LUSAKA – The United States is considering withholding critical HIV/AIDS assistance to Zambia as part of a broader strategy to secure greater access to the country’s vast mineral resources, according to a draft State Department memo.
The document, prepared for Secretary of State Marco Rubio, outlines a plan to increase pressure on the Zambian government by potentially scaling back health support “on a massive scale” if negotiations over a new bilateral agreement fail.
According to a report by The New York Times, the memo states: “We will only secure our priorities by demonstrating willingness to publicly take support away from Zambia on a massive scale.”
Zambia is one of the largest beneficiaries of the United States’ HIV/AIDS programme, the President’s Emergency Plan for AIDS Relief (PEPFAR), with approximately 1.3 million people relying on treatment funded through the initiative. The programme has been central to the country’s fight against HIV, tuberculosis and malaria for more than two decades.
The proposed agreement under negotiation goes beyond health funding. It includes provisions that would grant American companies increased access to Zambia’s critical minerals, including copper, lithium and cobalt—resources seen as essential to the global energy transition.
The draft proposal reportedly offers Zambia about US$1 billion in health funding over five years, contingent on the government committing additional domestic spending and agreeing to broader economic and regulatory reforms. However, this would represent a significant reduction from previous levels of U.S. assistance.
The negotiations also include a potential restructuring of a separate development agreement with the Millennium Challenge Corporation, as well as governance reforms in Zambia’s mining sector.
The The New York Times report highlights growing frustration within the U.S. administration over delays in finalising the agreement, particularly as other countries have already signed similar deals tied to continued American support.
Zambian officials have so far declined to comment publicly on the negotiations.
Concerns have also been raised by civil society groups regarding provisions in the draft deal that could require Zambia to share sensitive health data and biological samples with the United States for extended periods.
Meanwhile, uncertainty surrounding the future of U.S. funding has sparked anxiety among people living with HIV in Zambia, many of whom depend on daily medication supplied through American assistance programmes.
Health advocates warn that any abrupt reduction in support could have severe consequences for the country’s public health system, which still relies heavily on external funding despite gradual efforts by the government to assume greater responsibility.
The outcome of the negotiations, expected in the coming months, is likely to have far-reaching implications for both Zambia’s healthcare system and its role in the global minerals supply chain.
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