In July 2007, the Government of Lesotho signed a compact with the
Millennium Challenge Corporation to provide $362.5 million in support to develop Lesotho's water sector, healthcare
infrastructure, and private sector. The compact ended in September 2013, with approximately 1 million people expecting to benefit from its investments. In January 2025, the
second Trump administration ordered
the cut of most American foreign aid programs. This had a disastrous effect upon Lesotho's health care system, which heavily depended on American aid. In April 2025, during the
reorganization of US tariffs, Lesotho received a 50% tariff, the highest rate of any country. Most exports to the US come in the form of textiles to be made in Jeans, including in the brand
Levi Strauss & Co. These tariffs added to the economic stresses caused by the foreign aid cuts to Lesotho earlier in the year. The country reached a new foreign aid agreement with the United States on the 10th of December. The former agreed to invest $232 million in Lesotho's health care system. In exchange, Lesotho agreed to invest at least $132 million. This deal was part of a larger effort by the Trump administration to procure bilateral aid agreements that differ from the multilateral approach taken by the
World Health Organization and differ from traditional
USAID delivery methods. The United States has signed similar deals with 16 other African countries as of March 2026. The deal was criticized by 21 civil society organizations in Lesotho who argued the deal threatened "national sovereignty" and lacked transparency. == Political relations ==