WIREDGOV

EXPERT COMMENT

African countries have an important opportunity to align the strategy with their own health security agendas.

It has been nearly two months since the release of the long-anticipated America First Global Health Strategy (AFGHS), a document whose very title feels inconsistent – and exposes what many in the field have long understood: that global health, as practiced, has rarely been truly global. Rather it has often meant that a few countries and institutions have exerted overwhelming influence on the development and management of health policy and strategy in poorer countries.

The AFGHS reflects a clear logic of commercial diplomacy: using foreign assistance to advance American innovation abroad while reinforcing domestic economic interests. Roughly a quarter of its health funding is earmarked for commodities – diagnostics, medicines, and vaccines – with procurement preferences that privilege US-made products.

For Washington, this approach aligns health security with industrial competitiveness. For its partners in Africa and elsewhere, however, it risks hardening patterns of structural dependency precisely when they want to improve their own manufacturing and regulatory capacity.

Yet this challenge need not become a zero-sum equation. If negotiated strategically, the AFGHS could be part of a transitional compact – one that balances US industrial priorities with Africa’s long-term health security and economic sovereignty.  

Click here to continue reading the full version of this Expert Comment on the Chatham House website.