US gives 5 weeks for 5-Year Aid Plans
Complete implementation plans due on February 27 for some countries
US government teams have received, and begun sharing with government counterparts, the implementation planning tools for the America First Global Health Strategy agreements. I’ve been reviewing these tools as drafts submitted for review, but it’s now confirmed that they are also in country hands, including the Implementation Process Overview—a calendar that lays out one of those blistering timelines that is becoming something of a GHSD trademark.
For countries that have already signed their Memorandum of Understanding1, the first deadline is just five working days from today. For those that have not, there’s more time to clear your calendars.
The milestones are:
January 31 (or within 30 days of MoU signing): Reviewing existing implementation mechanisms
February 27 (or within 60 days of MoU signing): Completion of implementation plans
March 31 (or within 90 days of MoU signing): standing up the governance and management systems, and draft plans for modifying, terminating or creating new awards
Alt text: The implementation planning process overview submitted for approval. A version with the February 27 due date was provided to USG and country partners this week. The full document is at the bottom along with some others, but you know how much I love screenshots, don’t you.
In recent posts, I've gone over some of the requirements for the implementation plans which must be completed, not drafted, in 35 days for some countries. Here’s a handy to-do list:
Condense a strategy for reaching or sustaining progress toward the three “95s” of knowledge of HIV status, access to antiretrovirals among those who know their status, virologic suppression among those who are on ARVs; reducing pediatric infections and bringing down overall HIV incidence into ten pages or less.
Do the same for malaria polio, maternal child health and global health security.
Write a digital health strategy if you do not already have one.
Find a senior health ministry official who is smart, focused, effective and relieve them of all of their duties so that they can devote 100 percent of their time to standing up a Transition Management Office. (Note - while the implementation plans require specifics on the Transition Management Office and the Steering Committee, the overview suggests countries have until March 31 to get these structures in place. If the overview is correct, this ever-so-slightly begs the question of who will be doing the implementation plan, if not the very smart health ministry lieutenant.)
Figure out what procurement mechanisms you are going to use for the next five years and how you are going to justify using them if the US can procure the same thing for less.
Figure out whether the fact that the US has left the World Health Organization as of today means that the US will not accept WHO prequalification as a regulatory standard where relevant.
Figure out what in the actual flounder is going on with the America flag that used to fly outside of the World Health Organization.2 (Wait, you’re too busy? Okay. Let’s leave that off.)
Figure out how you are going to involve people impacted by the diseases and health issues the MoU will program for including people living with and at risk of HIV, TB and malaria, cisgender women of reproductive age, as well as people with experience in civil society-led accountability in your steering committee. (Wait, you think this isn’t in the Implementation Plan guide? It isn’t. But it isn’t not there either. Please do this.)
Figure out how much Global Fund money you might actually receive for a funding round that didn’t meet replenishment targets, for which funding envelopes have not been set yet, and use that figure that you came up with somehow to do holistic programming.
Figure out whether the US folks asking for login credentials to your data system are serious about wanting the password to be: Password123. Then decide it’s better not to ask.
Tell the people running your pandemic preparedness and outbreak response units that, in the event of an outbreak, some or all of the coordination with the US may need to run through the Steering Committee that you’re setting up. If these people ask how that’s going to work or be efficient when there is an actual outbreak, tell them you’ll get back to them when the Steering Committee and Transition Management Office is set up.
Figure out what each of the following terms means: “gender ideology, discriminatory equity ideology and DEI / abortion as a method of family planning.”3 Figure out if the State Department grammarian is pleased with the implication that DEI is a method of family planning.
Remember above all that every co-signatory country is a sovereign nation with agency, experience, immense community-derived knowledge, decades of experience in delivering programs that save lives against incredible odds, and that there is immense opportunity in this moment if there is stamina, risk-taking and refusal to accept terms that do not uphold health and dignity for all.
Have an excellent weekend.
Let’s remember that as of now out of the 14-odd countries with signed MoUs, only FOUR are circulating, and only Kenya’s has been shared officially. I’ve dropped all of the copies that are “in the wild” here so that folks who need them can find them. All of these are versions shared in semi-public fora. Except in the case of the Kenyan agreement, these may not be the final version.
https://www.state.gov/releases/office-of-the-spokesperson/2026/01/termination-of-u-s-membership-in-the-world-health-organization-who-joint-statement-by-secretary-of-state-rubio-and-secretary-of-health-and-human-services-kennedy
https://www.nbcnews.com/politics/trump-administration/trump-vance-march-for-life-mexico-city-policy-abortion-dei-gender-rcna255639