Zambia has blocked a proposed U.S. health funding deal exceeding $1 billion, citing provisions in the draft that conflict with the nation’s interests.
The proposed U.S. health funding, valued at over $1 billion for the next five years, was intended to combat HIV/AIDS and malaria, improve maternal and child health services, and bolster epidemic preparedness in Zambia.
A draft shows that Zambia would also need to contribute roughly $340 million in co-financing, representing a significant domestic expenditure amid ongoing fiscal challenges.
Originally scheduled for completion in November 2025, the agreement stalled after revisions introduced a controversial clause. Sources indicate the draft included language stating that funding could be withdrawn if Zambia and the U.S. failed to agree on a “bilateral compact” by April 1.
The compact, apparently linked to a mining partnership, raised concerns that critical health financing might be tied to access to Zambia’s strategic mineral resources. This is particularly sensitive for a copper-rich nation increasingly central to global critical mineral supply chains.
Owen Mulenga, an officer at the Treatment, Advocacy and Literacy Campaign, stressed the need for transparency. He noted that the government has avoided addressing concerns from activists about potential links between the health deal and mining interests.
Asia Russell, executive director of Health GAP, warned that the arrangement could divert U.S. funding away from vital health programs, prioritizing mining corporations over the needs of Zambians living with HIV.
President Hakainde Hichilema has urged Zambia to reduce dependence on foreign aid, calling recent reductions “long overdue” and framing them as an opportunity for the country to manage its own affairs, despite the obvious risks.
In 2025, the United States provided about $598 million to Zambia’s health sector, accounting for nearly one-third of the national health budget, largely supporting HIV/AIDS treatment and maternal health initiatives. Earlier cuts of $50 million followed reports of stolen and resold medical supplies, tightening the funding environment.
Zambia’s caution reflects a broader trend across Africa, where governments are re-evaluating the conditions attached to international aid. Zimbabwe recently withdrew from a $350 million U.S. health agreement, citing sovereignty concerns, particularly over long-term access to national health data.
In contrast, Burkina Faso signed a $147 million health deal with the U.S., combining humanitarian support with strategic objectives, including $107 million in domestic co-financing and investments in digitization and laboratory capacity, highlighting the growing role of co-financing in modern aid arrangements.