October 1 ushered in a new era in U.S. foreign aid. What's the plan? Will it work?

In December, State Department senior official Jeremy Lewin welcomed Rwanda Foreign Minister Olivier J.P. Nduhungirehe for the signing of a multi-year Memorandum of Understanding on global health cooperation. U.S. Office of Foreign Assistance hide caption U.S. Office of Foreign Assistance The Trump administration says that October 1 marks the dawn of a new era in global healthcare. It's the age of the "America First Global Health Strategy." And that means rewriting the rules for funding healthcare in low- and middle-income countries. A key part of the "America First" strategy is the idea that the U.S. should not hand out billions of dollars for health and development programs without reaping concrete benefits — access to local minerals, for example — and without a commitment from governments to spend their own money. To be eligible for U.S. funds, each country is asked to sign a Memorandum of Understanding detailing the amount of money the U.S. will invest as well as the country's financial pledge. The administration says the requirement that countries chip in will make them more self-reliant and eventually less dependent on U.S. assistance. It's an idea that has merit, according to...