The United States and Malawi have signed a five-year, $936 million bilateral health cooperation agreement aimed at strengthening Malawi’s health system and protecting against infectious disease threats.

Under the Memorandum of Understanding (MOU), the United States intends to provide up to $792 million, subject to congressional approval, to support Malawi’s fight against HIV/AIDS, malaria, tuberculosis, and other infectious diseases, as well as to improve disease surveillance and outbreak response.

Malawi, in turn, committed to increasing its annual health spending by an additional $143.8 million over the life of the agreement.

The partnership emphasizes national ownership, accountability, and co-investment, building on Malawi’s progress toward achieving and sustaining the 95-95-95 HIV/AIDS targets (a global goal that by 2028 95% people know their status, 95% of those diagnosed received antiretroviral treatment, and 95 percent of those on ART achieve viral suppression) through integrated and government-led service delivery.

The MOU represents a shift away from parallel NGO-run systems toward strengthening Malawi’s public healthcare institutions, with expanded focus on maternal and child health, polio eradication, global health security, and digital health solutions to reach rural communities.

Officials said the agreement is designed to create a more sustainable and resilient health system in Malawi while reducing global health risks.