediaries in Washington, DC.

"You never built durability or self-reliance in these African governments because they had this parallel system," said Undersecretary of State Jeremy P. Lewin.

Critics have warned that the strategy could increase the risk of corruption and ineffective outcomes.

"The capacity is not there, and the level of corruption is so high that money is going to disappear," said Andrew Natsios, a former head of USAID under President George W. Bush.

One epidemiologist estimated that up to 750,000 people have died since Trump began dismantling USAID, a figure the State Department disputes.

The program includes agreements with Kenya, Cameroon, Rwanda, Mozambique, Nigeria, and other countries, while Panama is set to become the first non-African participant.

Some aid deals are linked to US commercial interests, including ExxonMobil's energy operations in Mozambique and Zipline's medical drone services in Rwanda.

The US is also funding Starlink to provide internet access to rural health clinics.

"The free wifi draws people to the clinics, where they get care at the same time," Lewin said.