A Zambian healthcare worker checks a malaria test in this file photo in Matongo village, April 23, 2008. REUTERS/Thierry Roge (ZAMBIA)
Zambia has gone months without meaningfully engaging with the United States over a landmark health aid agreement worth more than $1 billion, the outgoing American ambassador warned Thursday, as a key deadline passed with no deal in sight.
Michael Gonzales, who is preparing to leave his post in Lusaka, said Washington had encountered “effectively zero substantive engagement” from Zambian officials since January — with calls going unanswered and scheduled meetings cancelled — leaving negotiations on future health cooperation at a standstill.
“Instead of continuing to languish without engagement, the actual funding under our Health MOU should have started this month,” Gonzales said in remarks delivered Thursday evening.
The memorandum of understanding (MOU), which was initially expected to be signed in November, stalled after revised drafts were circulated and Zambia failed to respond to repeated outreach from Washington. The April 30 deadline has now passed without a deal, leaving more than $1 billion earmarked for HIV, malaria, maternal and child health, and disease preparedness programmes disbursed on a piecemeal basis, without a coherent implementation framework.
Under the terms of a draft reviewed by Reuters, the agreement would also require Zambia to contribute around $340 million in co-financing over the same period — a provision that may have added to Lusaka’s hesitation.
The impasse has drawn sharper attention given that Washington previously cut aid to Zambia over the theft of donated medicines, raising broader concerns about governance within the country’s health system. Health advocates have added to the tension by alleging that the new agreement ties funding to mining access and creates data-sharing risks — claims Gonzales forcefully dismissed, calling them “disgusting and patently false.” He denied that Washington was threatening to withhold life-saving healthcare support “unless we get critical minerals.”
Zambia’s presidential spokesperson Clayson Hamasaka responded by signalling a willingness to talk, but insisted that any discussions take place through official channels. “We appreciate the support we have received from the U.S. and other countries…If there are any concerns, we are open to dialogue but that should be done through laid down diplomatic channels,” he said.
Gonzales, for his part, sought to reassure Zambians that core programmes would not be abandoned, saying Washington would honour its commitment to providing antiretroviral drugs and preventing mother-to-child HIV transmission. However, he made clear that broader, large-scale assistance would be contingent on concrete reforms from Lusaka’s side.
Zambia has one of the highest HIV prevalence rates in sub-Saharan Africa, with approximately 1.5 million people living with the virus, making U.S. support through programmes such as PEPFAR critical to the country’s public health infrastructure.
By: Andrews Kwesi Yeboah