The United States and Nigeria have formalised a landmark five-year $5.1 billion bilateral health cooperation Memorandum of Understanding (MOU), advancing the America First Global Health Strategy by promoting resilient, self-reliant health systems, accountability, and shared responsibility.

According to a media statement published on the website of the US Missions in Nigeria on 21 December 2025, the agreement commits nearly $2.1 billion in U.S. assistance, matched by $3.0 billion in new Nigerian domestic expenditures—the largest co-investment under the strategy to date. 

Key Focus Areas of the MOU

• Strengthening surveillance and outbreak response
• Expanding laboratory systems capacity
• Ensuring reliable supply of health commodities
• Supporting frontline health workers
• Enhancing data systems for accountability and planning

Nigeria faces severe health challenges, including one of the world’s highest maternal and child mortality rates and carrying nearly 30% of the global malaria burden. U.S. support will claim to target expanded access to services for HIV/AIDS, tuberculosis, malaria, polio, and maternal/child health.

A distinctive emphasis is placed on $200 million dedicated to bolstering over 900 Christian faith-based clinics and hospitals, which serve more than 30% of Nigeria’s 230 million population, often in underserved rural areas. These investments aim to integrate HIV/TB/malaria/maternal-child services and build workforce capacity.

The MOU also links to Nigerian reforms prioritising protection of Christian communities from extremist violence. The U.S. retains rights to pause or terminate programs misaligned with national interests, expecting “measurable progress” against religiously motivated attacks.

This pact follows similar multi-year MOUs signed across Africa in December 2025, marking a broader rollout of the America First Global Health Strategy.