FOR IMMEDIATE RELEASE
September 26, 2025
Washington D.C. - The Modernizing Foreign Assistance Network (MFAN) appreciates the Administration’s recent release of its new America First Global Health Strategy, but also notes its risks and limitations.
Producing and sharing publicly a sector-focused strategy with clear objectives is an important step towards maintaining the United States’ vital leadership in providing and enhancing lifesaving assistance around the world. MFAN commends the Global Health Strategy’s focus on long-term country ownership, local systems strengthening, technical innovation, data coordination, and private sector engagement – all key pillars of aid effectiveness. MFAN also supports the strategy’s emphasis on cost effectiveness, government-to-government support where possible, integrated health planning, and support to countries' frontline health workforce. We agree that U.S. investments in global health assistance and other development initiatives are highly correlated with a country’s economic growth and stability, which in turn benefit U.S national interests.
At the same time, elements of the strategy raise serious questions and concerns. For example, the strategy risks sidelining vital technical expertise, defines “global health” far too narrowly, omits acknowledgement of the important role that Congress plays in global health policy, and sets unrealistic timelines for transitioning to locally led models.
“America’s global health programs represent some of the most successful, lifesaving, and effective components of U.S. foreign assistance,” said Tod Preston, MFAN’s Executive Director. “This new strategy lays out a needed vision for helping ensure continued advances in saving lives and making programs more sustainable. But the lack of sufficient operational capacity and clarity around implementation, the sidelining of technical expertise, and the narrow framing of global health priorities risk jeopardizing the very systems the strategy aims to strengthen.”
MFAN’s recent report, Operational Readiness: What the State Department Needs to Effectively Manage U.S. International Development and Humanitarian Assistance, details how the State Department currently lacks sufficient staffing and systems to effectively manage its global health and international development portfolio. To be successful, the State Department will need to increase staffing in areas such as country-level planning and coordination, technical expertise, monitoring and evaluation, and data reporting.
MFAN applauds the Global Health Strategy's intent to improve the efficiency and effectiveness of foreign assistance, a goal that is at the heart of MFAN’s mission. We believe implementing partners have a vital role to play in this regard – and in helping countries make the needed transition to health care self-reliance.
NGOs have deep expertise in implementing USG-directed global health programs and are well-positioned to work with the State Department and Congress as subject matter experts to develop a global health framework that enhances efficiency, effectiveness, and accountability, while reducing the administrative burden placed on implementing partners. On this point, we note that technical expertise and technical support are critical components of effective and impactful health assistance – not a form of overhead or administrative costs, as the strategy suggests.
We caution that the strategy endorses a highly selective definition of "global health" and lacks a focus on other global health priorities, such as maternal and child health, nutrition, and neglected tropical diseases. There continues to be bipartisan support for these issues in Congress, and the strategy’s narrow and disease-specific approach will undermine its ability to achieve functioning and holistic health systems at scale. A broader view is critical. As Congress and the Administration define the next iteration of a successful and sustainable global health strategy, it will require sustained investments on many development axes – not just medicines.
We are also concerned that the new strategy’s timelines for stakeholder discussions are unrealistic, given that funding to many of those actors has been withdrawn and USG global health staffing has been sharply reduced. Without the funding, technical support, and expertise in place to develop these critical programs, they risk being less effective and less sustainable. Past U.S. global health successes cited by the strategy, such as those in Zambia and Kenya, required years of sustained engagement, training, and investment by both the U.S. Government and U.S. implementing partners. These lessons must inform any effort to scale up local ownership, and engagement with Congress and U.S. civil society will be essential for successful implementation.
Lastly, this new strategy would also benefit from greater clarity on ways to maximize cost-effectiveness and evidence-based approaches to “do more with less,” as well as a clear plan for the future of PEPFAR. The absence of any reference to the Centers for Disease Control and Prevention (CDC)’s role, as well as coordination with other important U.S. government actors like the U.S. International Development Finance Corporation and the Millennium Challenge Corporation, also raises questions about how the U.S. government will harness its full set of global health expertise.
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About MFAN
The Modernizing Foreign Assistance Network (MFAN) is a bipartisan coalition of international development practitioners, policy advocates, and experts committed to making U.S. foreign assistance more effective, accountable, and results-driven.
For media inquiries, please contact Tod Preston, MFAN Executive Director, at Tod.Preston@modernizeaid.net
