Extractive Bilateralism: Health Aid Needs Urgent Attention and Action

Policy Blog
This article was written by Kathya Acuña Luna, a student in Gavin Yamey’s Geneva-based summer course in global health policy. Kathya is a biomedical engineer with an additional MSc in AI, currently completing her second MSc in Global Health at the University of Geneva. Her main interests surround the development and application of technology for the improvement of healthcare access for the most vulnerable populations, addressing critical inequalities in health.  A central pillar of the America First Global Health Strategy, released on September 18 2025, is bilateral agreements between the United States (US) and countries that receive US health aid. As of July 1 2026, 34 countries had signed such agreements, of which 25 are in Africa.  Human Rights Watch has assessed seven of the bilateral agreements with African countries, specifically Ethiopia, Kenya, Mozambique, Nigeria, Rwanda, Liberia, and Uganda. The results of this analysis are deeply concerning—they show that the US government is making lifesaving health assistance conditional upon “surveillance…
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Explaining the Rise of Female Genital Mutilation/Cutting up the Global Health Agenda

Policy Blog
This article was written by Mary Ann Fahmy, a student in Gavin Yamey’s master’s course, “Global Health Policy: Transforming Evidence Into Policy.” In the piece, she uses Shiffman and Smith’s well-known agenda-setting framework to understand how female genital mutilation/cutting rose up the global health agenda. The framework proposes that health concerns gain global priority based on four factors: “the strength of the actors involved in the initiative, the power of the ideas they use to portray the issue, the nature of the political contexts in which they operate, and characteristics of the issue itself.” Introduction Female genital mutilation/cutting (FGM/C) is defined as any procedure that partially or totally removes external female genitalia for non-medical reasons. 1 Although globally recognized as a violation of human rights, it is a cultural practice…
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Why did Polio Elimination Rise to the Top of Pakistan’s Health Agenda?

Policy Blog
This article was written by Hira Farooq, a student in Gavin Yamey’s master’s course, “Global Health Policy: Transforming Evidence Into Policy.” In the piece, she uses John Kingdon’s well-known multiple streams policy framework to understand how and why Pakistan prioritized polio elimination. The framework proposes that a policy concern rises to the top of a national agenda when three “streams” collide: the problem stream (identification and definition of the problem), the policy stream (development of policy solutions), and the politics stream (the political climate). Kingdon also noted the importance of policy windows (moments in time when the streams converge) and policy entrepreneurs (individuals skilled at bringing the streams together).   Since the establishment of its national Polio Eradication Programme in 1994, Pakistan has conducted hundreds of polio campaigns, declared polio…
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