Zambia signs US health deal after disputes over data-sharing
The US will provide $1.5bn (£1.1bn) under the deal that was negotiated after Trump cut USAID funding.
Zambia has entered into a five-year health financing agreement with the US, bringing an end to months of public argument over claims that the country was exchanging citizens’ medical data and mineral rights for aid.
The memorandum of understanding, signed in Lusaka on Thursday together with a data-sharing agreement, will see the US provide about $1.5bn (£1.1bn), with Zambia also making a contribution.
Civil society organisations had criticised a leaked draft, saying it permitted excessive data sharing, while activists highlighted reports that health funding was being tied to preferential access for US companies to minerals. The then-US ambassador denied that claim.
The agreement follows cuts to the US Agency for International Development (USAID).
US President Donald Trump had accused USAID of wasteful spending. After shutting the agency last year, Washington has sought similar arrangements with several African countries, saying partner governments should shoulder more of the cost.
Kenya, Tanzania and Uganda are among the countries that have signed. Ghana and Zimbabwe have refused agreements because of conditions on sharing data and specimens.
Officials say the revised wording of Zambia’s new deal deals with concerns about privacy, intellectual property and benefit-sharing.
Health Minister Roma Chilengi said earlier this week that provisions requiring Zambia to send biological specimens to the US had been removed, and that the deal would not permit the sharing of individual patient records.
He said data exchange would be restricted to information needed to monitor and evaluate programmes funded under the agreement.
A draft leaked earlier this year led civil society groups to warn that Zambia was accepting broader data-sharing terms than other African countries, including long-term access to pathogen information and specimens.
The Chapter One Foundation, a human rights organisation, said the government risked “signing away” citizens’ health data. HIV campaigners, including the Treatment Advocacy and Literacy Campaign, said the flow of information would be one-way and called for the text to be published.
Opposition figures and activists also focused on reports that health funding was being linked to preferential access for US companies to Zambia’s large reserves of copper and other critical minerals.
In May, Foreign Minister Mulambo Haimbe described the data terms as a privacy violation and “unconscionable”, and accused Washington of linking the package to minerals. Michael Gonzales, then-US ambassador, rejected that version of events as false.
The dispute was intensified by an earlier US suspension of drug funding after the embassy alleged theft of donated medicines, an accusation the government denied.
Zambia’s new agreement replaces support that for years had flowed largely through US programmes. The funding is meant to support HIV/Aids, tuberculosis, malaria, maternal and child health, disease surveillance and broader health system work, including the hiring of community health workers.
The US has presented the arrangement as a move away from a donor-recipient model toward shared responsibility, with US funding expected to fall over the five years as Zambia raises domestic spending.
Officials have valued the combined package covering 2026 to 2030 at about $3.6bn, although figures for Zambia’s contribution have differed.
Soon after beginning his second term in January 2025, Trump ordered USAID to be closed, effectively devastating health programmes in some African countries that depended on American funding.
Critics say the decision has affected how quickly the current Ebola outbreak in the Democratic Republic of Congo is detected and the scale of the response, stressing that the humanitarian agency was vital for logistics, supplies and local outreach.
The US says its cuts have not damaged efforts, arguing that they are more “aligned and effective” under the new arrangement and pointing to the $270m it has donated to fight the epidemic.