The United States is making significant strides in its America First Global Health Strategy, recently entering into bilateral health agreements with various African nations, including Malawi and Côte d’Ivoire. This initiative, which aims to replace traditional aid frameworks like USAID, is backed by an ambitious $11 billion plan that seeks to enhance self-reliance in healthcare across the continent. While some view this strategy as a shift towards national ownership of health initiatives, it has attracted criticism for stripping moral framing from foreign aid and is perceived as a departure from established humanitarian approaches. Additional investments are also being made in countries like Kenya and Nigeria, with a focus on faith-based healthcare and pooled procurement of medicines. However, some key exceptions exist as the U.S. moves forward with these agreements, raising questions about the inclusivity and sustainability of the new aid model.