Africa Watch
U.S. and Kenya Seal Landmark Health Pact as Trump Pushes ‘America First’ Strategy Into Global Health Policy
The United States has signed a landmark bilateral health agreement with Kenya, marking the first major step in the Trump administration’s new America First Global Health Strategy.
Secretary of State Marco Rubio announced the deal in Washington on Thursday, December 4, 2025, after hosting Kenyan President William Samoei Ruto and Prime Cabinet Secretary Musalia Mudavadi.
The agreement, which Rubio described as a model for dozens of similar compacts expected “in the coming weeks,” is designed to shift how U.S. global health assistance is delivered.
Instead of funneling large portions of aid through NGOs and parallel structures, the new approach pushes resources into Kenya’s national health system — and requires the Kenyan government to co-invest significantly in return.
Rubio said the pact “supports Kenya’s leadership in charting its own health priorities” by bolstering data systems, procurement capacity, and modernization efforts needed for long-term self-reliance. The deal also sets out performance benchmarks intended to ensure accountability on both sides.
For Kenya, the agreement represents both an opportunity and a test: more direct control over health financing, but also greater responsibility for meeting targets without the insulation traditionally provided by donor-run programs. For Washington, it is a key example of how the administration wants to reshape foreign assistance — tightening oversight, reducing what Rubio called “dependency, ideology, inefficiency, and waste,” and moving partner nations toward financial and operational independence.
Global health experts will be watching closely.
The shift away from NGO-dominated systems could help strengthen national capacity if executed well, but it also risks straining public health operations in countries where government systems remain uneven. Kenya, however, has made significant reforms in recent years, and officials in Nairobi have repeatedly signaled their desire for more direct funding and clearer lines of accountability.
Rubio said he expects “several more agreements” to be finalized soon, positioning the Kenya compact as the first in a new wave of bilateral health deals intended to “strengthen the foreign assistance architecture” under the America First doctrine.
As Africa continues navigating post-pandemic pressures — from supply chain vulnerabilities to rising infectious disease threats — the U.S.–Kenya partnership will serve as an early test of whether the administration’s reworked global health strategy can deliver both efficiency and impact.
Africa Watch
Domino Effect: Ghana’s Evacuation of Citizens from South Africa Sparks Regional Exodus as Nigeria Follows Suit
Ghana’s decision to evacuate its citizens from South Africa amid rising xenophobic attacks has triggered a regional domino effect, with Nigeria now set to begin withdrawing its own nationals next week, according to Ghana’s High Commissioner to South Africa, H.E. Benjamin Quashie.
Speaking on Citi Eyewitness News, Quashie disclosed that discussions with his diplomatic counterparts suggest growing regional backing for Ghana’s stance, positioning Accra as the catalyst for what could become a continent-wide exodus.
“A lot of them are following what we have done. I am aware that Nigeria will be evacuating its citizens next week,” he said.
The High Commissioner’s remarks come in direct response to criticism from some South African figures, including politician Julius Malema, who has argued that Ghana overstated its decision to evacuate. Quashie’s disclosure that Africa’s most populous nation is preparing to follow Ghana’s lead appears to undercut those claims, suggesting that fears over foreign nationals’ safety are far from exaggerated.
Ghana began its evacuation exercise on Wednesday, May 28, with the first batch of 300 citizens arriving at Accra International Airport, where they were received by a government delegation led by Chief of Staff Julius Debrah and Foreign Affairs Minister Samuel Okudzeto Ablakwa. More than 800 Ghanaians have so far registered for voluntary evacuation following renewed fears over xenophobic attacks and insecurity targeting foreign nationals.
The evacuation exercise, announced earlier this month by Foreign Affairs Minister Samuel Okudzeto Ablakwa, forms part of measures to ensure the safety and welfare of Ghanaians abroad. The government has indicated that returnees will receive transport support, reintegration assistance, psychosocial counselling, as well as access to employment and start-up support programmes.
With Nigeria’s evacuation now imminent, questions are mounting over whether other African nations with large diasporas in South Africa—including Zimbabwe, Malawi, and Mozambique—will similarly activate repatriation plans. The growing exodus threatens to deepen diplomatic tensions between South Africa and its continental partners, even as Ghana’s High Commissioner maintains that the evacuations are a necessary precaution rather than a hostile act.
For the hundreds of Ghanaians who have already registered to leave, the decision is deeply personal. Many have spent years building livelihoods in South Africa, only to feel forced out by rising hostility.
As one returnee from the first batch reportedly shared upon arrival in Accra, home now feels like the only safe option.
Africa Watch
Analyst Warns AES Collapse Fuels Arms Flow and Jihadist ‘Creep’ Into Ghana
ACCRA – The collapse of military-led states in the Sahel is fueling arms trafficking and allowing jihadist networks to creep southward toward Ghana’s northern border, according to a sobering new analysis.
The analysis authored by Joseph McCarthy, an analyst and researcher specializing in governance, security, and political transitions in the region, warns that the self-styled Alliance of Sahel States (AES), comprising Mali, Burkina Faso, and Niger, has failed to contain extremism despite initial promises by the juntas that seized power in Bamako (2020), Ouagadougou (2022), and Niamey (2023).
Instead, the security situation has deteriorated dramatically.
‘State Presence Is Shrinking’
McCarthy notes that large portions of northern and eastern Burkina Faso are now either under jihadist influence or violently contested. In Mali, the regions of Taoudéni, Timbuktu, Ménaka, Gao, and much of Mopti remain outside effective state authority. While Niger retains a stronger foothold around Niamey and Maradi, insecurity is steadily creeping into Diffa, Tahoua, and Agadez.
