Zimbabwe, Zambia now reject US health funding deal over data fears

Kenya has emerged as the pacesetter in a growing continental revolt against the terms of a major health financing deal with the United States, with Zimbabwe and Zambia now following suit by suspending or rejecting similar agreements over concerns about sovereignty and data sharing.

What was marketed by Washington as a return to the basics of global health assistance—emphasising shared responsibility and clearer rules—has hit a wall of resistance in Africa, where governments are increasingly scrutinising the fine print attached to billions of shillings in aid.

The new approach, which seeks to link health funding to access to strategic minerals and pathogen data, is facing its stiffest test in Africa.

In Zambia, negotiations on a health Memorandum of Understanding stalled after the US reportedly linked a billion-dollar grant to access to the country’s copper and cobalt reserves. The deal, scheduled for signing last December, hit a snag just four days before the ceremony.

“We want to leverage US assistance to bring about reforms that will unleash business investment that enhances US access to critical supply chains,” said Caleb Orr, US Assistant Secretary of State for Economic, Energy, and Business Affairs, announcing the proposed minerals-for-aid swap.

But Lusaka has since confirmed it is unhappy with the terms. The government has requested revisions to the MoU, which reportedly saw the US commitment drop from $1.5 billion (Sh193.5 billion) to $1.012 billion (Sh130.5 billion). A leaked draft also revealed demands for Zambia to share data on pandemic-potential pathogens for 25 years.

Further south, Harare has taken an even firmer stance. This week, it emerged that Zimbabwe’s President directly ordered a halt to negotiations on a $367 million (Sh47.3 billion) health deal.

In a leaked letter, Zimbabwe’s Secretary for Foreign Affairs, Albert Chimbindi, instructed officials to “discontinue any negotiations with the USA,” describing the proposed MOU as “clearly lopsided” and an affront to the nation’s sovereignty.

“Zimbabwe was being asked to share its biological resources and data over an extended period, with no corresponding guarantee of access to any medical innovations—such as vaccines, diagnostics, or treatments—that might result from that shared data,” explained Nick Mangwana, the government’s spokesman.

He added that accepting a bilateral arrangement that bypasses multilateral mechanisms would undermine the solidarity African nations have been advocating for on the global stage.

Back in Nairobi, the blueprint for these agreements remains locked in a legal battle. Kenya was the first African country to sign the new health cooperation framework with the US in October last year, a Sh322 billion deal involving $1.6 billion (Sh206 billion) from the US and Sh109 billion from Kenya.

However, the High Court suspended its implementation following a petition by lobby groups and Busia Senator Okiya Omtatah, who raised questions over the signing process, constitutionality, and data-sharing clauses.

While the US insists the matter is for Kenya to resolve, the stalemate is causing anxiety among health stakeholders who fear a disruption in services for HIV, TB, and malaria once a temporary bridge funding mechanism expires next month.

Chargé d’Affaires at the United States Embassy in Kenya Susan Burns maintained that the decision lies with Kenyans.

“It is up to Kenyans to decide whether they want this funding and how they want it implemented,” Burns said in Nyeri.

The delay has split opinion among Kenyan health stakeholders.

Kristine Yakhama, a representative of TB Women Kenya, noted that while core services have not yet been affected, the legal pause threatens future planning. “The delay affects planning for HIV and other health services in the meantime,” she said.

Health economist Beatrice Kairu defended the judicial intervention, arguing it affirms constitutional governance. “Policy certainty comes from strong processes, whereas weak processes create expensive policy failures,” Dr Kairu said.

But Nelson Otwoma, Executive Director of the National Empowerment Network of People Living with HIV/Aids in Kenya, criticised the legal challenge, warning of potential medicine stock-outs. “For 20 years, the American government has funded Kenyan health programmes through Pepfar, USAID, and there have never been any breaches,” Otwoma said. He questioned why litigants would block what is coming without considering an alternative funding arrangement for HIV.