The United States has signed new bilateral health cooperation agreements with Guatemala, Guinea and El Salvador as part of efforts to promote sustainable health systems under the America First Global Health Strategy of President Donald Trump.
Announced on 27 February 2026, the Memoranda of Understanding (MOUs) aim to strengthen country-led healthcare systems while enhancing disease detection and emergency response capabilities across partner nations. The agreements are designed not only to support public health improvements locally but also to help protect American communities from emerging global health threats.
In Guatemala, the US Department of State, in collaboration with Congress, intends to provide nearly $60 million in support, while the Guatemalan government will contribute $1.6 million in domestic funding. The agreement includes the development of a strengthened surveillance and laboratory system capable of detecting infectious disease outbreaks within seven days, notifying international authorities within 24 hours, and launching response measures within another seven days.
Meanwhile, a five-year agreement with Guinea is valued at $142 million and focuses on transitioning the country towards independent management of its health system by 2030. Under the arrangement, the United States plans to provide more than $91 million to support programmes targeting HIV/AIDS, malaria, maternal and child health, polio eradication, and broader global health security initiatives.
Guinea has committed to co-invest over $51 million and will prioritise strengthening laboratory networks to meet international biosafety and biosecurity standards by 2027. The partnership also includes improved malaria surveillance and skills transfer to national health professionals to ensure long-term sustainability.
In El Salvador, the US intends to provide up to nearly $31.9 million over the next five years to support efforts to combat HIV/AIDS and improve disease surveillance and outbreak response. El Salvador has pledged to increase its domestic health spending by more than $19.7 million, signalling a stronger commitment to national ownership of its healthcare system. Of the US funding, $7.9 million will be directed specifically towards Global Health Security initiatives.
According to the State Department, the agreements form part of a broader global effort under the America First Global Health Strategy. To date, the US has signed 24 bilateral health MOUs worldwide, representing more than $20.2 billion in new health funding. This includes over $12.5 billion in US assistance and $7.7 billion in co-investment from participating countries.
The partnerships build on longstanding international efforts to combat infectious diseases such as HIV/AIDS, malaria and tuberculosis, while strengthening preparedness against future health threats.
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