{"id":302661,"date":"2026-02-26T06:03:12","date_gmt":"2026-02-26T06:03:12","guid":{"rendered":"https:\/\/www.newsbeep.com\/nz\/302661\/"},"modified":"2026-02-26T06:03:12","modified_gmt":"2026-02-26T06:03:12","slug":"us-accused-of-shameless-exploitation-over-proposed-zambian-health-aid-deal-global-health","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/nz\/302661\/","title":{"rendered":"US accused of \u2018shameless exploitation\u2019 over proposed Zambian health aid deal | Global health"},"content":{"rendered":"

The US has been accused of \u201cshameless exploitation\u201d over a health financing agreement with Zambia worth more than $1bn (\u00a3740m), amid warnings that the country is getting a raw deal from the Trump administration<\/a>.<\/p>\n

A leaked draft of a five-year memorandum of understanding (MOU) between the two countries, seen by the Guardian, reveals that Zambia may accept terms worse than health financing agreements the US has reached with 16 other African countries<\/a>.<\/p>\n

The terms include a commitment to give Washington access to its health data for 10 years \u2013 far longer than other countries have negotiated. Zambia\u2019s deal also predicates any health financing on an even more covert arrangement that could open up the country\u2019s mining industry to US interests.<\/p>\n

Asia Russell, director of the HIV advocacy organisation Health Gap, said: \u201cThese terms are vastly worse than other deals. [The US] is conditioning life-saving health services on plundering the mineral wealth of the country.<\/p>\n

\u201cIt\u2019s shameless exploitation, which is immoral. It\u2019s also dangerous \u2013 when health programmes are treated like a bargaining chip by a rapacious administration, everyone suffers,\u201d she said.<\/p>\n

The Trump administration is pursuing these bilateral global health deals<\/a> after dismantling most of the federal development agency, USAID<\/a>.<\/p>\n

The new strategy channels health financing directly to governments, rather than through aid organisations, while also requiring increased investments from partner countries.<\/p>\n

On Wednesday, Zimbabwe said it was halting its bilateral health agreement talks with the US over concerns about the sharing of sensitive health data.<\/p>\n

In Zambia\u2019s case, Washington is offering $1.012bn in health funding<\/a> in exchange for Lusaka\u2019s commitment to hire 40,000 new health workers and contribute an additional $400m in health services over five years, while improving the health sector\u2019s performance, according to the leaked draft. The country\u2019s 2026 budget for health services is roughly $1.3bn.<\/p>\n

If Zambia faltered on any of these fronts, Washington could terminate the agreement and withdraw its funds.<\/p>\n

Julius Kachidza, chair of Zambia\u2019s Civil Society Self-coordinating Mechanism<\/a>, supports much of what the MOU is trying to accomplish, such as improved services and increased domestic financing, but worries that if the country were to fall short of the set terms, then the entire health system would be put at risk.<\/p>\n

\u201cI\u2019m a person living with HIV,\u201d he said. \u201cIf the HIV programme in Zambia is distorted or it\u2019s disrupted or it\u2019s derailed, I\u2019ll be the first casualty, as well as hundreds of thousands of other people.\u201d<\/p>\n

People queue to access child health services during the World Aids Day commemorations in Lusaka in 2020. Photograph: Imago\/Alamy<\/p>\n

Civil society groups are pressing to amend the agreement. The MOU includes a clause that the entire process will be terminated if an agreement is not reached by 1 April.<\/p>\n

For advocates, their foremost demand is stripping out any data-sharing requirements from the deal.<\/p>\n

Josiah Kalala, director of the Chapter One Foundation, a human rights organisation, said: \u201cThis is essentially our Zambian government signing away the right to access health data of its citizens to another country.\u201d<\/p>\n

Zambia is also preparing to give Washington information on any new or emerging pathogens within its borders over the next 25 years.<\/p>\n

Other countries have committed to sharing data, but on less exacting terms. None of the publicly available MOUs include 25-year pledges to sharing pathogen data. Kenya limited sharing of its health data to seven years but is still facing a legal challenge<\/a>.<\/p>\n

