By Jennifer Rigby and Humeyra Pamuk
(Reuters) -The United States will prioritize frontline health supplies, staff, and working directly with countries under a new global health strategy released by the Trump administration on Thursday after months of uncertainty following sweeping aid cuts.
The plan also requires recipient countries to co-invest in global health goals around diseases such as HIV/AIDS, malaria, tuberculosis and polio, and outlines plans to transition away from aid to self-reliance over
the next few years.
The strategy, named "America First Global Health Strategy", also covers the U.S. response to pandemic threats and outbreaks, but does not mention a host of areas that have been prioritized under past administrations, including maternal and child health, cholera, and vaccine-preventable diseases such as measles.
"We must keep what is good about our health foreign assistance programs while rapidly fixing what is broken," Secretary of State Marco Rubio wrote in the introduction to the strategy.
STRATEGY COMES AFTER TRUMP'S DISMANTLING OF USAID
The strategy is the clearest sign yet on what the U.S., previously the world's biggest global health funder, now aims to prioritize, although it provided no budget details.
It follows the dismantling of the United States Agency for International Development earlier this year, which has been brought into the State Department as part of President Donald Trump's plans to significantly scale back U.S. foreign aid.
The strategy also envisages changes to the United States' flagship President's Emergency Plan for AIDS Relief, highlighted as a notable success in previous years in a wider global health effort that the new document criticises as inefficient.
In particular, and across its priority diseases, the U.S. will focus on country-to-country agreements rather than contractors, and will ensure that more of the funding goes to buying drugs and treatments and supporting health workers rather than on programmatic overheads, which it says took up to 60% of the money in the past. It will also focus on promoting U.S. health innovation and products overseas.
But an effective response to an infectious disease requires more than just products, said Asia Russell, director of Health GAP, an HIV advocacy group. For example, outreach is necessary even just to get patients into the health system, she said.
"This is still an emergency but the U.S. is going into retreat," she said of HIV/AIDS particularly.
Two senior administration officials who briefed reporters on the new strategy on Thursday on condition of anonymity said Washington would use next week's U.N. General Assembly meetings in New York to engage with countries about potential bilateral meetings.
"Many of us are going to be up at the U.N. General Assembly...to start those discussions," one of the officials said.
The strategy envisages that most of the 71 countries the U.S. supports on health will have full plans by next March that involve "transition to full self-reliance". They will get bridge funding for life-saving activities in the meantime.
The strategy also pledges a U.S. response within 72 hours to disease outbreaks that threaten Americans. It does not mention climate change, which disease experts say is a contributing factor in rising outbreaks worldwide.
(Reporting by Jennifer Rigby in London and Humeyra Pamuk in Washington Editing by Gareth Jones)