“The trajectory across all three countries is identical: state presence is shrinking; militant mobility corridors are expanding southward,” McCarthy writes.
The analyst points to coordinated attacks across Mali in April 2026, striking Mopti, Gao, Kidal, Sévaré, and approach routes to Bamako simultaneously, as confirmation that Jama’at Nusrat al-Islam wal-Muslimin (JNIM) and Islamic State affiliates are growing more sophisticated, more coordinated, and operationally bolder.
The Threat to Ghana
While Ghana has not yet experienced large-scale jihadist violence, McCarthy argues the country is not insulated from what is coming.
“The expansion of JNIM and IS-affiliated operations into southern Burkina Faso has intensified arms trafficking, infiltration networks, and radicalization risks along Ghana’s northern border,” he writes.
McCarthy specifically highlights the Bawku conflict, rooted in ethnic and chieftaincy tensions, as “precisely the kind of local instability that extremist organizations have exploited elsewhere to gain a foothold.”
Ghana’s Security Response
According to the analyst, Ghanaian security agencies have responded with Operation Conquered Fist, expanded border surveillance, joint intelligence operations, and counter-extremism programs.
McCarthy describes these efforts as “reflecting a growing, sober recognition that this crisis is no longer distant. It is at the door.”
Broader Regional Warning
The analyst warns that the Sahel has become a sanctuary where extremist organizations regroup, recruit, train, and launch operations southward into coastal West Africa. He notes that Benin has already suffered deadly attacks near Pendjari National Park, Côte d’Ivoire continues fortifying its northern frontier following the Grand-Bassam massacre, and Togo has seen mounting infiltration pressure.
A Lesson Learned at Enormous Cost
McCarthy draws a stark conclusion from the AES experience: no country defeats a transnational insurgency through isolationist nationalism or militarized governance alone.
“Security and development are inseparable,” he writes. “Roads, schools, healthcare, agriculture, jobs, and functioning local governance are as essential to counterterrorism as soldiers and weapons. Where states are absent, extremists fill the space.”
He urges Ghana and the wider ECOWAS community not to treat the Sahel as someone else’s problem, warning that “West Africa cannot afford to learn that lesson twice.”
Joseph McCarthy is an analyst and researcher specializing in governance, security, and political transitions in the Sahel. The views expressed in his opinion article are his own.
Africa Watch
Full Itinerary of President Mahama’s High-Level Engagements at the Africa Forward Summit in Nairobi
The President of the Republic of Ghana and African Union (AU) Champion for African Financial Institutions, John Dramani Mahama, has arrived in Nairobi, Kenya, to participate in the Africa Forward Summit – a high-level France-Africa partnership meeting convened by French President Emmanuel Macron.
The summit has brought together African Heads of State, global business leaders, and international partners to foster collaboration on sustainable development, economic resilience, and global cooperation. President Mahama’s presence underscores Ghana’s active role in shaping continental policy on finance, industrialisation, and health.
Below is the detailed itinerary of President Mahama’s engagements during his working visit to Nairobi.
Day 1: Arrival and Opening of Summit
Tuesday, Morning Session – Green Industrialisation and Energy Transition
President Mahama will join a high-level discussion on Green Industrialisation and Energy Transition. This session aims to chart a practical path for Africa’s industrial growth while simultaneously addressing the urgent challenges of the global climate crisis. The discussion will explore how African nations can leapfrog to cleaner energy systems without sacrificing development targets.
Tuesday, Midday – Working Lunch on Reform of the International Financial Architecture
Reflecting his strategic role as the AU Champion for African Financial Institutions, President Mahama will participate in a working lunch centered on the Reform of the International Financial Architecture. This discussion will focus specifically on:
- Improving African countries’ access to sustainable financing.
- Ensuring that the global financial system becomes more equitable.
- Making international financial institutions more responsive to the continent’s unique development needs.
Tuesday, Afternoon – Co-Chairing the Round Table on Health
President Mahama, who is leading Ghana’s domestic Accra Reset Initiative on healthcare transformation, will co-chair a Round Table on Health themed: “Rethinking global health and building resilient national health systems.” This engagement will highlight strategies for strengthening health systems across Africa to withstand future pandemics and health emergencies.
Tuesday, Late Afternoon – Side Meetings and Bilateral Engagements
On the sidelines of the summit, President Mahama is scheduled to hold several high-profile bilateral meetings. These include talks with:
- H.E. António Guterres – Secretary-General of the United Nations. Discussions will focus on global cooperation and multilateral support for Africa’s development agenda.
- Kristalina Georgieva – Managing Director of the International Monetary Fund (IMF). The meeting will centre on economic stability, fiscal policy, and Ghana’s ongoing reforms.
- Alvaro Lario – President of the International Fund for Agricultural Development (IFAD). Talks will address food security, agricultural financing, and rural development in Ghana and across Africa.
Tuesday, Evening – Departure
President Mahama is expected to leave Nairobi in the evening and return to Accra, concluding his working visit to Kenya.
Summary of Presidential Itinerary
| Time | Engagement |
|---|---|
| Morning | High-level discussion: Green Industrialisation & Energy Transition |
| Midday | Working lunch: Reform of International Financial Architecture |
| Afternoon | Co-chair Round Table on Health: Rethinking global health systems |
| Late Afternoon | Bilateral meetings: UN Secretary-General, IMF MD, IFAD President |
| Evening | Departure from Nairobi, return to Accra |
Source: Richard Aniagyei, Information Services Department
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