Negotiations have started between the US and numerous governments on bilateral health Memoranda of Understanding or MOUs. These concern all areas of US health assistance, ie HIV, TB, malaria, maternal and child health, health systems, health emergencies etc. The guidance the US has provided to its negotiating teams refers to coordination with the Global Fund, but no specifics are given.
There is some positive rhetoric from the US about country ownership but there are many concerns, and civil society should do all it can to assert its voice and encourage governments to define their own national priorities and have all baseline information in hand, in all health areas, before engaging.
Here are several resources that will be helpful in this process:
- This posting has a calendar for negotiations and some reflections on how governments might approach the talks. One thing to note is that the calendar does not include countries where we know for a fact that MOUs are being drafted by the US Embassy and the MOH, for instance in Haiti. So, if you do not see a country listed that does not necessarily indicate nothing is happening there yet. This process is starting in Africa but will move to other regions.
- For info on some baseline funding levels go to this link. Useful to compare US funding proposals against previous funding levels as a baseline
- The leaked US drafts of guidance to its negotiating teams for these MOUs can be found here
- PIH is sponsoring a weekly info sharing call for CSOs, country partners, regarding the negotiation by the US of health MOUs, and you are welcome to tune in to the Chatham House rules-based conversation.
- Here is a link to the signed MOU with Kenya and the data “sharing” agreement, both posted on X today by the MOH, following advocacy by CSOs: Here and Here
- Emily Bass posted a related funding table on her substack, showing large reductions in TB and malaria funding from the US: https://emilysbass.substack.com/p/lessons-from-americas-health-agreements
- The Rwanda agreement was also signed. Uganda and Cote d’Ivoire may also be signing soon. We do not have the text of that, but the announcement shows a very large reduction in US funding over five years: Continuing to Deliver on the America First Global Health Strategy with the Signing of the United States-Rwanda Bilateral Health Cooperation Memorandum of Understanding – United States Department of State