The Trump administration has signed the first in what are expected to be dozens of “America First” global health funding agreements that will prioritize combating infectious diseases in countries deemed to be aligned with the president’s broader foreign policy goals and positions.

The five-year, $2.5 billion agreement with Kenya was signed Thursday by Kenyan President William Ruto and Secretary of State Marco Rubio to replace a patchwork of previous health agreements that had traditionally been run by the US Agency for International Development for decades until the Trump administration dismantled it earlier this year.

The elimination of USAID as a separate agency sparked widespread criticism and concern in the global health community as its immediate impact resulted in the defunding

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