WASHINGTON (AP) — 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 U.S. 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 of hundreds of programs focused on the developing world, including cuts to maternal and child care, nutrition and anti-HIV/AIDS programs.
Rubio said the agreement with Kenya “aims to strengthen U.S. leadership and excellence in global health while eliminating dependency, ideology, inefficiency, and waste from our foreign assistance architecture.” He also praised Kenya for its role in leading and contributing to the international stabilization force working to combat powerful gangs in Haiti.
Ruto lauded the agreement and said Kenya would continue to play a role in Haiti as the gang suppression force transitions to a broader operation.
Under the health deal with Kenya, the U.S. will contribute $1.7 billion of the total amount, with the Kenyan government covering the remaining $850 million. The agreement focuses on preventing and treating diseases such as HIV/AIDS, malaria and tuberculosis with an emphasis on faith-based medical providers, although all clinics and hospitals enrolled in Kenya’s health insurance system will be eligible to receive funding, according to U.S. officials.
“This cooperation framework is quite a departure from the past and will have a lasting impact on health for all,” said Ouma Oluga, Kenya's principal secretary for medical services.
Family planning programs that comply with U.S. restrictions on the provision of abortion services will also be eligible, according to Jeremy Lewin and Brad Smith, two State Department officials involved in the negotiations. They said the agreement would not discriminate against gay and transgender people or sex workers.
A number of other African countries are expected to sign similar agreements with the U.S. by the end of the year, according to the officials, although two of the continent’s most populous nations — Nigeria and South Africa — are not expected to be among that group due to political differences with Trump, according to Lewin and Smith.
However, discussions on a deal with Nigeria are underway despite the “very significant concerns the president has around the persecution of Christians,” Lewin said. He added that if a health agreement is reached with Nigeria, the administration is hopeful it would “enhance” efforts to address those concerns.
Dismantling USAID had repercussions across Africa, shutting down programs that fought disease and hunger and supported maternal health, and even some that tackled extremism and promoted democracy. It also put thousands of health workers out of jobs because their salaries were funded by U.S. aid.
Sub-Saharan Africa’s battle against HIV might be set back years, experts warned, after the closing of USAID affected the President’s Emergency Plan for AIDS Relief, a bipartisan program launched by the administration of George W. Bush in 2003 and which is credited with saving around 25 million lives across the globe.
Africa is the main focus for PEPFAR, and South Africa — which has the highest number of people living with HIV in the world — had relied on USAID and PEPFAR for more than $400 million a year in help to roll out life-saving antiretroviral drugs to some of its more than 5 million people receiving treatment. American taxpayer money funded nearly 20% of South Africa’s HIV program — the biggest in the world — until the Trump administration cut or froze the funding.
Experts at UNAIDS — the U.N. agency tasked with fighting the virus globally — warned in July that up to 4 million people worldwide would die if funding wasn’t reinstated.
After stinging criticism that defunding PEPFAR would cost lives, the Trump administration moved to restore some help, including a $115 million grant for South Africa’s HIV program that should help fund it until at least March.
However, Trump has said he will cut all financial assistance to South Africa over his widely rejected claims that it is violently persecuting its Afrikaner white minority.
Trump has also voiced extreme displeasure with Nigeria, another country hard hit by HIV/AIDS, over allegations of discrimination and violence targeting the Christian community.
Nigeria’s health sector was propped up by the international aid, chiefly by USAID, which poured nearly $4 billion into the country’s health care system between 2020 and 2025.
The Nigerian health system had become fragile due to years of underinvestment, with the federal government budgeting an average of 4% to 5% of the national budget to health for its nearly 220 million people in one of the world’s fastest-growing populations.
The sudden cut deepened the crisis, where aid-funded programs had created critical lifelines for millions of people.
Imray reported from Cape Town, South Africa. Associated Press writer Ope Adetayo in Lagos, Nigeria, contributed to this report.
France's President Emmanuel Macron, left, and Kenya's President William Ruto talk during their meeting on the sideline of the African Union-European Union summit in Luanda, Angola, Monday, Nov. 24, 2025. (AP Photo/Thibault Camus)
President Donald Trump closes his eyes as Secretary of State Marco Rubio speaks during a Cabinet meeting at the White House, Tuesday, Dec. 2, 2025, in Washington. (AP Photo/Julia Demaree Nikhinson)
FILE - U.S. Secretary of State Marco Rubio, right, and Kenyan President William Ruto pose for photos before a meeting, Sept. 24, 2025, in New York. (AP Photo/Heather Khalifa, Pool, file)
EL SEGUNDO, Calif. (AP) — The Los Angeles Chargers had to adjust on the fly after Justin Herbert broke a bone in his non-throwing hand last Sunday.
As optimistic as they are that Herbert will be ready to start against the visiting Philadelphia Eagles on Monday night, the Chargers (8-4) have spent this week accounting for every possible contingency.
“I think you got to try to look at it from all the different angles, you know, as you prepare,” offensive coordinator Greg Roman said. “What if this happens? What if that happens?”
Planning went into practice during a 31-14 win over the Las Vegas Raiders, when Herbert had to play the final three quarters with his left hand in a hard cast and protective glove. The injury prevented Herbert from taking snaps under center, with the Chargers using shotgun and pistol formations the rest of the way.
