AVAC: The new model for US global health partnerships

AVAC analysis

PEPFAR and US bilateral health agreements continue to evolve. This week, Think Global Health expanded its tracker of the US Administration’s bilateral health agreements, showing that 31 countries have now signed five-year agreements that increasingly shift financing and implementation responsibilities to national governments through co-investment and country ownership models. Andrew Green focuses on one country, South Sudan, in a Devex piece that looks at the country’s new three-year, $166 million MoU with the US, noting that while it preserves support for HIV and disease surveillance, funding may be insufficient to offset recent aid reductions and the country may struggle to meet its own financial commitments.

In a separate analysis, Jirair Ratevosian broke down what five reports from the US Department of State to Congress reveal about the Administration’s vision for global health. He writes, “Read together, these excerpts are overwhelmingly about the mechanics of transition: MOUs, implementation plans, co-investment, funding adjustments, corrective actions, benchmarks, workforce transfer, and reductions in US assistance. There is much less discussion of incidence, viral suppression, advanced disease management, prevention gaps, community systems, or epidemic control… It suggests they are no longer the organizing principle.”

IMPLICATIONS: These pieces reflect a move toward implementation of the new global health agreements. As implementation continues, we’ll be watching whether the financing assumptions, implementation systems and country commitments that are the foundation of these agreements are sufficient enough to sustain HIV and broader health gains. As Ratevosian notes, “Every Administration has its own priorities. But organizing principles matter because they determine what leaders measure, what they reward, and ultimately what they protect. When transition becomes the primary frame, there is a risk that epidemic control becomes something assumed rather than something actively managed.”

AVAC publishes a weekly Global Health Watch, a curated digest of key developments in global health. Access this week’s issue (10 July) here.

SEE ALSO:

• The Independent: I fear a new HIV and AIDS epidemic is coming – and the world won’t care, UN official warns
• Devex: The HIV prevention approach needs reprioritization, not acceleration /free registration is required/
• The Lancet editorial: Ending HIV: a reality check