After months of uncertainty over the future of U.S. support to Uganda’s health sector, Washington has restored major funding under a new five-year cooperation framework worth more than $2.3 billion. The deal effectively ends the lull caused by President Donald Trump’s January directive halting parts of U.S. global health assistance — a move that rattled programmes across Uganda earlier this year.
The memorandum of understanding, signed Dec. 10 between the U.S. Embassy and Uganda’s Ministry of Finance, lays out a redesigned model for how the two countries will work together on public health. Ugandan officials had long argued that earlier funding arrangements created parallel systems and left core national institutions underdeveloped. The new approach, they say, centres Uganda’s own priorities and legal frameworks, including the country’s data-protection laws and the Public Health Act.
Health Minister Ruth Aceng, who has been one of the most vocal critics of the old setup, said the new agreement puts sovereignty at the centre of health cooperation.
“Uganda’s sovereignty over its biological resources and health data is invaluable and non-negotiable,” she said. She added that the government is “leaving behind outdated, extractive models,” stressing that any exchange of information must respect “mutual benefit, prior sovereign consent, and full transparency in compliance with Ugandan law.”
For Aceng, the shift is not cosmetic. She said the model moves the country from aid dependence to “a strategic, sovereign-driven collaboration that accelerates Uganda’s Health Sector Development Plan and builds a resilient system led by Uganda.”
Under the deal, the United States will provide $1.7 billion over the next five years. Uganda will contribute an additional $500 million — one of the largest joint health-sector commitments Uganda has seen in decades.
U.S. Ambassador William W. Popp described the agreement as part of a broader foreign assistance doctrine championed by Secretary of State Marco Rubio, who has pushed for American funding overseas to be tightly linked to shared strategic interests.
“This agreement represents a significant commitment by the United States and Uganda to co-invest in our shared global health priorities,” Popp said. He said the countries are “building on prior successes” but also shifting toward stronger national leadership, community-level health systems and clear performance benchmarks.
Popp, who has served in Uganda during an era of intense debate over foreign assistance, said the partnership is designed to correct long-standing inefficiencies.
“The previous model created parallel systems, inefficiencies, and a culture of dependence, and that model is changing,” he said. The framework, he added, aims to strengthen Uganda’s capacity to prevent and respond to HIV, tuberculosis, malaria and new infectious threats “through integrated systems rather than disease-by-disease interventions.”
He also noted that the United States has been Uganda’s largest health partner for more than six decades. The focus now, he said, will be on systems that outlive donor cycles — procurement, diagnostics, surveillance, supply chains and the training of 14,000 community health workers. “These provisions strengthen a health system that protects both Ugandans and Americans. This is exactly what the America First Global Health Strategy calls for,” Popp said.
Uganda’s finance minister, Matia Kasaija, welcomed the renewed partnership but pressed the point that Uganda must increase its own investment over time.
He noted that Uganda “acknowledges the critical importance of preventing the spread of emerging and existing infectious disease threats globally,” and recognised the U.S. commitment of $1.7 billion through 2030. Kasaija said Uganda would gradually raise its own share to more than $500 million over the same period as U.S. funding tapers.
“This collaboration will yield not only disease-specific outcomes but also significant improvements in national systems, institutions, and workforce capacity. This is highly commendable,” he said.
Later, he added that “Uganda commits to increasing its health sector budget by US$1.5 billion over the five-year period as the US gradually reduces its financial share.” He said the partnership must translate into stronger institutions, improved health outcomes and “accountable use of public resources.” He also pointed to Parliament’s oversight role under the Constitution and the Public Finance Management Act, saying transparency will be built into implementation.
The memorandum aligns with the America First Global Health Strategy that Secretary Rubio unveiled on Dec. 4, which seeks to consolidate U.S. health aid into long-term, government-to-government agreements. The strategy’s emphasis on national resilience and outbreak prevention loomed over the ceremony.
Brad Smith, a senior adviser on global health security, called Uganda one of Washington’s “most critical partners in Africa.” The new deal, he said, ends the system of parallel programmes and replaces it with “a unified, country-led plan.”
“The real work starts now,” he added.
The agreement lands at a sensitive moment for Uganda’s health system. Just last week, Parliament approved 503.26 billion Ugandan shillings (about $132 million) in emergency funding to fill gaps created when USAID froze programmes earlier this year. Those freezes had threatened HIV treatment, tuberculosis services and maternal health programmes, prompting warnings from hospital administrators and civil society groups.
Analysts say the renewed partnership is likely to stabilise Uganda’s health sector, which relies on external financing for more than 40 percent of its budget, according to the Ministry of Health. Whether the new framework delivers on its promise of stronger national systems will become clear only as the money begins to flow — and as both governments navigate the political and logistical tests ahead.
