Uganda has signed a new five-year health cooperation agreement with the United States worth Ksh297 billion, becoming the latest East African country to align with Washington’s “America First Global Health Strategy”.

The deal comes just days after Kenya entered a similar framework, although Kenya’s version has already run into legal challenges.

The agreement, signed in Kampala on December 10, 2025, sets out a plan to strengthen Uganda’s health system while gradually shifting financial responsibility from the U.S. government to Uganda. Under the Memorandum of Understanding, the U.S. plans to provide up to Ksh228 billion between 2026 and 2030. Uganda will raise its own domestic health spending by over 65 billion during the same period.

The funds will support a wide range of programmes, including HIV/AIDS, tuberculosis, malaria, maternal and child health, polio, disease surveillance and emergency preparedness. The United States remains Uganda’s largest health partner and has worked with the country for more than six decades.

U.S. Ambassador William W. Popp, who witnessed the signing with Finance Minister Matia Kasaija, said the agreement marks a shift toward self-reliance. He said both governments will invest in stronger community health systems, improved performance tracking and better disease surveillance tools. He added that the deal aims to prevent outbreaks in Uganda and reduce health threats that could reach the United States.

The agreement includes several long-term reforms. Uganda will gradually take over the procurement of medical commodities that Washington currently buys. Frontline health workers funded by the U.S. will be mapped to government-approved roles and placed on the Ugandan payroll.

The U.S. will also invest heavily in Uganda’s data ecosystem, including electronic medical records, improved data capture and integration with national information systems.

Faith-based health facilities, which serve a significant share of Uganda’s population, will receive support through performance-based agreements, increased primary healthcare grants and digital upgrades.

Finance Minister Matia Kasaija said the partnership will strengthen national systems and build a more capable workforce. He said Uganda recognises the importance of preventing both existing and emerging disease threats and appreciates the scale of US support.

Uganda moves past Kenya

Uganda’s agreement mirrors recent deals signed by Kenya and Rwanda under the same U.S. strategy. Kenya signed its Ksh206 billion pact on December 4, 2025. However, Kenya’s version has attracted controversy.

A petition filed by the Consumers Federation of Kenya (Cofek) raised concerns about data sharing, prompting the High Court to suspend implementation until the case is heard. U.S. officials in Nairobi have since said only aggregated statistical data, not personal medical information, will be shared.

Despite the debates in Nairobi, Uganda has welcomed its agreement without notable opposition. The deal is expected to shape the country’s health investments for the next five years. It also forms part of Washington’s broader approach to reduce reliance on U.S. aid by pushing partner countries to take on more financial responsibility.

US Secretary of State Marco Rubio has said the bilateral health agreements in East Africa are central to the America First Global Health Strategy, which seeks to ensure accountability, improve efficiency and shift countries toward self-funded health systems.