Kachidza said Zambian activists would also consider going to court over the agreement.<\/p>\n

In early December, the US embassy in Zambia confirmed that the health financing agreement was contingent on \u201ccollaboration in the mining sector and clear business-sector reforms\u201d that would improve US economic access to the country.<\/p>\n

The MOU also commits the Zambian government to monthly briefings with the US embassy on trade and investment efforts between the two countries, with a goal \u201cof expanding US commercial investment in Zambia\u201d.<\/p>\n

Kachidza described the situation as like \u201cbeing held hostage\u201d.<\/p>\n

A US state department spokesperson declined to discuss details of the MOU, but wrote in a statement: \u201cThe administration believes that American foreign assistance must demonstrably advance American national interests and use taxpayers\u2019 dollars efficiently.\u201d<\/p>\n

On 15 February, Zambia\u2019s health minister, Elijah Muchima, denied that health financing was linked to mining concessions. \u201cThe conditions that are on that MOU relate to how the money will be utilised,\u201d he said on television.<\/p>\n

\u201cIf there are other external conditions attached, I am personally not part of that,\u201d he said. The Zambian president, Hakainde Hichilema, fired Muchima three days later without explanation.<\/p>\n

Former Zambian health minister Elijah Muchima, who was fired shortly after denying that health financing was linked to mining concessions. Photograph: Courtesy of Ministry of Health Zambia<\/p>\n

Activists fear Zambia is being set up to fail, though Oliver Kaonga, a Zambian health economist, said it might be possible for the government to meet the new funding obligations. However, Zambia\u2019s spending remains constrained, with more than a third of its 2026 budget being spent on debt repayments<\/a>. \u201cThe starting point would be about, \u2018can we mobilise resources better?\u2019\u201d he said.<\/p>\n

The US is offering Zambia less health aid under the MOU than before. Washington had committed $367m to Zambia for HIV services<\/a> alone last year. The total health funding for 2026 is $320m under the draft MOU, which would cover programmes such as disease surveillance and treatment of malaria, TB and HIV.<\/p>\n

The overall US commitment of $1.012bn over five years is lower than the $1.5bn agreement that Muchima announced in November 2025. The US state department, whose Bureau of Global Health Security and Diplomacy has been negotiating the agreements, did not respond to a Guardian request for clarification.<\/p>\n

As its funding declines, Zambia is still expected to improve against performance targets, such as increasing the number of people enrolled in HIV treatment and reducing maternal mortality, or risk losing US support.<\/p>\n

Kalala suspects the Zambian government is going ahead with the agreement despite the risks partly because of its \u201cmajor concern about the sudden loss of funding to the health sector and the political fallout that might cause\u201d.<\/p>\n

Zambia\u2019s Ministry of Health did not respond to requests for comment.<\/p>\n

In Zambia, civil society groups finally secured a meeting with the health ministry on 3 February. But the two-hour briefing only addressed some components of the MOU, while multiple participants said officials warned them against considering legal action around the data-sharing provisions. Officials refused to clarify whether the MOU funding was tied to economic concessions.<\/p>\n

Advocates have presented a list of demands, alongside the removal of data-sharing, including a seat on the steering committee that will monitor progress.<\/p>\n

Kalala is also spearheading an access-to-information request to make public the latest version of the MOU and the bilateral agreement.<\/p>\n

\u201cOnce we get sight of the agreement and the compact, we\u2019ll even be able to see if we can challenge the constitutionality of some of the provisions,\u201d he said. \u201cWe have to get it right at the beginning.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"The US has been accused of \u201cshameless exploitation\u201d over a health financing agreement with Zambia worth more than…\n","protected":false},"author":2,"featured_media":302662,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[134,527,111,139,69],"class_list":{"0":"post-302661","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-healthcare","8":"tag-health","9":"tag-healthcare","10":"tag-new-zealand","11":"tag-newzealand","12":"tag-nz"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/302661","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/comments?post=302661"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/302661\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media\/302662"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media?parent=302661"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/categories?post=302661"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/tags?post=302661"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}