Zambia rejects US aid deal tying health funding to mining access
Zambia has refused a proposed agreement with the United States that would link more than $1 billion in health funding to expanded access for US companies to the country’s mineral resources, drawing criticism from health advocates and lawmakers.
The draft deal, first reported by The Guardian, outlines a five year package worth $1.012 billion covering HIV, malaria, tuberculosis and disease surveillance. In return, Zambia would be required to hire 40,000 new health workers and commit an additional $400 million in domestic co investment.
However, the proposal represents a reduction in funding compared with previous levels. The United States allocated $367 million for HIV related services in Zambia in 2025 alone, while total health funding under the new agreement would fall to $320 million in 2026. Reports indicate the proposal cuts overall US health support to Zambia by more than half.
The agreement also includes strict conditions on data sharing, requiring Zambia to provide health data to Washington for 10 years and information on emerging pathogens for up to 25 years. These terms go beyond those agreed with other African countries. US officials have also linked the funding to cooperation in Zambia’s mining sector and broader business reforms.
Zambia has rejected the terms in their current form. The Ministry of Health said parts of the agreement do not align with national interests and called for revisions. President Hakainde Hichilema framed the dispute as an opportunity for Zambia to assert greater control over its economic decisions.
The country is Africa’s second largest copper producer and holds significant reserves of cobalt, lithium, nickel, manganese and rare earth elements, making it a strategic target for global resource competition.
Critics argue the deal uses humanitarian aid as leverage for economic access. Advocacy groups said the proposal prioritizes mining interests over public health needs, particularly for people living with HIV. US lawmakers also raised concerns, warning that such an approach risks treating African countries as sources of raw materials rather than equal partners.
Zambia’s stance reflects a broader pattern across the region. Zimbabwe suspended a $367 million health agreement in February over data sharing concerns, while Kenya’s High Court halted a $1.6 billion deal amid privacy challenges.
The draft memorandum sets an April 1 deadline for ratification, after which the United States could withdraw the offer. With more than a third of Zambia’s national budget allocated to debt repayment, civil society groups warn that financial pressure increases the country’s vulnerability in negotiations.
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