After shuttering USAID, Trump launches new foreign aid strategy

A foreign makeover

Indeed, one aspect of the America First Global Health Strategy aims to address a common complaint that USAID’s alleged inefficiency and dependence on NGOs perpetuated the issues affecting developing countries.

Rather than working with NGOs to administer aid, the new program will send funding directly to governments, health care organizations and drug manufacturers. This transition, experts say, offers both benefits and drawbacks.

This structure is designed to encourage foreign governments to take steps to eventually be in a place where they require no foreign aid and can operate self-sufficiently, said Max Primorac, a senior researcher at the Heritage Foundation and author of the section on foreign aid in its Project 2025 report.

“It's cheaper, and it also is going to promote the kind of self-reliance that we were trying to do during [Trump’s first term],” Primorac told Responsible Statecraft. “The benefits are just amazing by cutting out these international NGOs.”

However, many of these governments lack the resources to accommodate the fast-tracked pace of the health agreements made under this new strategy, according to George Ingram, a Senior Fellow Emeritus at the Brookings Institution.

“Transitioning private-sector engagement takes time,” Ingram told RS. “You don’t do that overnight.”

Furthermore, many of the NGOs that USAID collaborated with had decades of experience in distributing aid and could often “accomplish things that governments struggled to do,” Matthew Kavanagh, Director of the Center for Global Health Policy & Politics at Georgetown University, told RS.

“NGOs and nonprofit organizations often can serve the most vulnerable and the most marginalized in ways that major formal public institutions struggle to do,” Kavanagh said.

Investing in the future

The new strategy will also differ from the agency it replaces in terms of funding model. The “global health investments” will be structured around two- to five-year Memorandums of Understanding (MOUs), which place an emphasis on performance benchmarks and commitments from partner governments to provide co-financing that will increase over time, with an end goal of transitioning from U.S. assistance to self-reliance.

Each partner country will pledge to increase their domestic health spending as the U.S. decreases its assistance. The U.S. will focus on providing funding for commodities and front-line health workers, while reducing “nonfrontline” costs.

“That is a strength that was not always apparent in USAID,” Gyude Moore, a Non-Resident Fellow at the Center for Global Development and former Minister of Public Works for Liberia, told Responsible Statecraft. “USAID sometimes created the impression that it would be there forever. Encouraging countries to plan for self-financing is a good thing.”

Primorac concurred, saying that encouraging developing nations to spend alongside U.S. aid will encourage them to work toward self-sufficiency.

“If they're not spending money, they don't have skin in the game,” Primorac said. “If you get something for free, you're not really going to appreciate it. You're going to take it for granted. But if you have to pay for it, you're going to be much more attentive and much more willing to make sure you're not wasting your own money.

But the issue with solely transferring commodities without offering wraparound support arises when developing countries lack the necessary capabilities to apply the resources they receive. Former Chief Economist of USAID and Northwestern professor Dean Karlan compares it to trying to bake chocolate chip cookies with only chocolate chips.

The strategy is contradictory, according to Karlan. “It’s internally inconsistent to say, ‘We want you to be sustainable,’ while taking away the very parts of the aid program designed to help build sustainability,” Karlan told RS.

'Nakedly transactional'

Another key way that the America First Global Health Strategy differs from USAID lies in its apt name — the strategy seeks to put America first in a way that USAID purportedly did not.

For example, in Zambia, the health agreement was linked to U.S. access to mining opportunities. The conversation over Rwanda’s health agreement took place concurrently with discussions about American access to the nation’s critical minerals.

These “commercially based” agreements “are good, obviously, for our businesses, but they're good for the recipient company or recipient country,” according to Primorac.

“It forms a really nice relationship between us and those countries,” Primorac said. “It's commercially based. It's recognizing that it's the private sector that creates wealth, not government spending.”

This shift is striking, Kavanagh said, and is “nakedly extractive in a way that the previous approach was not.”

“Now it’s a much narrower interest about a very narrow understanding of pandemic preparedness, a very narrow set of activities that they’re willing to fund,” Kavanagh told Responsible Statecraft. “Most importantly, rather than a big approach to global health, it’s a set of bilateral deals that have come with really big political strings.”

Global implications

Foreign aid programs have long been one of the most predominant and effective soft power tools and this new strategy will undoubtedly have implications for American soft power and foreign influence.

Primorac believes the new strategy will “tremendously increase” American influence abroad, especially because the program prioritizes transparency.

“It's good for us in terms of creating more stable and healthy environments to sell things, creating more wealth,” Primorac said. “And it's good for these countries because they're able to strengthen their own government capacity to care for their own people.”

But with a relatively abrupt shuttering of USAID and the transactional undertones of the America First Global Health Strategy, other experts are unsure of whether the new U.S. foreign aid efforts will be received with the same open arms.

In fact, some say America’s approach could run the risk of eroding its soft power abroad, especially if the MOUs developing nations are agreeing to prove fatal for their relatively fragile states, according to Conor Savoy, a Visiting Fellow at the Center for Global Development who has served in two different capacities at USAID.

“My fear is that we are setting countries up for failure, which will damage perceptions of the United States as a constructive partner,” Savoy told RS. “Global health is an area where the U.S. has carried real moral weight and earned significant goodwill, and this strategy risks undermining that.”

On the other hand, it is possible that the Trump administration is looking to achieve a different kind of influence abroad, Kavanagh said.

“I think it is interested in a major disruption to the geopolitical order and supporting a set of governments that are aligned with its worldview,” Kavanagh said. “If we see this as an effort to build a coalition of more conservative governments around the world and have the ability to reward certain governments and extract certain concessions, then it makes a lot more sense.”

So far, Rubio has signed 15 agreements with African countries, with an emphasis on HIV/AIDS, malaria, tuberculosis and maternal health, committing $11.1 billion over five years to the developing nations. In turn, the countries have pledged $12.2 billion in matching funds and agreed to achieve specified performance goals. The State Department has stated that it hopes to have agreements with 50 countries within the next couple of months.

However, the new strategy is not grounded in legislation, so just as easily as the America First Global Health Strategy was created, it could be dismantled by future executive actions.

But in the meantime, the impacts of this strategy will be felt across the world and domestically. As Moore points out, “we live in a global society where we are only as strong as our weakest links.”