The U.S. State Department has prepared a new template for bilateral health agreements, requiring signatory countries to notify the United States within one day of discovering an infectious disease outbreak.
The new health agreement is seen as replacing the Pandemic Accord passed by the World Health Organization (WHO) in May this year, after President Trump announced the U.S.’s withdrawal from the WHO on his first day in office.
According to a 21-page memorandum template and a 13-page technical guide, as reported by Bloomberg on Friday (November 7th), the U.S. is requesting that each signatory country notify the United States within 24 hours of discovering an infectious disease outbreak, share pathogen samples within five days, and comply with decisions regarding emergency drug use made by the FDA.
The U.S. government is currently negotiating health agreements with approximately 60 countries, with the goal of completion by mid-December, led by the State Department.
Secretary of State Marco Rubio released a “U.S. First” global health strategy in September, emphasizing the establishment of a new global health cooperation framework.
The new agreement will grant the United States greater oversight over partner countries’ disease monitoring, outbreak reporting, and data sharing.
State Department officials stated that the agreement’s timelines and objectives will vary by country, with the U.S. providing support to nations temporarily unable to meet disease monitoring and early warning system standards.
A State Department official revealed that officials from the State Department and the U.S. Department of Health and Human Services (HHS) will travel to Africa this week to begin the first round of bilateral negotiations with countries including Uganda, Zambia, Ethiopia, Mozambique, Kenya, Rwanda, and the Democratic Republic of the Congo.
Jeremy Lewin, a Global Health Security official at the State Department, stated that the new framework “will enhance partner governments’ capabilities, improve public health, enhance the sustainability and self-sufficiency of local health systems, promote collaboration with U.S. health authorities, and prudently reduce U.S. spending on global health.”
The new health agreement framework draws on former President George W. Bush’s Emergency Plan for AIDS Relief (PEPFAR), giving the State Department greater control over U.S. global health funds. It also establishes shared funding and performance goals, allowing for aid reduction if goals are not met. Partner countries will gradually integrate U.S.-funded health workers into their national salary systems over five years, while increasing spending on pharmaceuticals and diagnostic supplies.
The memorandum also calls for joint audits and performance evaluations between countries and the U.S. State Department, along with the establishment of a 25-year long-term data and sample sharing mechanism. A new Joint Health Cooperation Steering Committee composed of senior representatives from both countries will hold quarterly meetings to track progress and make adjustments. The proposed plan is set to launch in April 2026.
The memorandum states that the U.S. prioritizes health strategy views bilateral health agreements as a geopolitical competition tool, leveraging America’s leadership in global health against Beijing, while promoting American-made drugs, diagnostic products, and logistical services.
The strategy indicates that the U.S. will continue comprehensive funding for essential health supplies in 2026, gradually transitioning costs to partner government.