Presented by Partners In Health, Pfizer, and BD
The United States is pushing a market-driven health model in Africa. Backers see innovation; critics warn of risky disruption.
Also in today’s edition: We talk to Christine Schraner Burgener, candidate for UNHCR chief, and deliver a dispatch from the G20 Social Summit.
+ Happening today at 12 p.m. ET (6 p.m. CET): Devex Editor-in-Chief Raj Kumar sits down with World Resources Institute CEO Ani Dasgupta to look at what strategies work in the field of climate funding. There’s still time to save your spot.
The U.S. is moving forward with its new ‘America First’ global health strategy in Africa — one that will work to position American companies to lead in African markets and position African governments as paying customers. Jeff Graham, senior official for the State Department’s Bureau of Global Health Security and Diplomacy, said at a conference in Kigali that the problem is clear: “American companies are largely absent from the world’s fastest growing consumer market.”
His team is now negotiating bilateral deals across the continent, moving away from NGO-led programs toward government, private-sector, and faith-based partnerships. “We’re not abandoning global health leadership — we’re transforming it,” he said. “The strategy isn’t about withdrawal, it’s about smarter partnerships … while opening markets for innovation.”
Graham highlighted two early examples, including a $150 million investment in Zipline announced this week at the conference, calling it a “down payment” on the vision: “You’ll watch American technology deliver lifesaving medicines to 130 million people. … You’ll see African governments paying for that service.”
He also pointed to a new agreement with Gilead and The Global Fund to Fight AIDS, Tuberculosis and Malaria to roll out the HIV prevention drug lenacapavir. The first doses are being delivered this week in Eswatini and Zambia.
Graham argued that previous U.S. aid “created dependency, not capacity,” leaving chronic stock shortages and fragmented supply chains, Devex Senior Reporter Sara Jerving writes. The new plan backs more pharmaceutical manufacturing in Africa, private-sector distribution, and regional regulatory harmonization. “We want to leverage America’s unmatched technological advantages,” he said, urging supply-chain leaders to help make “trade, not aid” real.
Reactions are mixed about the Trump administration’s new strategy, but Graham is confident: “The next several years of U.S.-Africa health partnerships will look fundamentally different … and we feel very confident it’s going to work.”
Read: US health strategy aims to position African governments as customers
ICYMI: US has begun bilateral health negotiations with 16 African nations
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Devex has learned that the Center for Global Development was already planning to replace former Harvard President Larry Summers as its board chair prior to this week’s revelations about his relationship with child sex offender Jeffrey Epstein. Summers, who carried on correspondence with Epstein for years after the disgraced financier pleaded guilty to charges related to soliciting a minor for prostitution, announced Monday that he was stepping back from a range of “public commitments.”
News reports confirmed that his role at CGD was among those being vacated. Summers was elected chair of the CGD board in March 2014. The current vice chair, Debra Fine, will be assuming the chair’s responsibilities. CGD is led by Rachel Glennerster, who was appointed president of the Washington, D.C.-based think tank in September 2024.
Devex Global Development Reporter Elissa Miolene is currently in South Africa, reporting on this week’s G20 Leaders Summit. But before that, she stopped into the Social Summit, a linked civil society-focused gathering launched last year at Brazil’s G20 summit.
She spoke to Jayati Ghosh, a member of the G20 Extraordinary Committee of Independent Experts on Global Inequality, about how to handle taxation of the superrich — and the U.S. intransigence about participating in international tax conventions. For Ghosh, the former is all about coalitions. And as for the U.S., it’s about other countries “learning how to swim around the big fish.”
You can follow all of Elissa’s coverage in her reporter’s notebook series or email her tips at elissa.miolene@devex.com.
Read: G20 reporter’s notebook — the Social Summit Day 1
ICYMI: What are the key issues at stake at the G20 summit in South Africa?
Digital public infrastructure — or DPI — now powers everything from digital payments to online IDs. It could accelerate progress on the Sustainable Development Goals, but understanding is uneven, a new Devex survey shows.
