The United States and Nigeria have finalized a landmark $5.1 billion health partnership that prioritizes the expansion of Christian faith-based medical services alongside nationwide disease prevention.
The five-year bilateral agreement, signed on December 20, 2025, represents a significant pivot in international aid under the America First Global Health Strategy.
Under the terms of the Memorandum of Understanding (MoU), the U.S. government intends to provide nearly $2.1 billion to combat HIV, tuberculosis (TB), malaria, polio, and maternal and child health issues. In a reciprocal commitment, Nigeria has pledged nearly $3 billion in domestic health expenditures, which the U.S. State Department identified as the largest co-investment by any nation to date under the new strategy.
A primary pillar of the deal involves directing approximately $200 million of the U.S. funding specifically to Nigeria’s 900 Christian clinics and hospitals. While these faith-based facilities comprise only 10% of the nation’s healthcare providers, they are responsible for treating more than 30% of the Nigerian population.
U.S. officials stated that this investment is uniquely positioned to complement public-run facilities and improve a national health system currently burdened by 30% of the global malaria cases and poor maternal health indicators.
The agreement is explicitly tied to Nigerian government reforms aimed at protecting Christian communities from targeted violence. This political context is critical, as the religiously mixed Middle Belt region has seen tens of thousands of Christians killed by extremist groups like Boko Haram and radicalized militias over the last decade.
Global watchdogs have warned that more Christians are killed for their faith in Nigeria annually than in all other countries combined.
Principal Deputy Spokesperson Thomas Pigott noted that the Trump Administration views this bilateral model as a way to increase partner-country participation and ensure healthcare system resilience.
However, the U.S. maintains strict oversight of the funds. The State Department emphasized that the president and Secretary of State retain the authority to pause or terminate any programs that fail to align with U.S. national interests or if Nigeria fails to make progress in combating extremist religious violence.