A significant shift in U.S. foreign aid was marked by the launch of the new America First Global Health Strategy on October 1, aiming to reshape global health initiatives. Despite the ambitious plans, concerns linger regarding the implementation status of bilateral health deals with 35 countries, which are reportedly not ready despite approaching deadlines. The recent healthcare memorandums have raised questions about their effectiveness and the U.S. commitment to global health funding. As the global health overhaul enters a critical phase, key issues remain unaddressed, prompting calls for external funding and tighter collaboration. The State Department is expected to clarify its implementation plans and address uncertainties about the agreements in the weeks to come.