Watch: Rubio and Kenyan President Ruto speak after signing the “America First” global health agreement.

WASHINGTON (AP) — The Trump administration has signed the first of what is expected to be dozens of “America First” global health funding agreements that will prioritize infectious disease control in countries deemed aligned with the president’s broader foreign policy goals and positions.

Watch remarks by Foreign Minister Marco Rubio and Kenyan President William Ruto in the video player above.

The five-year, $2.5 billion agreement with Kenya was signed Thursday by Kenyan President William Ruto and Secretary of State Marco Rubio to replace a group of previous health agreements that were traditionally administered by the U.S. Agency for International Development for decades until the Trump administration dismantled them earlier this year.

The elimination of USAID as a separate agency has drawn widespread criticism and concern in the global health community, as its direct impact has halted funding for several hundred programs focused on the developing world, including cuts to maternal and child care, nutrition, and HIV/AIDS programs.

He watches: Trump refuses to celebrate World AIDS Day because funding cuts threaten HIV prevention efforts

Rubio said the agreement with Kenya “aims to strengthen American leadership and excellence in global health while eliminating dependency, ideology, inefficiency, and waste in our foreign aid architecture.” He also praised Kenya for its role in leading and contributing to the international stability force working to combat powerful gangs in Haiti.

Ruto praised the agreement and said Kenya would continue to play a role in Haiti as the gang suppression force transitions to a broader operation.

Details of the deal with Kenya

Under the health agreement with Kenya, the United States will contribute $1.7 billion of the total amount, while the Kenyan government will cover the remaining $850 million. The agreement focuses on preventing and treating diseases such as HIV/AIDS, malaria and tuberculosis with an emphasis on faith-based medical providers, although all clinics and hospitals registered with Kenya’s health insurance system will be eligible to receive funding, according to US officials.

He watches: How USAID Cuts Impact HIV Control in Kenya

“This cooperation framework represents a complete departure from the past and will have a lasting impact on health for all,” said Ouma Oluga, Kenya’s Principal Secretary for Medical Services.

Family planning programs that comply with U.S. restrictions on providing abortion services would also be eligible, according to Jeremy Lewin and Brad Smith, two State Department officials involved in the negotiations. They said the convention would not discriminate against gay, transgender or sex workers.

A number of other African countries are expected to sign similar agreements with the United States by the end of the year, according to officials, although two of the continent’s most populous countries — Nigeria and South Africa — are not expected to be among that group due to political differences with Trump, according to Lewin and Smith.

The dismantling of USAID had repercussions across Africa, as programs that fought disease and hunger, supported maternal health, and even some that addressed extremism and promoted democracy were closed. This also led to thousands of health workers being laid off from their jobs because their salaries are funded by American aid.

The impact is faced by two African countries not expected to see such deals

Sub-Saharan Africa’s fight against HIV could be set back for years, experts have warned, after the closure of the United States Agency for International Development (USAID) affected the President’s Emergency Plan for AIDS Relief, a bipartisan program launched by the George W. Bush administration in 2003 that is credited with saving the lives of about 25 million people worldwide.

Africa is a major focus of PEPFAR, and South Africa — which has the largest number of people living with HIV in the world — has relied on USAID and PEPFAR for more than $400 million annually to help distribute life-saving antiretroviral drugs to some of its more than 5 million people on treatment. American taxpayer money funded nearly 20% of South Africa’s HIV program — the largest in the world — until the Trump administration cut or froze funding.

Read more: Vulnerable South Africans are struggling to find a cure for HIV after US foreign aid cuts

Experts at UNAIDS – the UN agency charged with fighting the virus globally – warned in July that up to 4 million people worldwide would die if funding was not restored.

After harsh criticism that defunding PEPFAR would cost lives, the Trump administration moved to restore some aid, including a $115 million grant to an HIV program in South Africa, which is supposed to help fund the program until at least March.

However, Trump said he would cut all financial aid to South Africa over his widely rejected claims that it violently persecutes the white Afrikaner minority.

Trump also expressed strong dissatisfaction with Nigeria, another country hard hit by HIV/AIDS, over allegations of discrimination and violence targeting the Christian community.

Nigeria’s health sector has been supported by international aid, led by the United States Agency for International Development, which pumped nearly $4 billion into the country’s healthcare system between 2020 and 2025.

Nigeria’s health system has become fragile due to years of underinvestment, with the federal government allocating an average of 4% to 5% of the national health budget to some 220 million people in one of the world’s fastest-growing populations.

The sudden cuts deepened the crisis, as aid-funded programs provided vital lifelines for millions of people.

Imray reported from Cape Town, South Africa. Associated Press writer Obi Adetayo in Lagos, Nigeria, contributed to this report.