“It’s just a good reminder you really need to work through these contingencies in your mind,” Roman said. “A lot of what we practiced that week went out the window. So, really, hats off to Justin and really everybody.”
Herbert had surgery on Monday and was back at practice Thursday, leaving an organization that typically treats such matters as state secrets expressing an unusually public degree of belief he will be ready to go against the NFC East-leading Eagles (8-4).
“That's the plan, is to prepare as if I'm going to play,” Herbert said Wednesday. “See how the next couple days goes, and do everything I can to be out there for the team and for the guys.”
However, that does not necessarily mean Herbert will be able to run the full offense. Backup Trey Lance worked with the first unit on Wednesday, and coach Jim Harbaugh has said the third overall pick in the 2021 draft would be prepared for situations where the Chargers might need to be under center, such as in short yardage or at the goal line.
Roman has used quarterback platoons at times, but never because of an injury like Herbert's.
“It was because of, you know, trying to throw some trickeration at people,” Roman said. “But, no, I mean, we’ll do whatever it takes.”
The uncertainty carries over to the Eagles, where defensive coordinator Vic Fangio has also been devising plans for Herbert and Lance, who has not thrown a touchdown pass in the NFL since Jan. 2, 2022, the last game of his rookie season with the San Francisco 49ers.
“We’ll have to prepare for both quarterbacks,” Fangio said. “Probably knowing that if Herbert plays, he’ll be in the pistol a lot and in the gun. Yeah, we’ll have to be ready for both.”
Philadelphia’s offense has absorbed the bulk of the blame for the team's struggles of late. Yet, it was the defense — especially the line — that got whipped against the Bears, when the unit allowed 281 yards. Chicago had two 100-yard rushers in a game for the first time since its dominant Super Bowl-winning 1985 season.
“I didn’t do a good enough job of preparing our squad for the quality and the diversity of their run game,” Fangio said. “We didn’t play the run and the blocks the way we had been playing.”
Herbert has experience going against Fangio’s schemes, having faced him four times from 2020-21 when Fangio was head coach of the Denver Broncos. Herbert went 2-2, throwing for 1,071 yards and eight touchdowns with four interceptions. Both wins were at home, and he did not throw a pick in those games.
Although the Eagles have allowed over 400 yards of offense in consecutive games for the first time under Fangio, Herbert expects a big response this week.
“We know how good their defense is, and we watch the film, and it doesn’t take long to turn it on and see the plays they make,” Herbert said. “They have guys on that side of the ball that are game-wreckers. And at the same time, they’re really well-coached, and it makes for a dangerous combination.”
Eagles coach Nick Sirianni has stood behind offensive coordinator Kevin Patullo, both professionally amid the offense's struggles and personally, after Patullo’s New Jersey home was vandalized with eggs over the weekend.
Sirianni said he’s leaned on advice he was given early in his coaching career: “Give strength to the people that need it.”
“I always thought that was really good,” Sirianni said. “Pick up people that need it, and that’s your job as a leader to do that. That’s why the relationship portion of it is so important because there are ups and there are downs in relationships.”
Patullo appreciated Sirianni’s trust in him to turn around a unit that is running out of time to perform like one that's capable of winning another Super Bowl. Saquon Barkley and Super Bowl MVP Jalen Hurts have seen their production dip, while former 1,000-yard receivers A.J. Brown and DeVonta Smith are behind the pace of their career averages. The Eagles are averaging 62.4 fewer yards per game and 4.7 fewer points than last season.
Coming off their bye week, the Chargers turned in arguably their best offensive performance since tackle Joe Alt was lost for the season on Nov. 2 in the win over the Raiders. To Harbaugh, it was clear the time off benefited the offensive line, with multiple players getting healthy and Jamaree Salyer having the chance to work exclusively at left tackle after previously splitting time at right guard. That switch will be permanent for the remainder of the season, Harbaugh said.
Harbaugh was especially pleased with the run blocking, which set the stage for 192 yards and two scores on the ground, and believes the front five has found some consistency without Alt.
“These are high (level), elite football players that have gotten their opportunity,” Harbaugh said. “Their playing is healthy and together and good. ... That bodes well for us down the stretch.”
AP Sports Writer Dan Gelston in Philadelphia contributed to this report.
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Philadelphia Eagles head coach Nick Sirianni speaks after his team's loss to the Chicago Bears in an NFL football game, Friday, Nov. 28, 2025, in Philadelphia. (AP Photo/Matt Slocum)
Los Angeles Chargers head coach Jim Harbaugh reacts on the sideline during the second half of an NFL football game against the Las Vegas Raiders, Sunday, Nov. 30, 2025, in Inglewood, Calif. (AP Photo/Jae C. Hong)
Philadelphia Eagles wide receiver A.J. Brown (11), right, celebrates his touchdown with quarterback Jalen Hurts (1) during the second half of an NFL football game against the Chicago Bears, Friday, Nov. 28, 2025, in Philadelphia. (AP Photo/Matt Slocum)
Los Angeles Chargers quarterback Justin Herbert (10) walks off the field after an NFL football game against the Las Vegas Raiders, Sunday, Nov. 30, 2025, in Inglewood, Calif. (AP Photo/Jae C. Hong)
