/>i
On November 25, 2025, the Department of State announced an agreement of up to $150 million with Zipline International Inc. to expand access to life-saving medical supplies across Côte d’Ivoire, Ghana, Kenya, Nigeria, and Rwanda. According to the fact sheet on Zipline’s website: “Zipline designs, manufactures, and operates the world’s largest and most experienced autonomous delivery service, which uses electric aircraft to get people instant access to what they need, on their terms.” Founded in 2014 and commencing commercial operations in 2016, Zipline’s fact sheet also touts the company’s operating on four continents, serving more than 5,000 hospitals and health facilities, and making a delivery somewhere in the world every 60 seconds.
Zipline’s agreement with the State Department has been described as using “milestone-based payments and co-financing commitments with partner governments to ensure sustainability and recipient government participation.” Axios reports this type of agreement is a “first-of-its-kind from the State Department.” The agreement is also one of the first agreements announced by the current administration implementing its new America First Global Health Strategy.
The America First Global Health Strategy was announced on September 18, 2025, and provided an overview of the new paradigm for delivering foreign aid in support of global health and international development. The strategy made “the purchase of innovative American products a key component of future U.S. health foreign assistance programs.” Similarly, the strategy described “larger opportunities across the health service delivery value chain where U.S. companies can capitalize on growing markets, including healthcare logistics, private pharmacies and clinics, and health data solutions.”
The Zipline agreement comes right on the heels of the State Department announcing its progress partnering with the Global Fund and the American company Gilead Sciences to make the human immunodeficiency virus (HIV) type 1 capsid inhibitor lenacapavir available in Africa. Lenacapavir is considered a breakthrough medication in the HIV prevention space, which Gilead has offered to the State Department at no cost for use in Eswatini and Zambia.
The State Department’s agreements with Zipline and Gilead provide examples of what the future of American-driven global health will look like, creating optimism for companies interested in engaging in international development. The optimism appears particularly warranted for U.S.-based entities that have an international footprint.
