The United States has added Malawi to its growing list of African partners under the America First Global Health Strategy, signing a five-year, $936 million bilateral health cooperation Memorandum of Understanding (MOU) aimed at strengthening the country’s healthcare system and fighting infectious diseases.
The agreement was announced in a statement by the U.S. Department of State, signed by Principal Deputy Spokesperson Thomas “Tommy” Pigott.
U.S. officials say the arrangement reflects a shift away from donor-driven NGO delivery systems toward government-led healthcare, placing responsibility for frontline services, medical workers and public health infrastructure squarely in the hands of national authorities.
U.S. health partnerships expand across Africa
Malawi is the latest country to join a rapidly expanding group of African nations signing similar health cooperation agreements with Washington under the new strategy.
The United States has already inked multi-year health MOUs with 12 African countries, including Nigeria, Kenya, Uganda, Mozambique, Ethiopia, Cameroon, Ivory Coast, Botswana, Lesotho, Eswatini, Rwanda, Liberia, Madagascar, and Sierra Leone creating a continent-wide framework linking U.S. funding to domestic co-investment and performance targets.
In Malawi’s case, the agreement builds on progress in tackling HIV, with the government committed to maintaining its 95-95-95 targets for epidemic control through more integrated and sustainable healthcare delivery.
The MOU also covers maternal and child health, polio, malaria, tuberculosis and global health security, while promoting digital health tools and disease-tracking systems to reach rural populations more effectively.
For African governments, it represents a shift toward long-term sustainability, even as it requires higher domestic spending and deeper accountability.
With Malawi now on board, the U.S. continues to widen its health footprint across Africa under a model that blends large-scale funding with national ownership and shared responsibility.
