Zambia signs US health deal after disputes over data-sharing
Zambia has entered into a five-year health financing agreement with the United States, bringing an end to months of controversy over allegations that the country could be exchanging citizens’ medical data and mineral interests for healthcare funding.
The memorandum of understanding was signed in Lusaka on Thursday alongside a separate data-sharing agreement. Under the arrangement, the US is expected to provide about $1.5 billion (£1.1 billion), with Zambia also making a financial contribution.
The agreement follows criticism from civil society organisations over an earlier leaked draft, which they said gave the US extensive access to health data. Activists also raised concerns over reports that the funding could be tied to preferential access to Zambia’s mineral resources by US companies. The then-US ambassador rejected those claims.
The deal comes after the US government dismantled the US Agency for International Development (USAID), with President Donald Trump accusing the agency of wasteful spending. Since then, Washington has negotiated similar health financing arrangements with several African countries, arguing that partner governments should assume a greater share of the financial burden.
Kenya, Tanzania and Uganda are among the countries that have signed such agreements, while Ghana and Zimbabwe have rejected proposed deals over concerns surrounding data and specimen sharing.
Zambian officials said the final agreement had been revised to address concerns relating to privacy, intellectual property and the sharing of benefits.
Health Minister Roma Chilengi said earlier this week that provisions requiring Zambia to provide biological specimens to the US had been removed. He also stressed that the agreement would not permit the transfer of individual patients’ medical records.
According to the minister, data exchanged under the arrangement will be restricted to information required to monitor and assess programmes financed through the agreement.
An earlier draft leaked this year had prompted civil society groups to warn that Zambia was accepting broader data-sharing provisions than other African nations, including potentially long-term access to information and specimens relating to pathogens.
The Chapter One Foundation, a human rights organisation, warned that the government risked compromising citizens’ health data. HIV advocacy groups, including the Treatment Advocacy and Literacy Campaign, argued that the proposed arrangement would create a one-way flow of information and called for the agreement to be made public.
Opposition politicians and activists also questioned reports that US health funding was being connected to preferential access for American companies to Zambia’s copper and other critical minerals.
In May, Foreign Minister Mulambo Haimbe described the proposed data provisions as a breach of privacy and “unconscionable”, while alleging that Washington was linking the health package to mineral interests. Former US ambassador Michael Gonzales dismissed the allegations as false.
Tensions were further heightened after the US previously suspended some drug funding following allegations from the US embassy that donated medicines had been stolen. The Zambian government disputed the allegations.
The new agreement replaces healthcare support that had largely been channelled through US-funded programmes for years. The funding will cover areas including HIV/AIDS, tuberculosis, malaria, maternal and child health, disease surveillance and broader health-system strengthening, including the recruitment of community health workers.
The US has described the agreement as a move away from the traditional donor-recipient model towards greater shared responsibility. American funding is expected to gradually decrease over the five-year period as Zambia increases its domestic contribution.
Officials estimate that the combined funding package for 2026 to 2030 will be about $3.6 billion, although estimates of Zambia’s contribution have varied.
Trump ordered the closure of USAID shortly after returning to office in January 2025, a decision that severely disrupted health programmes in several African countries that had depended on US support.
Critics have argued that the reduction in American assistance has affected the speed of efforts to detect and respond to the ongoing Ebola outbreak in the Democratic Republic of Congo, stressing that USAID had played an important role in logistics, supplies and community outreach.
The US government has rejected those criticisms, saying its new approach is more targeted and effective. Washington has also pointed to the $270 million it has provided towards the response to the Ebola outbreak.
Source: BBC
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