How Zambia’s Mining Wealth is Shaping Foreign Diplomacy
The US is facing controversy over a health financing agreement with Zambia valued at more than US$1bn, which suggests the country may face harsher terms than 16 other African nations in return for access to critical minerals.
A leaked draft memorandum of understanding (MOU) obtained by The Guardian suggests Zambia might accept conditions far more severe than previous US health deals across Africa.
The five-year agreement would require Zambia to share health data with Washington for 10 years, which is reportedly significantly longer than other countries have negotiated, and links the entire health financing package to a separate arrangement that could grant US interests access to Zambia's lucrative mining sector.
The Trump administration is pursuing bilateral global health deals after dismantling most of the federal development agency USAID, channelling financing directly to governments while requiring increased investments from partner countries.
On 12 February, Zimbabwe halted its bilateral health talks with the US over concerns about sensitive health data sharing.
What the agreement entails
According to The Guardian, Washington is offering US$1.012bn in health funding in exchange for Lusaka hiring 40,000 new health workers and contributing an additional US$400m over five years while improving health sector performance. Zambia's 2026 health budget stands at roughly US$1.3bn.
If Zambia fails on any front, Washington could terminate the agreement and withdraw funds.
The Guardian also reports the MOU includes a clause terminating the entire process if agreement isn't reached by 1 April.
The Guardian reports civil society groups are demanding the removal of data-sharing requirements, particularly Zambia's commitment to provide Washington information on any new or emerging pathogens for the next 25 years – far exceeding other countries' commitments.
Links to mineral extraction
On 2 December, the US embassy in Zambia confirmed the health financing was contingent on "collaboration in the mining sector and clear business-sector reforms" improving US economic access.
According to Reuters, the deal specifically targets Zambia's status as Africa's second-largest copper producer, with US interest extending to cobalt, nickel, lithium, manganese, graphite and rare-earth elements.
On 15 February, Zambia's Health Minister Elijah Muchima denied health financing was linked to mining concessions.
"The conditions that are on that MOU relate to how the money will be utilised," he said on television. "If there are other external conditions attached, I am personally not part of that."
The Health Minister has since claimed he was later fired without explanation.
Declining aid with stricter conditions
The Guardian found that the US is offering Zambia less health aid than before. Washington committed US$367m to Zambia for HIV services alone in 2025; total 2026 health funding under the draft MOU is US$320m, covering disease surveillance and treatment of malaria, TB and HIV.
The outlet also discovered the overall US commitment of US$1.012bn over five years is lower than the US$1.5bn agreement Zambia's former Health Minister announced in November 2025.
Despite declining funding, Zambia must still improve performance targets – increasing HIV treatment enrolment and reducing maternal mortality – or risk losing US support.
The move appears aimed at countering China's decades-long dominance in Zambian mining and infrastructure while securing critical minerals essential for electric vehicles, semiconductors and defence technology.
With more than a third of Zambia's 2026 budget allocated to debt repayments, critics argue the country's fiscal vulnerability could provide leverage for the US to extract mining concessions in exchange for desperately needed health funding.