Operational Updates

Advancing the America First Global Health Strategy Through Landmark Bilateral Global Health MOUs

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Key takeaways

  • The State.gov page for the referenced press release could not be loaded due to a site error.
  • The site displays: "We’re sorry, this site is currently experiencing technical difficulties."
  • The error includes the note: "Exception: forbidden," indicating access was blocked or restricted.
  • Because of the error, the text of the press release describing the bilateral global health MOUs is not available from this page.

Follow Up Questions

What specific bilateral global health MOUs were described in the original press release?Expand

The original State Department press release described four new bilateral "Global Health Cooperation" Memorandums of Understanding (MOUs) signed on December 22–23, 2025 between the United States and: (1) Ethiopia – a global health cooperation MOU totaling about $1.466 billion; (2) Botswana – a bilateral arrangement on HIV and health systems totaling about $487 million; (3) Sierra Leone – a health MOU of about $173 million focused on malaria, HIV, surveillance and workforce; and (4) Madagascar – a health MOU of about $175 million centered on malaria, maternal and child health, and health security. Together they total nearly $2.3 billion, with roughly $1.4 billion from the U.S. and over $900 million in partner-country co-investment, and include benchmarks, timelines, and consequences for non‑performance.

Which countries or partners are parties to those MOUs?Expand

Parties to the MOUs are the United States and four African partner governments: Ethiopia, Botswana, Sierra Leone, and Madagascar. Each MOU is a bilateral agreement between the U.S. government and the respective national government on global health cooperation and financing.

What are the main goals or provisions of the "America First Global Health Strategy" referenced in the title?Expand

The "America First Global Health Strategy" is a State Department framework that: (1) prioritizes making the U.S. "safer" by detecting and containing infectious disease outbreaks abroad before they reach American shores; (2) makes the U.S. "stronger" by using multi‑year bilateral health agreements with clear goals, data systems, performance benchmarks, and mandatory partner co‑investment to reduce inefficiency and dependency while maintaining funding for frontline commodities and health workers; and (3) makes the U.S. "more prosperous" by promoting American health innovation and products through aid procurement and by protecting the U.S. economy from disease‑driven disruptions. The new MOUs are presented as concrete tools to implement this strategy by tying U.S. health funding to measurable results and increasing partner governments’ financial responsibility.

Why is the State.gov page returning an "Exception: forbidden" error?Expand

The "Exception: forbidden" message indicates that the State.gov server is returning an HTTP 403 "Forbidden" error, meaning the server is currently refusing to fulfill the request—often because of access-control rules, security filtering, or other technical restrictions rather than because the page does not exist. The precise internal reason for this error on this specific press-release URL has not been publicly explained by the State Department.

Is there an alternative URL, archived copy, or press office posting where the release can be accessed?Expand

Yes. While the original State.gov press-release page is currently returning a 403 error, the full text of the release has been republished verbatim by several outlets that attribute it to the U.S. Department of State. Notable accessible copies include: (1) GAGE.news’s article "Advancing the America First Global Health Strategy Through Landmark Bilateral Global Health MOUs," which carries the full text and notes that the post "appeared first on U.S. Department of State"; (2) The Tanzania Times article "U.S signs new health agreements with Botswana, Ethiopia, Madagascar and Sierra Leone," which reproduces the same language and figures; and (3) a PublicNow copy that syndicates State Department releases.

Who at the State Department should be contacted for access to the press release or for more information?Expand

The press release lists the Office of the Spokesperson at the U.S. Department of State as the issuing office. For access or more information, inquiries should go to the State Department’s Office of the Spokesperson/Press Office, typically via the general press contacts listed on state.gov (e.g., the Bureau of Global Public Affairs press contacts) or through the main press inquiries email and phone numbers provided there.

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