PREVIEW
Activists in Lusaka and Harare oppose the US terms on offer and the pressure for access to minerals
The US State Department agreed a dozen bilateral deals with African states in December, featuring US funding commitments of over US$5 billion as part of its ‘America First global health’ programme (AC Vol 66 No 25, Trump’s USAID 2.0 takes shape). The latest signatories include Captain Ibrahim Traore’s self-styled radical nationalist regime in Burkina Faso which is now seeking security help from Washington having lost control of more than two-thirds of the country to jihadist insurgents.
But Zambia and Zimbabwe are pushing back against what their healthcare activists say are exploitative terms, linking pharmaceutical packages, access to personal data and critical minerals. On 25 February, the US announced that it was scrapping a planned five year $367 million funding deal after Zimbabwe’s President Emmerson Mnangagwa said that he would seek to re-negotiate the terms.
Mnangagwa complained that Washington wanted unfettered access to Zimbabwean health data but without any guarantees that it would offer privileged access to new vaccines or treatments based on the data. ‘In essence, our nation would provide the raw materials for scientific discovery without any assurance that the end products would be accessible to our people should a future health crisis emerge,’ Mnangagwa said.
The complaints about patient data access are not unique to Zimbabwe. In Kenya, implementation of a $1.6bn funding deal has been put on hold while the High Court considers a petition challenging the legality of the data sharing (Dispatches 8/12/25, Ruto moves adeptly to shore up ties with Washington).
A leaked draft of the agreement between Washington and Lusaka indicated that the US’s promise of $1.012bn in health funding requires President Hakainde Hichilema’s government to hire 40,000 new health workers and contribute an additional $400m in health services over five years. Failure to hit these targets would give the US permission to terminate the agreement.
Zambian officials have also expressed concern that the health funding was tied to US firms obtaining mining contracts. The Trump administration has made no secret of its wish to make its development spending far more transactional, particularly in promoting private medicine and Christian-linked foundations and in giving US firms access to African patient data.
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