The United States has announced a major change to how it provides foreign aid, with a new policy aimed at sending more money directly to partner countries and less to big international organisations.
The plan, revealed by U.S. Secretary of State Marco Rubio, moves away from what he calls the “NGO industrial complex” — meaning large non-governmental organisations (NGOs) that often take a big slice of aid money for administrative costs, salaries, and overheads.
Rubio made the announcement during the signing of a US$2.5 billion health cooperation agreement with Kenya. Under the deal, the U.S. will provide up to US$1.6 billion over five years to strengthen Kenya’s health sector, while the Kenyan government will put in US$850 million of its own funds to improve long-term capacity.
Rubio said the previous model was inefficient because American aid often went first to U.S.-based or foreign NGOs, which spent heavily before anything reached patients.
“We would drive over to northern Virginia, find an NGO, give them all the money and tell them to run a healthcare programme… and only a percentage of the money ever reached the patients,” he explained. “If we’re trying to help countries, help the country. Don’t help the NGO.”
U.S. officials pointed out that many NGO executives earn extremely high salaries. In 2024, some NGO leaders earned over US$1 million annually, paid using U.S. taxpayer-funded programmes.
A State Department spokesman said foreign aid should “not pad the pockets of overpaid executives.”
Kenya is the first country to sign this new type of agreement, but the U.S. expects to sign around 50 similar deals in the coming weeks with other nations.
U.S. officials say discussions with several governments have already been productive as part of the “America First Global Health Strategy.”
The health programmes under these agreements will target:
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HIV/AIDS
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Tuberculosis and malaria
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Maternal and child health
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Polio eradication
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Disease surveillance
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Outbreak response and preparedness
The new model aims to:
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Work directly with local health systems
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Reduce waste and duplication
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Improve accountability
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Support frontline workers
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Encourage partner countries to invest more themselves
Officials say their goal is to eventually get countries to a point where they no longer need foreign aid.
“Ultimately, the best aid is the aid that ends because it has worked,” a U.S. spokesman said.
The approach may influence future U.S. partnerships in this region by:
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Delivering aid more efficiently
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Strengthening national health systems
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Reducing reliance on foreign intermediaries
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Encouraging local investment and accountability
If agreements similar to Kenya’s come to the Caribbean, health systems could see better support, improved planning and stronger partnerships directly with government ministries.
The U.S. says more agreements will be announced soon.
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