On Sept. 1, Congress passed a continuing resolution with broad bipartisan support to extend federal funding through Dec. 11. The House approved the continuing resolution 370-48 after the Senate passed it 90-6, giving lawmakers more time to negotiate full-year appropriations.
The continuing resolution provides more time for Congress to understand the progress and implementation of bilateral memorandums of understanding (MOUs) signed with 35 partner countries under the America First Global Health Strategy. Congress should use the coming months to ensure adequate resources are both allocated and disseminated with strong accountability mechanisms to protect hard-won gains against HIV/AIDS, malaria, and other infectious diseases while strengthening U.S. health security. As implementation of the America First Global Health Strategy continues, sustained congressional engagement and oversight will be essential to ensure U.S. investments remain transparent, data-driven, and focused on measurable results.
America First Global Health Strategy Updates
After 22 years of U.S. global health support from PEPFAR, Namibia will take full financial responsibility for its HIV response beginning in 2028. This is the first country to announce a planned, phased out reduction of U.S. financial assistance through PEPFAR. However, PEPFAR funding and support will not stop overnight. The U.S. will assist with the transition by continuing to provide $45 million in fiscal year 2027, before shifting to technical cooperation. The announcement does not include exact details for how the transition will happen or how much financial and programmatic oversight Namibia currently has over national HIV/AIDS programming.
Earlier this year, Namibia underwent negotiations for a bilateral health agreement with the United States under the America First Global Health Strategy. Negotiations were put into question following Namibia’s concerns about U.S. access to health data and pathogen-sharing outlined in the proposed MOU. It is not clear if Namibia’s transition from PEPFAR funding is connected to the negotiations.
The U.S. and Cameroon are moving their bilateral health agreement from negotiation to implementation. The U.S. Department of State’s Bureau of Global Health Security and Diplomacy has opened a call for Statements of Interest to support implementation of the U.S.-Cameroon bilateral health agreement. The process is the first step in a two-phase application and could lead to up to three awards, with proposed projects lasting no more than five years. The open call provides an early look at how bilateral health agreement implementation may move from government-to-government commitments toward specific, operational projects.
Bush Institute Insights
On Wednesday, Sept. 9, President George W. Bush, former Secretary of State Condoleezza Rice, and Chairman of the Joint Chiefs of Staff General Dan Caine reflected on the 25th anniversary of 9/11 during a special Engage at the Bush Center event presented by NexPoint, Legacy of Service: America at the 25th Anniversary of 9/11.
President Bush stressed the importance of American leadership in strengthening freedom and opportunity across the globe.
“My view is that freedom is necessary for peace,” President Bush said. “It is not America’s gift to the world. I happen to believe it is the Almighty’s gift to the soul. And the idea of giving people the chance to live in freedom makes sense not only from a national security perspective, but it makes sense for helping to establish peace.”
Programs created in the aftermath of the darkness of 9/11, like the President’s Emergency Plan for AIDS Relief (PEPFAR), illustrate the impact that health, stability, and economic growth in countries around the world have on the peace and security that we have here in the United States.
The program also featured J.D. Crouch, former Deputy National Security Advisor, and voices from the post-9/11 generation of veterans, including Jared Lyon and Melissa Stockwell. The full program, including the President’s reflections, can be found here: A Legacy of Service: America at the 25th Anniversary of 9/11.
Figure of the Week
35% of the world’s vaccines produced by U.S. companies
U.S. pharmaceutical and biotechnology companies produce 35% of vaccines purchased worldwide, according to the Better World Campaign’s new Health for US initiative. The leadership of the U.S. in global health investments and through partnerships with organizations like UNICEF, the Global Fund, and Gavi helps expand access to lifesaving products globally while reinforcing the economic and security benefits of U.S. engagement at home.
Check out the Health for US interactive dashboard to explore state-level data showing how global health investments benefit local economies and communities across the country.
Ally Updates
Think Global Health recently released an analysis of 67 proposals, published since 2023, on the future of global health investment and programming. The analysis finds broad agreement that a future global health model should shift decision-making toward recipient countries, strengthen national health systems, improve regional coordination, and direct donor funding toward national and regional capacity rather than disease-specific programs. To successfully translate these recommendations into an effective system, reform processes should also consider three unresolved questions:
- How should funding influence decision-making?
- What could be lost by shifting from disease-specific models (such as PEPFAR and the President’s Malaria Initiative, or PMI)?
- Where should global institutions end and regional institutions begin?
The authors note that developing an ambitious vision is only the first step; the harder work will be determining how power and resources shift, setting priorities, and defining the roles and capacity of different institutions.
In the News
- Kenya is emerging as an early test case for how civil society can adapt under the America First Global Health Strategy, Devex reports. Following Kenya’s bilateral health agreement with the U.S., NGOs HENNET and Humentum convened a coalition of health organizations in Nairobi to develop a blueprint focused on securing a meaningful role for civil society in government decision-making, coordinating advocacy around health outcomes, and creating more formal ways to work with the Kenyan government. The effort offers a practical model for keeping civil society engaged as countries assume greater ownership of health programs.
- The State Department’s new Annual Program Statement could award $4.5 billion over the next five years in global health funding through over 100 grants. Unlike most funding under the America First Global Health Strategy, Devex writes that APS is open to competitive bids and is intended to supplement bilateral health agreements, with a preference for faith-based organizations, local NGOs, and private-sector partners. About $1.4 billion is already open for applications or nearing award, including funding for nutrition, disease surveillance, and country-specific health programs in Cameroon, Côte d’Ivoire, and Mozambique.
- According to the WHO, as of Sept. 10, the Democratic Republic of the Congo is facing the fastest-growing Ebola outbreak on record, with more than 6,700 confirmed cases and more than 3,200 deaths reported. Although the United Nations and its partners have scaled up their response to the crisis, a $1.1 billion funding gap remains, with efforts to reach affected communities further complicated by conflict and displacement. “Unless we scale up urgently, more lives will be lost, and the threat will grow,” U.N. Emergency Relief Coordinator Tom Fletcher said. Neighboring Uganda ended its own outbreak through rapid case detection, contact tracing, clinical care, community engagement, and strengthened surveillance.
- As the 2026 U.N. General Assembly gets underway, Brookings’ Foresight Africa podcast explored how African countries are increasingly shaping global priorities rather than simply responding to agendas set elsewhere. U.N. Under-Secretary-General Ahunna Eziakonwa and Brookings Senior Fellow Landry Signé discussed global financial reform, climate finance, regional integration, and greater investment in Africa’s young population and economic potential. Their conversation also examined the shift from traditional aid toward trade, domestic resource mobilization, and investment as drivers of long-term growth.
- Sudan’s health system is nearing collapse as funding shortages amid the ongoing war force clinics and hospital wards to close, BBC reports. Médecins Sans Frontières said 45 health centers in central Darfur lost funding in May alone, while admissions at MSF-supported facilities rose 22.5% from last year. Continued attacks on health facilities are further straining access to lifesaving care.
- An invasive, malaria-carrying mosquito is spreading across Africa faster than scientists anticipated. According to The New York Times, the Anopheles stephensi mosquito is particularly concerning because it thrives in cities, transmits malaria year-round, and carries genetic resistance to all insecticides currently used in mosquito-control efforts. As the mosquito pushes west and south across the continent, stronger surveillance and new prevention tools will be critical to direct limited resources and protect hard-won progress against malaria.