DPI is essentially a country’s digital plumbing: ID systems, payments, and data-exchange platforms that make services cheaper, faster, and more inclusive. Eight in 10 survey respondents say they know DPI, but 39% have barely used it.
As Antonio García Zaballos, director of the digital sector office at the Asian Development Bank, puts it: “The awareness gap exists because DPI is often seen as a technical niche, not as what it really is: the invisible backbone of modern development.” He adds: “Digital ID is the meter, payments are the current, data exchange is the substation, and cybersecurity is the circuit breaker that keeps the lights on.”
Once people understand that, support skyrockets — 95% say DPI is key to achieving the SDGs. Seventy-nine percent want local leadership and strong partnerships too, with 97% valuing collaboration with development organizations and 96% with global tech companies.
The survey also highlights how DPI and artificial intelligence strengthen each other, Devex Managing Editor Anna Gawel writes. Respondents flagged risks such as privacy, cybersecurity, and algorithmic bias, but also major potential for health systems, disaster response, and education. As Chrissy Martin Meier, director of policy at the Digital Impact Alliance, tells Devex: “AI is what will make DPI accessible, customizable, and engaging. … By connecting it to AI, we can turn secure IDs and other systems into tools that learn, adapt, and actually improve people’s experiences.”
Read: The critical but not well-understood technology underpinning daily life
Related: How digital public infrastructure has become a vital tool for development (Pro)
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Christine Schraner Burgener, Switzerland’s state minister for migration and a candidate for the U.N. high commissioner for refugees post, has a blunt message after touring camps worldwide: Many are unsafe and effectively permanent slums. “I know camps are really not ideal,” she tells Devex Senior Global Reporter Colum Lynch. “And honestly, if I get the position, my vision would be to close the camps.”
Backed by Switzerland, she’s one of 13 contenders to succeed Filippo Grandi — and if selected, would be only the second woman ever to run UNHCR. “The last and only woman who was a high commissioner was from Japan … and this is already 25 years ago,” she says.
She’s pitching a mix of principle and pragmatism: a “rights-based approach” for 40 million refugees, but also a “good sense of realpolitik.” She argues Switzerland’s neutrality, donor clout, and her long career — from U.N. special envoy to Myanmar to managing migration policy in Bern — position her well as UNHCR faces a financial crisis and rising anti-refugee politics. She had promised to work with Washington, too — up to a point.
“I will continue the dialogue … but when something happens, very totally against international law, then you have to be loud.”
Watch the interview with Schraner Burgener: Refugee camps unfit for refugees
Check out Colum’s interviews with the other candidates:
• Matthew Crentsil: A lone African seeks top UN refugee job
• IKEA chief Jesper Brodin: ‘I am the peacock in the land of penguins’
Open Philanthropy is rebranding and will now be known as Coefficient Giving. The philanthropic funder and adviser says the new identity better reflects its shift from serving one major partner to guiding a whole roster of big-ticket donors toward “cost-effective, high-impact giving.”
CEO Alexander Berger explains, “We’ve spent the last decade building a model for giving effectively at scale. … Our goal is simple: move more money to the world’s highest-impact opportunities, and make it easier for others to do the same.”
The rebrand comes with a next chapter — turning its signature programs into multidonor funds across areas such as science and global Health R&D, global aid policy, and abundance and growth. And heavyweight partners are enthusiastic. “Open Philanthropy has been a fantastic partner on high-impact giving,” said Bill Gates in the company’s press release. “This evolution of their work has great potential to bring other givers into neglected areas where they can make a huge difference in the lives of people around the world.”
Sentinel, an African-led project dedicated to strengthening infectious disease surveillance and response across the continent, has been awarded a $100 million, five-year grant by the MacArthur Foundation’s 100 & Change competition. [AP]
The World Health Organization is set to cut over 2,000 jobs by mid-2026 as part of a major reorganization and cost-cutting effort following the U.S. decision to withdraw its funding. [Reuters]
More than 300 lobbyists from the industrial agriculture sector, the leading driver of deforestation and among the top polluters, are participating in COP30 in Belém, Brazil. [The Guardian]
Update, Nov. 19, 2025: This article has been updated to correct the spelling of Debra Fine’s name.
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