Zambia has postponed a US$1 billion United States health aid agreement, citing provisions that the government says conflict with its national interests, as advocates raise concerns that the deal may be linked to mining access and sensitive data sharing.
The five-year package, designed to combat HIV and malaria, improve maternal and child health, and strengthen outbreak preparedness, was initially slated for signing in November 2025. Under the agreement, Zambia would contribute approximately $340 million in co-financing over the same period, according to a draft reviewed by Reuters.
A spokesperson for the Zambian Ministry of Health told AFP that a section of the revised draft “did not align with the position and interests of the government of Zambia.” The ministry declined to provide details, emphasizing that the focus of the deal is strictly on health.
Reports indicate the draft linked the aid to a “bilateral compact” proposed by U.S. Secretary of State Marco Rubio to Zambian President Hakainde Hichilema in November 2025. Three sources familiar with the discussions said the compact involved collaboration in Zambia’s mining sector. Zambia is Africa’s second-largest copper producer after the Democratic Republic of Congo and also exports cobalt, nickel, lithium, manganese, graphite, and rare-earth minerals.
“This deal has no relation whatsoever to minerals, mining, or any natural resources,” the spokesperson said, adding that Zambia remains open to negotiations only under terms that are clear, mutually agreed, and aligned with national priorities.
Health advocacy groups have raised alarms over a proposed ten-year data-sharing arrangement, which would allow the United States to receive health information from Zambia. Owen Mulenga, of the Treatment, Advocacy and Literacy Campaign, warned that the data flow would be “one way, from Zambia to the U.S., and would primarily benefit the United States.” Asia Russell, executive director of Health GAP, a global HIV advocacy organization, said the arrangement could risk slashing U.S. funding for critical programs while prioritizing the interests of multinational mining firms over local health needs.
The U.S. State Department, when approached by AFP, reiterated that foreign assistance is intended to serve U.S. national interests and declined to comment on the status of negotiations. The department did not address the allegations that mining access was being linked to health funding.
Zambia’s caution mirrors trends elsewhere in Africa. Zimbabwe recently withdrew from a $367 million U.S. health funding deal, citing data privacy and sovereignty concerns. Kenya’s $1.6 billion agreement is also suspended pending legal scrutiny. Other countries, including Nigeria and Uganda, have signed their respective agreements.
Analysts say the dispute highlights the growing tension between donor conditions and national sovereignty in Africa, particularly in countries with rich natural resources. “Zambia needs the health funding, but it also must protect control over its mineral wealth and sensitive national data,” said Sibusiso Phiri, a Lusaka-based political analyst.
The deal is part of a broader U.S. strategy under the Trump administration to link foreign assistance to strategic interests, following cuts to international aid, dismantling of aid agencies, and a pivot to an “America First” approach in global health. Experts say such policies are increasingly testing the ability of recipient countries to balance urgent public health needs with sovereignty and long-term economic security.
Zambia now faces the challenge of renegotiating the aid package in a manner that preserves critical funding for lifesaving health programs, while ensuring that no clauses infringe on the country’s autonomy over its natural resources or national health data.
“The government’s move to delay is prudent,” Phiri said. “It sends a message that Zambia will accept aid only on terms that benefit its people first, not just foreign interests.”
With HIV and malaria still major public health concerns and health systems stretched thin, experts caution that any delay in funding could have immediate consequences on treatment access and disease prevention efforts.
