The Trump administration dissolved USAID in 2025 and is now shifting to bilateral agreements where individual countries contribute to shared funding. The 29 countries that have signed memoranda of understanding face varying cofinancing provisions as the U.S. transitions away from traditional aid . This represents a dramatic restructuring of U.S. global health assistance — from multilateral programs through a single $40 billion agency to individual country deals, though experts have raised concerns about sustainability and reach.