The Foundation for AIDS Research (amfAR) has released a critical report analyzing the first set of seven publicly available Memoranda of Understanding (MOUs) signed under the United States' America First Global Health Strategy. The agreements cover Ethiopia, Kenya, Liberia, Mozambique, Nigeria, Rwanda, and Uganda — countries that together represent a significant share of the global HIV burden.
According to amfAR, the MOUs fall short of what is needed to sustain effective HIV prevention and treatment programs. The report raises concerns that the agreements lack binding financial commitments and do not guarantee continuity of care for millions of people currently relying on U.S.-funded HIV services, particularly those supported through the President's Emergency Plan for AIDS Relief (PEPFAR).
amfAR's analysis highlights that the MOUs place an increased burden on recipient countries to finance and manage programs that have historically depended on U.S. funding, without providing adequate transition timelines or resources. Critics warn this approach could reverse decades of progress in reducing HIV transmission and AIDS-related deaths across sub-Saharan Africa.
The report calls on the U.S. government to strengthen the agreements by including enforceable funding guarantees, clear transition plans, and measurable health outcome targets. Global health advocates have echoed these concerns, warning that abrupt or underfunded transitions risk disrupting antiretroviral therapy for vulnerable populations and could lead to preventable deaths.
