Zambia and the United States have concluded a five-year healthcare financing agreement worth approximately $1.5 billion, following months of controversy over concerns about patient confidentiality and access to the country’s mineral resources.
The memorandum of understanding, signed in Lusaka on Thursday alongside a separate data-sharing arrangement, will see both nations contribute towards healthcare programmes between 2026 and 2030.
The agreement follows widespread criticism of an earlier leaked proposal, which rights organisations feared could expose sensitive medical information and grant American businesses preferential access to Zambia’s copper and other valuable minerals.
Health Minister Roma Chilengi said amendments had been made to address the concerns, including the removal of provisions requiring the transfer of biological samples to the US.
He maintained that individual patients’ medical records would remain protected, with information exchanges restricted to monitoring projects financed under the arrangement.
Civil society organisations, including the Chapter One Foundation and the Treatment Advocacy and Literacy Campaign, had previously challenged the proposed conditions, demanding greater transparency and safeguards against the misuse of citizens’ health information.
In May, Foreign Minister Mulambo Haimbe described the original data provisions as unacceptable and accused Washington of linking financial assistance to mineral interests.
Former US ambassador Michael Gonzales dismissed the allegations.
Tensions also increased following Washington’s suspension of certain pharmaceutical funding after allegations that donated medicines had been stolen, a claim disputed by Zambian authorities.
The latest arrangement is intended to finance programmes addressing HIV/AIDS, tuberculosis, malaria, maternal and child healthcare, disease monitoring and the recruitment of community health personnel.
Officials estimate the overall package, including Zambia’s contribution, will amount to approximately $3.6 billion over five years, although estimates of the country’s financial commitment have differed.
The agreement forms part of Washington’s revised approach to international assistance after President Donald Trump ordered the closure of the United States Agency for International Development (USAID) in 2025, arguing that the institution wasted public funds.
Under the new policy, African governments are expected to assume a greater share of healthcare costs as American contributions gradually decrease.
Kenya, Tanzania and Uganda have accepted similar arrangements, while Ghana and Zimbabwe have declined proposals over concerns about biological samples and information-sharing requirements.
The withdrawal of USAID funding has also raised concerns about the capacity of African countries to respond to public health emergencies.
Critics argue that reduced American support has weakened disease surveillance and logistical operations during the ongoing Ebola outbreak in the Democratic Republic of Congo.
Washington, however, maintains that its revised funding model improves coordination and efficiency, citing $270 million allocated towards combating the epidemic.
By: Magdalene Agyeiwaa Sarpong