Zambia Finalizes Health Pact With U.S. Amid Data Privacy Concerns

Zambia has signed a five-year health financing agreement with the United States, concluding months of public disagreements concerning the potential trading of citizens' medical data and mineral rights for aid. The memorandum of understanding, accompanied by a data-sharing deal, was signed in Lusaka, with the U.S. committing to provide approximately $1.5 billion.

Earlier discussions were marked by criticism from civil society groups regarding a leaked draft that they argued allowed excessive data sharing. Activists also raised concerns, fueled by reports linking health funding to preferential access for U.S. companies to Zambian minerals, allegations that the then-U.S. ambassador denied.

The agreement follows the closure of the U.S. Agency for International Development (USAID) operations in Zambia, a move initiated after former President Donald Trump accused the agency of wasteful spending. Washington has since pursued similar agreements with several African nations, advocating for partner governments to assume greater financial responsibility.

Zambia's newly revised deal incorporates amendments to address concerns about privacy, intellectual property, and benefit-sharing. According to Health Minister Roma Chilengi, clauses requiring Zambia to send biological specimens to the U.S. have been removed, and the agreement will not permit the sharing of individual patient records. Data exchange will be confined to information necessary for program monitoring and evaluation.

A prior leaked draft had prompted warnings from civil society groups that Zambia might accept broader data-sharing terms than other African countries, including long-term access to pathogen information and specimens. The human rights group Chapter One Foundation expressed concerns that the government risked "signing away" citizens' health data, while HIV advocates demanded the text's publication, citing concerns about one-way information flow.

Opposition figures and activists had also pointed to reports suggesting a connection between health funds and preferential access for U.S. companies to Zambia's mineral reserves. In May, Foreign Minister Mulambo Haimbe described the data terms as a violation of privacy and "unconscionable," accusing Washington of linking the package to minerals. At the time, then-U.S. ambassador Michael Gonzales refuted these claims.

The dispute was further complicated by a prior suspension of U.S. drug funding, which the embassy attributed to alleged theft of donated medicines—a claim the Zambian government disputed.

The new agreement replaces years of support that largely flowed through U.S. programs. The funding is allocated for HIV/Aids, tuberculosis, malaria, maternal and child health, disease surveillance, and broader health system strengthening, including the recruitment of community health workers. U.S. officials have characterized the arrangement as a transition from a donor-recipient model to one of shared responsibility, with U.S. contributions projected to decrease over the five years as Zambia increases its domestic health spending.

Officials have estimated the combined package for 2026 to 2030 at roughly $3.6 billion, although figures for Zambia's contribution have varied. Following his return to office, Trump ordered the closure of USAID, impacting health programs in some African countries dependent on U.S. funding. Critics have argued that this decision has hindered responses to health crises, such as the Ebola outbreak in the Democratic Republic of Congo, due to the agency's crucial role in logistics and outreach.