On December 10, 2025, the United States and Uganda signed a bilateral Memorandum of Understanding (MOU) focused on health cooperation. The five-year agreement is valued at $2.3 billion and aims to improve Uganda’s ability to contribute to global health security, enhance health outcomes for its citizens, and gradually reduce reliance on foreign health assistance.
Under the terms of the MOU, the United States Government will provide $1.7 billion in support over five years. Meanwhile, Uganda has pledged to increase its domestic health expenditures by $577 million during this period in order to assume greater financial responsibility.
The initiative aligns with the America First Global Health Strategy, which was released on September 18. This strategy emphasizes enhancing U.S. safety and prosperity while reinforcing global health leadership. It also aims to save lives and prevent disease spread by shifting U.S. global health assistance toward multi-year bilateral agreements that reinforce local health systems and promote sustainability.
According to the factsheet, this approach is designed to "reduce inefficiencies and dependency in foreign health assistance," "help countries build resilient, durable health systems," and "strengthen bilateral relationships and foster co-investment."
Priority areas identified for the MOU with Uganda include improving surveillance and outbreak response capabilities; reducing HIV, tuberculosis (TB), and malaria burdens; strengthening frontline healthcare workers such as Community Health Extension Workers (CHEWs); integrating robust data systems; enhancing laboratory systems; advancing digitization for monitoring purposes; and developing a transparent supply chain system for healthcare commodities.
The agreement requires Uganda’s government to take on procurement responsibilities for most commodities related to HIV, TB, and malaria. The transition also includes moving from U.S.-funded human resources in healthcare to Ugandan-supported staffing models. For example: "The United States Government plans to train and equip 14,000 Community Health Extension Workers (CHEWs) while Uganda’s Ministry of Health will provide their stipends in a phased manner during the course of the 5-year MOU, moving to a model the Government of Uganda can sustain long-term." These CHEWs are expected to deliver community-based services and participate in disease surveillance.
Over the next five years, significant investment from the U.S. will go toward upgrading data capture systems—including electronic medical records—and integrating these into national databases for better interoperability.
Through this MOU, Uganda has committed not only to funding human resources but also increasing its total domestic investment in healthcare by roughly $50 million each year over five years—resulting in more than $500 million additional funding during that period.
The United States expects to remain the largest contributor to Uganda's health sector throughout this agreement. The MOU underscores ongoing support for global health security initiatives aimed at protecting both countries—and others—from infectious diseases. Additionally, it includes continued backing for faith-based healthcare providers operating across Uganda.