President Donald Trump is once again doing what Washington insiders said couldn’t—or shouldn’t—be done: shaking up a broken system and putting America First. The Trump administration has launched an $11 billion global health initiative designed to replace the U.S. Agency for International Development with a far more direct, results-driven model.
According to Axios, the new program, called the America First Global Health Strategy, will send aid straight to foreign governments, hospitals, and health institutions—cutting out the maze of nongovernmental organizations that previously operated through USAID. In other words, less money for Beltway middlemen and more money where it’s actually supposed to go. Imagine that.
Under the plan, the United States will commit $11.1 billion to participating countries. Secretary of State Marco Rubio has already signed 15 agreements with African nations focused on strengthening health systems, with an emphasis on HIV/AIDS, malaria, tuberculosis, and maternal health. The State Department aims to bring 50 countries on board within the next few months, signaling a rapid shift toward accountability and efficiency.
Rubio made it clear this initiative replaces what he called the “NGO industrial complex,” which he said siphoned off roughly 70% of U.S. funding to Washington-area bureaucrats and contractors. Former USAID officials dispute that figure—but interestingly, not the part about the system being bloated and ineffective.
Jeremy Lewin, undersecretary of state for foreign assistance, explained the problem bluntly. USAID, he said, built parallel healthcare systems by flying in American workers rather than helping countries build their own capacity. Progress was made, but it stalled—and durability and self-reliance were never achieved. Lewin even described the approach as fostering a “neo-colonial mindset,” where foreign governments were treated as permanently dependent instead of capable partners.
The new strategy aims to change that by strengthening local healthcare systems and promoting long-term self-sufficiency. Less hand-holding, more empowerment. That’s not cruelty—that’s common sense.
President Trump moved early in his administration to overhaul USAID, pushing to shrink its footprint, tighten oversight, and redirect foreign aid toward clearly defined America First priorities. His team proposed budget cuts, increased scrutiny of grants and contracts, and reduced reliance on outside partners and multilateral institutions that often benefited bureaucrats more than the people they claimed to help.
While many of these efforts faced resistance from Congress and the foreign policy establishment—shocking, I know—they laid the groundwork for this broader restructuring of how the U.S. delivers aid overseas.
Once again, Trump is proving that reform doesn’t mean abandoning the world—it means demanding results, accountability, and respect for American taxpayers. An $11 billion investment that actually builds self-reliance instead of funding bureaucracy is a step in the right direction, and it’s exactly the kind of bold, practical leadership that keeps America strong and respected on the global stage.
