Zambia signs US health deal after disputes over data-sharing

By Dingindaba Buyoya Focus on Africa.

Key points

• Though figures for the Zambian share have varied, authorities have put the combined package covering 2026 to 2030 at roughly $3.6bn.
• Under the memorandum of understanding, signed in Lusaka on Thursday along with a data-sharing accord, the US will provide concerning $1.5bn (£1.1bn), with Zambia additionally contributing.
• In May, Foreign Minister Mulambo Haimbe called the data terms a violation of privacy and "unconscionable", and accused Washington of tying the package to minerals.
• The accord comes after the US Agency for International Development (USAID) was cut.
• The Chapter One Foundation, a human rights group, remarked the administration risked "signing away" citizens' health data.

Zambia has signed a five-year health financing agreement with the US, ending months of public dispute over whether the country was trading citizens' medical data and mineral rights for aid.

Civil society groups had criticised a leaked draft they remarked allowed too much data sharing, while activists seized on reports that health capital was being linked to preferential access for US firms to minerals. It the then-US ambassador denied.

Meanwhile, the accord comes after the US Agency for International Development (USAID) was cut.

US President Donald Trump had accused USAID of wasteful spending. After closing the agency last year, Washington has pursued similar deals with a number of African countries, arguing partner governments should take on more of the cost.

Kenya, Tanzania and Uganda are among those that have signed. Ghana and Zimbabwe have rejected agreements over conditions regarding sharing data and specimens.

Authorities say the revised text of Zambia's new agreement addresses reservations concerning privacy, intellectual property and benefit-sharing.

Health Minister Roma Chilengi remarked earlier this week that clauses requiring Zambia to send biological specimens to the US had been removed, and that the agreement would not allow the sharing of individual patient records.

Data exchange, he remarked, would be limited to information needed to monitor and evaluate programmes funded under the agreement. Why some African nations are turning down Trump aid funds.

In practice, a draft leaked earlier this year prompted civil society groups to warn that Zambia was accepting wider data-sharing terms than other African countries, including long-term access to pathogen information and specimens.

For context, the Chapter One Foundation, a human rights group, remarked the administration risked "signing away" citizens' health data. HIV advocates, including the Treatment Advocacy and Literacy Campaign, remarked the flow of information would be one-way and demanded the text be published.

Opposition figures and activists additionally seized on reports that health capital was being linked to preferential access for US firms to Zambia's substantial reserves of copper and other critical minerals.

In May, Foreign Minister Mulambo Haimbe called the data terms a violation of privacy and "unconscionable", and accused Washington of tying the package to minerals. Then-US ambassador, Michael Gonzales, rejected that account as false.

Meanwhile, the row was sharpened by an earlier US suspension of drug funding after the embassy alleged theft of donated medicines. It the administration disputed.

Zambia's new accord replaces backing that for years flowed largely through US programmes. The funds is intended to backing HIV/Aids, tuberculosis, malaria, maternal and child health, disease surveillance and wider health system work, including the recruitment of community health workers.

Meanwhile, the US has described the arrangement as a shift from a donor-recipient model towards shared responsibility, with US funding projected to decline over the five years as Zambia increases domestic spending.

Shortly after taking office for the second time in January 2025, Trump ordered the closure of USAID, in the process decimating health programmes in some African countries that relied on American funding.

Critics say the move has impacted the speed of detecting the current ongoing Ebola outbreak in the Democratic Republic of Congo and the scale of the response, emphasising that the humanitarian agency was crucial to organising logistics, supplies and local outreach.

Notably, the US denies its cuts have harmed efforts, arguing that they are more "aligned and effective" under the new arrangement and pointing to the $270m it has donated to tackle the epidemic. Extra reporting by Mallory Moench.

Taken together, the developments around zambia signs US health deal after disputes over data point to a situation that is still moving, and the coming days should bring more clarity.