To End a Plague ... Again

The Department of State's June 5 funding announcement for Nigeria is the clearest sign yet that State is taking over activities that, for years, have been led by the U.S. Centers for Disease Control and Prevention.

The Ugandan implementation plan for the America First Global Health Strategy, portions of which are shared here for the first time, is long on bullet-pointed lists and soaring aspirations and, for all its hundreds of pages, surprisingly thin on explanations of how those aspirations are expected to translate into measurable public health results.

Secretary Rubio: Does this make America safer? Countries receiving funds under America First Global Health Strategy agreements will have the final say in how much money the US CDC has for specific global health activities, according to a statement by a spokesperson for the US Department of State reported in Politico earlier this week.1 The position makes the United States highly dependent on sovereign nations to decide that a robust CDC presence matters within their borders.

A trial balloon for a US shake-up of global health procurement MIGHT have just gone by Note to readers: After publication, GHSD leadership reached out to me to state that Graham did not state that the US was exploring an alternative to pre-qualification, and requested that I take the post down. As the analysis of this scenario remains sound and potentially relevant, I have edited the post to reflect GHSD’s position on what was discussed at the briefing.

It's okay dude. I'm not mad at you. This post is dedicated to Renee Nicole Good who was shot and killed by ICE in Minnesota this week, seconds after she uttered the words in this post’s subtitle and closing line to her assassin. For Renee and all the people, mainly Black and brown, who have been, and are yet to be, slain even after they’ve smiled and tried to deescalate and disengage.

In Kenya, Uganda and Liberia some process and outcome metrics stop making sense The Kenyan Memorandum of Understanding includes epidemiological targets and baseline data points that make no sense. So, to a lesser extent, do the agreements signed by Uganda and Liberia. There are fancier ways to say this, like: some of the figures and approaches in the MoUs confound interpretation in the context of the most recent published information. There are simpler ways, too: sometimes the numbers do not math.

Your weekend reading list In this short sweet post, sharing all of the documents currently available from the Bureau of Global Health Security and Diplomacy related to implementation of the America First Global Health Strategy. Today’s motto: When they flood the zone, pick up a snorkel. Alt text: The anatomy of a snorkel - labelled parts include splash guard, tube, mask clip, mouth piece, purge valve.

The senior official at the US Bureau of Global Health Security and Diplomacy reached out yesterday to say that I had mischaracterized his remarks at a recent briefing for Congressional staffers in a post published on Friday. Jeff Graham told me that he did not say that the US was exploring alternatives to WHO prequalification at the briefing.

Cracking the code on Project Vault and the Art of the (America First Global Health Strategy) Deal Last week, the US-Rwanda Memorandum of Understanding signed in December 2025 slipped into public circulation. The 23-page agreement is so qualitatively different from the other four MoUs in public circulation that it fried the circuits in my ‘how is this MoU different from the others and the template’ machine.

A lone mention of PrEP amidst thousands of words speaks volumes The search is over! After reading nearly 150 pages of Memoranda of Understanding, Implementation Planning Tool, its Companion1 and assorted other documents, I’ve finally found the word “PrEP,” an abbreviation for pre-exposure prophylaxis that refers to the use of medications and other agents to prevent people who are HIV-negative from acquiring the virus.