In a diplomatic standoff highlighting the new practices of the Trump administration in international aid, Zambia has just refused to sign a memorandum of understanding (MOU) with the United States for over a billion dollars in health funding, stating that certain clauses of the agreement do not serve its national interests.

The agreement in question was supposed to cover funding for essential programs to combat HIV/AIDS, malaria, tuberculosis, as well as epidemic preparedness, maternal and child health over a period of five years. This funding is vital for a country where American aid recently represented 367 million dollars per year for HIV services alone.

But behind this discourse lie demands that Lusaka deems unacceptable. According to a draft of the agreement cited on Thursday, February 26 by Reuters, Washington conditions the disbursement of this aid on concessions in the mining sector and economic reforms favoring American commercial interests in Zambia, the second largest copper producer in Africa behind the DRC, and rich in cobalt, lithium, nickel, and rare earth minerals.

Beyond the mining issue, Zambian civil society is sounding the alarm on another controversial provision: a 10-year agreement to share health data. “This data sharing will be one-way, from Zambia to the United States, and will only benefit the latter,” says Owen Mulenga of the International AIDS Society, as cited by the media. “It’s as if our government is signing away the right to access health data of its citizens to another country,” adds Josiah Kalala, director of the Chapter One Foundation.

Civil society is demanding the total removal of data sharing clauses, as well as a seat on the steering committee overseeing the agreement.

In December 2025, the US embassy in Zambia officially confirmed that health funding was conditioned on “collaboration in the mining sector and economic reforms favoring American access.” Caleb Orr, a senior official at the State Department responsible for energy and business development, had traveled to Lusaka to convey this directly to President Hakainde Hichilema.

Some describe this system of mining concessions in exchange for humanitarian aid as “unprecedented” and “unprecedented in the history of the State Department.” “These conditions are infinitely worse than those negotiated by other countries. The United States is conditioning vital health services on the plundering of the country’s mineral wealth. It’s shameless exploitation,” says Asia Russell, executive director of the Health GAP NGO.

Zambia’s Ministry of Health has acknowledged that some sections of the draft agreement “do not align with the government’s position and interests” and has requested revisions. The institution also officially states that the agreement “has no relation to minerals, mines, or any natural resources.”

Zambia’s rejection comes in a broader continental context. On the same day, Zimbabwe backed out of a similar $367 million agreement, citing concerns about sensitive data sharing and the unequal nature of the arrangement. In Kenya, a $1.6 billion agreement has been suspended since December 2025 following a court decision.

On the other hand, Nigeria, Uganda, and Burkina Faso have already signed their own MOUs with Washington. Negotiations are still ongoing, with a deadline set for April 1, 2026.

Since Donald Trump’s return to the White House, the administration has dismantled USAID, frozen billions of dollars in foreign aid, and embarked on a complete overhaul of global health strategy. The new “America First” approach systematically links health funding to economic and commercial agreements favorable to American interests, including access to markets, data, and/or natural resources.