Zambia and the United States signed a five-year health financing agreement in Lusaka on Thursday, ending months of dispute over whether the southern African country was being asked to trade citizens' medical data and mineral access for aid. Under the memorandum of understanding, signed alongside a separate data-sharing deal, Washington will provide about $1.5 billion. Zambia is also contributing, and officials put the combined package for 2026 to 2030 at roughly $3.6 billion, though figures for the Zambian share have varied.
The money is meant to sustain HIV/Aids treatment and to fight tuberculosis and malaria. It also covers maternal and child health, vaccination, disease surveillance and wider health-system work, including recruiting community health workers. The US describes the arrangement as a shift from a donor-recipient model to shared responsibility, with American funding expected to fall as Zambia raises its domestic spending.
Two issues had stalled talks. A draft leaked earlier this year suggested Zambia would accept broader data-sharing terms than other African countries, including long-term access to pathogen information and biological specimens. Civil society groups such as the Chapter One Foundation warned the government risked "signing away" health data. Separately, reports that the funding was tied to preferential US access to Zambia's copper and other critical minerals drew criticism. In May, Foreign Minister Mulambo Haimbe called the data terms "unconscionable" and accused Washington of linking aid to minerals, a claim then-US ambassador Michael Gonzales rejected as false. A US embassy statement in December had, however, described the deal as requiring a counterpart in mining collaboration.
Health Minister Roma Chilengi said the clauses requiring specimens to be sent to the US have been removed, individual patient records will not be shared, and data exchange will be limited to monitoring and evaluating funded programmes. He said the health ministry had never seen any agreement referring to strategic minerals. The government says minerals will be negotiated separately, and talks continue. Relations were also strained after the US suspended some drug funding, alleging theft of donated medicines, which Lusaka disputed.
The deal is part of a wider US push for bilateral health agreements since President Donald Trump closed the US Agency for International Development (USAID), which he accused of wasteful spending. Kenya, Tanzania and Uganda have signed, while Ghana and Zimbabwe rejected deals over data and specimen-sharing conditions. Critics say the aid cuts have slowed the response to the current Ebola outbreak in the Democratic Republic of Congo; the US denies this and points to $270 million it has donated.
Why it matters: Zambia's health system still depends heavily on foreign aid, so the agreement secures significant funding. Yet the text will not be made public, and Chapter One Foundation director Josiah Kalala argues that without parliamentary scrutiny, the public can only speculate about commitments, including any clauses that could abruptly halt essential care.