Zambia signed a five-year health financing agreement with the United States on Thursday, concluding months of intense negotiations. The finalized deal removes contentious clauses that would have required the African nation to share patient medical data and biological specimens with Washington, ending a public dispute over national sovereignty and privacy.
Zambia and US Share Costs of Health Package
The memorandum of understanding, signed at the Ministry of Finance and National Planning in Lusaka, covers the period from 2026 to 2030. While officials have described the total package as being worth roughly $3.6 billion, the exact distribution of costs remains a point of varying estimates. According to the Agence de Presse Africaine, the U.S. is set to contribute $1.516 billion, while the Zambian government provides $2.107 billion. The deal replaces a long-standing model of U.S.-led funding with a shift toward shared responsibility,
where American support is expected to decrease over the five-year term as Zambia expands its domestic health spending.
The finalized text explicitly excludes the controversial requirements that previously stalled the pact. As the MoU stands now, it completely has no reference to any specimen-sharing conditions. That appendix is completely dropped,
said Zambian Minister of Health Roma Chilengi, as reported by APAnews.
Activists Claim US Tied Funding to Mineral Access
Public opposition to the deal had centered on fears that the U.S. was using health aid to secure strategic interests. Activists and opposition politicians previously alleged that Washington was tying the funding to preferential access for American companies to Zambia’s reserves of copper and other critical minerals. In May, Foreign Minister Mulambo Haimbe called the data terms a violation of privacy and unconscionable,
and accused Washington of tying the package to minerals, a claim then-U.S. ambassador Michael Gonzales rejected as false. Zambian officials confirmed on Thursday that the health agreement contains no such provisions and that any discussions regarding mineral resources will be handled through separate negotiations.
Privacy concerns regarding the handling of sensitive health information were also addressed. The revised agreement limits information exchange to data strictly necessary for monitoring and evaluating the programs funded by the pact. The Ministry clarified that the deal does not permit the transfer of individual patient records.
Broader U.S. Health Strategy in Africa
The new arrangement aligns with the Trump administration’s America First Global Health Strategy,
which has pursued bilateral agreements across the continent following the dismantling of the U.S. Agency for International Development (USAID). The U.S. government maintains that these revised agreements are more aligned and effective
than previous donor-recipient models. Mich Coker, Chargé d’Affaires at the U.S. Embassy in Lusaka, stated that the partnership is also about shared security and prosperity, noting that infectious diseases know no borders.
However, the strategy has faced criticism. Human rights groups, including the Chapter One Foundation, had warned that earlier drafts of the agreement risked “signing away” citizens’ health data. HIV advocates, including the Treatment Advocacy and Literacy Campaign, previously demanded the text be published, fearing the flow of information would be one-sided. While the U.S. has signed data-sharing agreements with at least nine other African nations, countries such as Ghana and Zimbabwe have rejected similar conditions. The U.S. has stated that such data is intended to benefit medical treatments developed by non-government entities.
Zambia’s Domestic Health Challenges
The signing of the pact follows a tumultuous period for Zambia’s domestic health management. In 2025, the U.S. announced it was withdrawing $50 million in annual aid, citing “systemic theft” of donated medicines and medical supplies, an allegation the government disputed. Minister Chilengi noted that the new funding is earmarked for critical sectors, including the recruitment of 40,000 healthcare workers, epidemiological surveillance, and programs to combat HIV/AIDS, tuberculosis, and malaria. The partnership is intended to serve as a cornerstone for health security across Zambia’s 10 provinces and 116 districts.