Washington tells Zambia: open mineral sector or risk HIV funding for 1.3 million people
The United States has told Zambia to grant American firms preferential access to its mineral resources or risk losing funding that supports HIV treatment for about 1.3 million people, according to a report by the New York Times. The deadline given was April 30, 2026.
A draft memo prepared for US Secretary of State, Mr Marco Rubio, by the State Department’s Africa Bureau set out the position. It said Washington would only secure its interests by showing a readiness to withdraw support from Zambia on a large scale. The New York Times reported that the document outlines how the threat was structured.
Zambia’s copper, cobalt and lithium deposits are central to the demand. US aid currently supports antiretroviral treatment for more than one million people in the country. These medicines suppress the HIV virus and allow patients to live longer. A withdrawal of funding could put many lives at risk.
The financial offer under discussion is lower than previous support. The United States is proposing $320 million for all health programmes in Zambia in 2026, compared with $367 million provided last year for HIV programmes alone. The proposed funding is also expected to decline in the coming years. Reports say Washington is considering cuts as early as May if Zambia does not accept the terms.
The development comes at a time when several African countries are questioning similar arrangements.
Ghana recently declined a bilateral health agreement with the United States after rejecting terms that required the sharing of sensitive health data. The government of President John Dramani Mahama took that position before an April 24, 2026 deadline set for the talks.
The proposed agreement, which discussions began on in November last year, would have provided $109 million in US health support to Ghana over five years. In 2024, the United States provided $219 million in assistance to Ghana, including $96 million for health.
A source familiar with the matter told the Daily Graphic that Ghana could not agree to share sensitive health data of its citizens with a foreign country. The US State Department declined to give details, stating only that it continues to explore ways to strengthen ties with Ghana.
Other countries have taken different positions. Zimbabwe rejected a $350 million health deal with the United States over funding concerns. In Kenya, a similar agreement has been put on hold by a court after a legal challenge by a consumer group. Zambia had earlier stepped back from talks in late 2025 over the conditions attached. At least five African countries have signed related agreements, pointing to a mixed response across the continent.
African countries have relied on US support for health services over the years. In 2024, total US assistance to Africa stood at $5.4 billion, much of it directed at health, humanitarian and disaster response programmes. The Trump administration began reducing this support in January 2025 and moved to shut down the US Agency for International Development.
Estimates indicate that the cuts have been linked to rising deaths from preventable diseases such as HIV and tuberculosis.
The policy aligns with President Donald Trump’s America First approach, under which foreign aid is tied to US national interests.
South Africa has also faced the impact of strained relations with Washington. The country has lost access to US health support following disagreements over its case against Israel at the International Criminal Court and over domestic policies criticised by the United States. The result has been disruption to HIV prevention programmes and research work between the two countries.
Zambia now faces a decision that could have wide implications, as other African countries watch closely how the situation unfolds.
