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August 29, 2026The Journal of Law Medicine & EthicsOpen Access

America First Bilateral Health Agreements Threaten to Undermine the Multilateral Global Health Order

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Authors

SSSharifah SekalalaSLShajoe J. LakeAMAllan Maleche

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Overview

Policy analysis reveals US bilateral health agreements alter healthcare financing across 27 nations, highlighting threats to multilateral legal obligations and the right to health.

Key Points

  • Examine how United States bilateral health agreements signed under the America First strategy affect partner health systems and multilateral international law.
  • Reviewed policy frameworks of bilateral health agreements established between the United States and at least 27 partner states across Africa and Latin America.
  • Assessed treaty implications regarding health financing, domestic regulatory oversight, capacity development, and multilateral governance during the US withdrawal from the World Health Organization.
  • Demonstrated that bilateral pacts systematically restructure domestic health financing, regulation, and monitoring across 27 signatory countries.
  • Identified significant risks of weakening multilateral legal obligations governing transparency, access and benefit sharing, capacity building, and the universal right to health.

Cite This Study

Sekalala et al. (2026) studied this question.

synapsesocial.com/papers/6a92994d8e5d7d1fc0c112b9https://doi.org/10.1017/jme.2026.10274
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