This week, Malaria No More co-hosted a timely discussion on the State Department’s new America First Global Health Strategy, with Georgetown University’s School of Health, the Georgetown University Global Health Institute, the Center for Global Health Policy & Politics, the Walsh School of Foreign Service, and the O’Neill Institute. Moderated by Georgetown’s Dr. John Quattrochi, the event highlighted perspectives from Joy Phumaphi, former Minister of Health of Botswana and Executive Secretary of the African Leaders Malaria Alliance (ALMA), and Dr. Matthew Kavanagh, Director of the Center for Global Health Policy & Politics.

The discussion explored how U.S. and African governments can partner to ensure a successful transition to country ownership of health programs while sustaining progress against malaria, HIV/AIDS, and TB.

Here’s what we heard:

1. Country ownership only works if it comes with partnership and alignment.

Joy Phumaphi emphasized that while African countries welcome several elements of the strategy, partnership cannot be one-sided: “There is a lot countries can work with in the new strategy – the focus on sustainability, on efficiency, and on taking lessons from COVID-19, where we saw how critical data sharing is. But to build robust systems and achieve the SDGs, there must be sharing of medical countermeasures and the innovations that come from pathogen and data sharing.”

She stressed that U.S. efforts cannot exist in a silo: “The U.S. strategy must align with the Global Fund, Gavi – all the key partners. We need harmonized engagement using the same reporting, monitoring, and planning frameworks. That is the only way to build sustainability.”

Dr. Matthew Kavanagh highlighted the critical importance of U.S. leadership, warning that the U.S. risks undermining its own interests if it disengages from African-led institutions: “The African Union is building strong pandemic-response capacity. If the U.S. isn’t at the table, or is seen as disruptive, it’s not clear that serves the goals stated in the strategy.”

Photos Courtesy of the Georgetown University Global Health Institute

2. Without a pathway for new tools, malaria programs will stall.

Joy Phumaphi underscored that innovation will be key to progress against malaria: “We are not going to eliminate malaria with the current innovations alone. New spatial repellents are promising and affordable. We have advances in the vaccine space. Novartis and MMV have announced a new non-artemisinin-based medicine. The issue is there’s no clarity [in the strategy] around the introduction of these new innovations into countries.”

“Malaria is often referred to as a pathfinder. By strengthening surveillance capacity, we can detect new or harmful pathogens early – making it a vital part of an effective early warning systems and stronger health systems overall.”

3. A shifting global landscape requires the U.S. to engage differently.

Dr. Kavanagh grounded the discussion in a broader geopolitical shift: “The international liberal order as we’ve known it is crumbling. And it’s not just about the U.S. Many countries are stepping away. At the same time, you’re seeing rising powers like China, Brazil, and India – so we are in a very different environment – and the America First push acknowledges that… We’re on the way to 2 billion Africans in the world, a force that is not going to be best served by the aid model that had come before.”

He and Phumaphi also raised concerns about fiscal constraints: “High debt rates mean that countries are not able to respond to malaria and may be less prepared for pandemics today than they were before COVID-19,” Kavanagh noted. “And that should worry everybody… Unless the U.S. wants to massively scale up aid, which it doesn’t, we need to allow countries to have the fiscal space to be able to respond to pandemics and stop outbreaks. In that way, the goal of this strategy makes a ton of sense.”

You can watch the full discussion here.