MANILA, PHILIPPINES - MARCH 10: The USAID logo is seen on a machine that processes recycled plastic into construction blocks at the Pasig Eco Hub, a project impacted by the Trump administration's freeze on foreign aid, on March 10, 2025 in Pasig, Metro Manila, Philippines. The recent suspension of USAID funding by the Trump administration has resulted in the loss of at least $69.7 million (approximately PHP 4.06 billion) in aid programs across the Philippines, affecting 39 ongoing projects spanning environmental conservation, health initiatives, disaster response, and education—some of which were set to continue until 2029. Among the impacted projects is the Pasig Eco Hub, a USAID-funded waste management facility, which shut down due to financial constraints, with USAID funding cuts further disrupting its recycling and sustainability programs. (Photo by Ezra Acayan/Getty Images)
The Trump administration’s so-called “America First Global Health Strategy” turns one of the most effective and humane tools of U.S. foreign policy into an instrument of coercion. We now condition lifesaving health aid on concessions from vulnerable countries and replace partnership with exploitation, thus undermining both American values and long-term national interests.
Throughout the 20th and into the 21st century, American resources were deployed to provide relief to countless millions throughout the world. Think Herbert Hoover in the aftermath of World War I, the Marshall Plan after World War II and the later formation of the United States Agency for International Development (USAID). These initiatives were driven by both genuine concern for the wellbeing of others, but also enlightened self-interest. Stable and healthy nations were less likely to wage war. American aid benefited the American economy that produced the tools and the agricultural products that were the foundation for this aid.
For decades, U.S. foreign assistance has represented a tiny share of federal spending — about one percent of the budget — but has delivered outsized benefits. It has helped contain infectious diseases before they reach our shores, stabilized fragile regions and built goodwill that strengthens diplomatic relationships while saving millions of lives at relatively low cost.
Trump has abandoned any pretense of foreign aid altruism, replacing it with a sullied quid pro quo. The new approach abandons that framework. It was previewed in his dealings with Ukraine when he conditioned continued military assistance to that country on mineral concessions before simply insisting that other NATO members buy American weaponry and transfer these to Ukraine. Trump now applies this sinister transactional approach to medical aid to some of the poorest countries in the world.
According to reporting in The New York Times and the Associated Press and analysis by Public Citizen, the administration has pressed some 30 countries in Africa and Latin America to sign agreements granting the United States access to sensitive health data and valuable natural resources as a condition for receiving even minimal health assistance. These are not routine bilateral arrangements negotiated on equal footing. They are ultimatums delivered to countries facing urgent public health crises.
Consider Zambia, where the administration has reportedly weighed a $2 billion deal withholding, among other things, HIV treatment support affecting over one million people unless the country expands U.S. access to its mineral resources. In short, it is leveraging human lives for economic gain. In other cases, countries are being asked to provide viral samples and health data without assurances that resulting vaccines or treatments will be shared equitably. This raises profound ethical concerns and threatens to erode global cooperation in disease surveillance — cooperation that is essential to preventing the next pandemic. Not surprisingly, certain governments, among them Ghana, Zimbabwe and Kenya, have rejected the overtures, having concluded that the trade-offs are too high a price.
The moral problem is obvious. Conditioning lifesaving aid on unrelated concessions exploits desperation. It echoes a discredited era when powerful nations extracted wealth from poorer ones under the guise of assistance. The United States should not revive that model, particularly in the realm of global health, where trust and transparency are indispensable.
The strategic costs are just as serious. The perception that U.S. aid is transactional and predatory will diminish cooperation on data sharing, early warning systems, and joint research. That makes Americans less safe, not more. Furthermore, foreign policy conducted through secret deals that trade public health for private advantage invites abuse and evades democratic accountability. Congress cannot exercise meaningful oversight if it is kept in the dark, and the public cannot assess policies whose consequences include preventable illness and death.
Proponents may argue that tying aid to economic or strategic benefits simply reflects realism. But realism properly understood recognizes that power is not only measured in transactions. It is also measured in credibility, alliances, and the willingness of others to cooperate in times of crisis. A policy that saves pennies while sacrificing trust is not pragmatic; it is shortsighted.
The United States can pursue its interests without abandoning its principles. That means maintaining robust global health programs that are transparent, evidence-based, and grounded in mutual benefit. It means supporting equitable access to the fruits of medical research. And it means rejecting the premise that the lives of people in poorer countries can be used as bargaining chips. When the U.S. conditions lifesaving care on extractive concessions, it diminishes the nation’s moral standing, weakens its strategic position, and endangers global health. Congress should demand full disclosure of these agreements, prohibit coercive conditions on humanitarian aid, and reaffirm a simple proposition: that American leadership is strongest when it aligns power with principle.
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Courtesy of Alaska Beacon
