Zambian officials have declined to move forward with a major health assistance agreement from the United States worth over $1 billion, stating Wednesday that portions of the deal conflict with their national priorities.
The comprehensive funding package was designed to address HIV, malaria, disease preparedness, and maternal health initiatives across a five-year period. Under the proposed terms, Zambia would have contributed approximately $340 million in matching funds during the same timeframe, according to draft documents obtained by Reuters.
Originally scheduled for completion in November, the agreement stalled when updated versions contained concerning provisions, according to a Zambian Health Ministry representative who spoke with Reuters Wednesday.
The problematic section “did not align with the position and interests of the government of Zambia… We have therefore requested further revisions to the content in question,” the official explained, though they would not specify the nature of the disputed content.
Last December, American officials announced they had reached “a plan that aims to unlock a substantial grant package of U.S. support in exchange for collaboration in the mining sector and clear business sector reforms” with Zambian leadership.
The African nation ranks as the continent’s second-largest copper producer behind the Democratic Republic of Congo, while also possessing significant deposits of cobalt, nickel, manganese, graphite, lithium and rare-earth materials.
When contacted this month, a State Department representative told Reuters via email that specific details of active diplomatic discussions would remain confidential. “Secretary [of State Marco] Rubio has consistently been clear that foreign assistance is not charity; it is designed to further the national interests of the United States,” the spokesperson stated.
Zambian authorities maintain the health agreement stands separate from resource extraction issues. “It has no relation whatsoever to minerals, mining, or any natural resources,” their spokesperson emphasized, adding they welcome productive discussions “but only within terms that are clear, mutually agreed upon, and fully aligned with Zambia’s national interests.”
Nevertheless, the draft documentation examined by Reuters indicates the arrangement would end and financial support would cease if both nations cannot reach consensus by April 1 regarding a “bilateral compact” that Secretary Rubio presented to Zambian President Hakainde Hichilema on November 17, 2025. Three informed sources confirmed this compact involves mining cooperation.
Public health organizations in both countries have raised objections to the proposed data-sharing components, which would extend for a decade, while expressing concern about the secretive nature of the discussions.
“The data sharing will be one way from Zambia to the U.S. and the information will benefit the U.S.,” explained Owen Mulenga, who works with the Treatment, Advocacy and Literacy Campaign, a local organization advocating for HIV/AIDS treatment access. “We need support from the U.S. but there should be transparency,” Mulenga told Reuters, noting widespread speculation about mining connections that government officials refuse to address with advocacy groups.
Asia Russell, who leads Health GAP, a worldwide HIV advocacy organization monitoring the negotiations, criticized the arrangement: “This deal would slash U.S. government funding to life-saving programs… while prioritizing the interests of mining corporations over the needs of Zambians with HIV.”
This development represents part of a broader shift in how the Trump administration structures international health assistance after dissolving its primary aid agency last year, reducing global funding and contracts, and implementing an “America First” approach to health diplomacy.
On the same day, Zimbabwe withdrew from its own $367 million agreement, citing data privacy issues and describing the terms as unfair. Kenya’s larger $1.6 billion arrangement with Washington remains on hold due to ongoing legal challenges, though Nigeria and Uganda have completed their agreements.
