Zambia Delays U.S. Health Deal Over "National Interest" Concerns

Zambia’s decision to seek revisions to a major U.S. global health financing package highlights a widening negotiation gap, with the agreement, valued at more than $1 billion over five years, governs U.S. funding for HIV, malaria, maternal and child health, and outbreak preparedness.

Lusaka confirmed that it objected to provisions in revised drafts, delaying a signing initially scheduled for November.

According to a draft reviewed by Reuters, the framework also requires approximately $340 million in Zambian co-financing over the same five-year period.

A Ministry of Health spokesperson said the delay followed the inclusion of a section that “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 government declined to detail the disputed language.

The friction comes amid broader policy signals from Washington. In December, the United States referenced 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.”

Zambia is Africa’s second-largest copper producer after the Democratic Republic of Congo and holds reserves of cobalt, nickel, manganese, graphite, lithium, and rare-earth elements.

Lusaka rejected any linkage between health financing and mineral access, stating the agreement “has no relation whatsoever to minerals, mining, or any natural resources.”

The draft agreement outlines termination mechanisms tied to a proposed “bilateral compact.” Funding would be discontinued if Zambia and the U.S. fail to agree by April 1 on the compact put forward by Secretary of State Marco Rubio to President Hakainde Hichilema on November 17, 2025.

Three sources told Reuters that the compact was connected to mining collaboration. The U.S. State Department declined to disclose details of ongoing negotiations, while reiterating Rubio’s long held position that foreign assistance is designed to advance U.S. national interests.

Health advocates raised parallel concerns over a 10-year data-sharing clause in the draft. Owen Mulenga of the Treatment, Advocacy and Literacy Campaign said, “The data sharing will be one way from Zambia to the U.S. and the information will benefit the U.S.” He added, “We need support from the U.S. but there should be transparency.”

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.

Executive Director of Health GAP Asia Russell

Zimbabwe withdrew from a $367 million arrangement on Wednesday, citing privacy and data concerns. Kenya’s more than $1.6 billion agreement remains suspended pending legal proceedings. Nigeria and Uganda, by contrast, have signed comparable deals.

For Zambia, the immediate priority remains safeguarding the continuity of disease-control and health-system programs while negotiating terms “fully aligned with Zambia’s national interests,” as officials framed it.