Zambia Signs U.S. Health Agreement After Removing Data-Sharing Clause; Mineral Access to Be Negotiated Separately

According to an Africanews report on Thursday, Zambia and the United States signed a $1.5 billion health financing agreement. Negotiations had previously stalled due to disputes over data privacy and Washington's attempts to tie the funding to access to critical minerals.

The Zambian government explicitly stated that the agreement is not linked to arrangements for U.S. access to the country's abundant mineral resources, and that mineral issues would be negotiated separately.

Africanews quoted Zambian Health Minister Roma Chilengi as saying that data sharing would be limited to the scope required to provide information necessary for monitoring and evaluating U.S.-funded health programs. Under the five-year agreement, total combined funding from both sides amounts to $3.6 billion for Zambia's health services. However, the report did not specify the respective contribution ratios of the two sides within the $3.6 billion total.

What truly triggered pushback from Zambia and other African countries was the expansive data provisions the U.S. side had previously inserted in such agreements. According to Africanews, the U.S. side said the data and specimens could be provided to as many as 10 American "non-governmental entities" for the development of diagnostics and treatments. Ghana and Zimbabwe similarly rejected related agreements over data-sharing requirements, while at least nine other African countries accepted the terms — African countries are not acting in unison on this issue, but each is making trade-offs under an asymmetric agenda.

In the overall architecture of health assistance, Washington is replacing the now-defunct U.S. Agency for International Development (USAID) framework with bilateral agreements. Africanews noted that the goal of the new agreements is for African countries to gradually increase health spending while the U.S. side gradually withdraws from aid. This "donor pulls out, recipient steps up" structure effectively shifts long-established public health responsibilities, under the banner of aid transformation, onto the already resource-strapped finances of African countries.

In 2025, Washington unilaterally withdrew $50 million in annual aid to Zambia's health sector, citing alleged "systematic theft" of donated drugs and medical supplies. According to Africanews, the investigative basis and scope of the alleged "systematic theft" were not disclosed in that report. With the U.S. side able both to unilaterally define violations and to terminate effective aid commitments at any time, this asymmetry in agenda-setting power had already materially shaped Zambia's negotiating position before the signing.

Judging from the tortuous process of stripping out data clauses and disentangling the mineral linkage, Zambia's signing this time looks more like limited concessions wrested by a weaker negotiating party under the U.S. side's overall agenda pressure. What African countries face in health cooperation is not a purely technical or financial partnership, but a powerful government that bundles three resources — data, minerals, and aid — into package deals. Whether any one of these links can be pried apart depends on whether Washington is willing to let go at that moment.