Presented by World Health Summit
The United States has unveiled its new “America First Global Health Strategy,” framing the country’s global health assistance around a refrain that by now we’ve all grown intimately familiar with: making America safer, stronger, and more prosperous.
The document — which was released by the U.S. State Department yesterday — provides the clearest picture yet for how the country wants to reshape its global health assistance, a portfolio that makes up nearly two-thirds of the programming that survived the government’s USAID cull.
Also in this edition: An “America First” push at the World Bank and IMF, and Guterres’ vision for a merging, changing United Nations.
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So, what’s in? Protecting Americans from disease, prioritizing frontline health support, and promoting American health products. The administration will also be increasing its health investment in the Western Hemisphere and Asia-Pacific, and using global health leadership to counter Chinese influence — especially in Africa.
What’s out? Family planning, technical assistance, and other hallmarks of the Biden era — an approach that for Secretary of State Marco Rubio, means keeping what’s “good” while “rapidly fixing what is broken.”
“We lay out a vision to end the inefficiencies, waste, and dependency of our current system,” Rubio wrote in the strategy’s foreword. “In its place, we cast a positive vision for a future where we stop outbreaks before they reach our shores, enter strong bilateral agreements that promote our national interests while saving millions of lives, and help promote and export American health innovation around the world.”
The strategy signals a shift away from NGO-led delivery toward more bilateral deals, country coinvestments, and partnerships with private sector and faith-based organizations, Senior Reporter Sara Jerving writes.
It’s also meant to end spending that the administration called “inefficient and wasteful,” pointing to technical assistance, program management, and “other forms of overhead.” The strategy also displays the salaries handed out to the CEOs of eight U.S.-funded health partners, two of whom had compensation surpassing $1 million a year.
“There is substantial opportunity to materially reduce these technical assistance, program management, and overhead costs without materially impacting outcomes and, in fact, reducing these costs is critical if the programs are ever to move to local country ownership,” the strategy states.
Read: Trump administration releases long-awaited global health strategy
It’s not just global health that’s getting an America First reboot.
In a report to the U.S. Congress, the country’s Treasury Department outlined how it wanted to influence international financial institutions — and specifically, how it felt organizations such as the International Monetary Fund and World Bank should be moving away from climate work, ending financial support for China, and returning to what the U.S. views as their core missions.
For the IMF, that’s global monetary policy and fiscal stability; for multilateral development banks, that’s poverty alleviation and private-sector-led economic development. It’s not a new message, Senior Reporter Adva Saldinger writes — and in fact, some of what the report states echoes what we’ve heard from U.S. Treasury Secretary Scott Bessent in the past.
“The Bretton Woods institutions must step back from their sprawling and unfocused agendas which have stifled their ability to deliver on their core mandates,” Bessent told those gathered at the World Bank-IMF Spring Meetings in April.
But even so, the report — which was obtained by Adva this week — provides more detail on how the U.S. is thinking about international financial institutions, and what role the country wants them to play. And as with so much in the development world, what the U.S. wants matters: America is the largest shareholder in the IMF and every multilateral development bank it is a part of, aside from the African Development Bank, where it places second.
Read: How the US is pushing its ‘America First’ vision at World Bank, IMF
ICYMI: US Treasury secretary — US will stay engaged with World Bank, IMF
The same day that the U.S. unveiled its global health plan, United Nations Secretary-General António Guterres rolled out his own reform blueprint — which my colleague Colum Lynch describes as a sweeping proposal to merge agencies, cut senior posts, and consolidate functions across the U.N. system in the name of efficiency.
The proposal — which will still require approval by U.N. member states — calls for merging UNOPS into the U.N. Development Programme, combining the U.N. Population Fund and UN Women, and shuttering or sunsetting UNAIDS by the end of 2026. It also calls for rationalizing the U.N. economic analysis divisions spread across several agencies, including the Department of Economic and Social Affairs, the U.N. Trade and Development agency, and the U.N. regional economic commissions. And, it calls for consolidating and streamlining many other functions across the U.N., merging various U.N. envoys and offices from Cyprus to Central Africa and Yemen.
There are also proposals of a New Humanitarian Compact, which would encourage the U.N.’s semiautonomous agencies to share premises, fleets of vehicles, security, and IT; and a Human Rights Group that would coordinate human rights activities across the U.N. system. On top of that, Guterres is pushing to integrate the U.N. Interregional Crime and Justice Research Institute and the U.N. Office on Drugs and Crime, and have the Office for Disarmament Affairs swallow up the U.N. Institute for Disarmament Research.
Guterres also called for the elimination of posts at every level across most departments in the U.N. Secretariat, including five senior posts. Many of those posts, however, are already vacant — or their inhabitants have recently been transferred to other posts.
Devex has previously reported on other aspects of Guterres’ reform push, including a call for eliminating 55 out of 291 posts in the U.N. Department of Political and Peacebuilding Affairs, and 68 posts out of 487 in the Department of Peace Operations.
The reform package will have to go before the U.N. member states’ budget committee for a final decision. There is no guarantee that the members will embrace the reforms.
ICYMI: UN80 and the incredible shrinking United Nations
+ Listen: For the latest episode of our weekly podcast series, Colum joins Devex’s David Ainsworth and Allison Lombardo, former deputy assistant secretary for international organization affairs at the U.S. State Department, for a look ahead to next week’s high-level meetings at UNGA80.
For months, aid organizations have been scrambling to keep their once-USAID-funded projects alive — and for Mercy Corps, that meant halting two water and sanitation projects just as they were set to deliver.
But instead of breaking apart, Mercy Corps was able to pivot its approach — securing money from new, private donors to bring the programs back online. In Nigeria, that was thanks to Project Resource Optimization, an initiative formed by former USAID staffers to help philanthropists identify and support programs closed by the Trump administration, writes my colleague Raquel Alcega.
Mercy Corps continued to piece together new funding, securing grants from private donors to get critical infrastructure back online. The stopgap funds restored clean water for nearly 26,000 people. But the fixes, however, only go so far: Large pieces of Mercy Corps’ portfolios in Nigeria and Afghanistan remain unfunded, and future projects in Sudan, Somalia, and Ethiopia hang in the balance.
Read: Lessons from Mercy Corps’ fundraising playbook (Pro)
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Ahead of the U.N. General Assembly, EU member states have failed to agree on a binding climate plan to reach net-zero emissions by 2050, while Australia has unveiled its new target of cutting greenhouse gases by at least 62% from 2005 levels by 2035. [Financial Times and BBC]
Geir Pedersen, who has served as the U.N. special envoy for Syria for over six years, announced he will be stepping down, but no exact date of departure yet. [Xinhua]
A new World Meteorological Organization report finds that in 2024, only a third of the world’s river basins had normal water conditions, as climate-driven extremes of flood and drought bring about food insecurity, displacement, and conflict in affected regions. [The Guardian]
Colum Lynch contributed to this edition of Devex Newswire.
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