Abstract
The United States is rolling out bilateral health agreements across Africa under its America First Global Health Strategy. Its announcement on 4 December of a US$1.6-billion health agreement with Kenya was the first, and signals a shift in how the United States intends to engage with African health systems. Rather than strengthening relevant continental bodies such as the World Health Organization (WHO), the African Union and the Africa Centres for Disease Control and Prevention (CDC), the strategy leans towards one-to-one agreements between governments. The timing could not be more delicate. It follows the United States' withdrawal of funding from Gavi, the Vaccine Alliance, and the WHO, two international health institutions that African governments rely on for vaccines, coordination and technical support, and the importance of which in the region has grown since the COVID-19 pandemic.
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NSTL