The State Department rolled out 12 funding addenda totaling $1.43 billion to support bilateral health agreements, as KFF reported.
Following the dissolution of the U.S. Agency for International Development, the State Department launched the America First Global Health Strategy in September 2025, according to KFF. This strategy ties U.S. health assistance to direct bilateral memoranda of understanding with partner nations.
To implement these pacts, officials introduced the Advancing Global Health Annual Program Statement mechanism in March 2026. This open competitive framework aims to disburse up to $4.5 billion across four funding windows spanning through February 2027.
The mechanism bridges post-USAID foreign aid shifts by targeting both specific MOU nations and cross-cutting health priorities. Eligible applicants range from foreign public institutions to faith-based organizations and private enterprises, with grants scaling from $500,000 to $250 million over five years. As KFF noted, the 12 released addenda represent nearly a third of the total anticipated funding envelope.
- Direct G2G Funding: Money flows directly through government-to-government agreements and competitive addenda rather than traditional USAID channels.
- Targeted Windows: Funding is split between country-specific programs in seven MOU nations and global health initiatives like outbreak response and nutrition.
- Implementation Unknowns: Although billions are allocated, no actual awards have been publicly announced yet, leaving the real-world operational footprint to be determined.
The released addenda represent 122 potential awards spread across country-specific and area-specific solicitations, KFF reported. Seven addenda focus squarely on nations that have signed bilateral memoranda of understanding over the past year: Cameroon, Côte d’Ivoire, Malawi, Mozambique, Nigeria, the Philippines, and Uganda.
Country-specific awards account for $730 million, representing roughly 10% of the $7.3 billion expected under those bilateral compacts. Nigeria leads the count with up to 20 potential awards, while the Philippines and Nigeria each command up to $200 million in potential funding. Meanwhile, five area-specific addenda capture $700 million, focusing on neglected tropical diseases, nutrition, child protection, population surveys, and rapid outbreak responses.
| Funding Window | Addenda Focus | Potential Awards | Total Funding (Up To) |
|---|---|---|---|
| Window 1 (Mar–May 2026) | Child Protection, Outbreak, Philippines | 21 | $542,650,000 |
| Window 2A (Jun–Jul 2026) | Nigeria, Uganda, Malawi MOUs | 39 | $295,000,000 |
| Window 2B (Jul–Sep 2026) | Cameroon, Côte d’Ivoire, Mozambique, Surveillance | 25 | $315,400,000 |
| Window 3 (Aug–Oct 2026) | Neglected Tropical Diseases, Nutrition | 37 | $277,000,000 |
The remaining fourth funding window is expected to run from November 2026 through January 2027. State Department documentation details these opportunities through the Advancing Global Health APS portal, while the broader architecture is outlined in the America First Global Health Strategy report.
The operational scope varies widely across the country addenda. Cameroon utilizes a One Health approach for public health security and emergency response, while Côte d’Ivoire targets cross-border disease surveillance and localized health delivery. Malawi concentrates on supply chain strengthening and data interoperability.
Despite the release of 12 addenda across three rounds, the competitive process continues. No individual awards have been publicly announced by authorities, leaving investigators to monitor how government-to-government agreements and competitive grants will ultimately align with the broader bilateral framework.
- U.S. Department of State. America First Global Health Strategy Report. Published September 2025.
- KFF. Analysis of the State Department’s Bureau of Global Health Security and Diplomacy AGH/APS Funding Opportunities. Published October 2026.
- Grants.gov. Advancing Global Health Annual Program Statement Opportunity Posting.
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