Zambia signs five-year, $3.6bn US health deal after removing specimen-sharing clauses

Left · 1Zambia's Health Minister, Roma Chilengi, announced on 6 October that Zambia would sign a revised health agreement with the United States without the clauses committing it to share patient health data and specimens with the US government. 1 Centre · 1The BBC reported that the five-year health financing agreement was signed in Lusaka on Thursday 8 October, as a memorandum of understanding together with a data-sharing deal. 2 Mixed · 2Chilengi put the total value at $3.6 billion in combined US and Zambian funding. He did not say how much the US would commit, but told state broadcaster ZNBC the US would provide $1.5 billion over five years. The BBC says officials put the combined 2026–2030 package at roughly $3.6bn, though figures for Zambia's share have varied. 1 2

Mixed · 2Chilengi said the agreement had no reference to specimen-sharing conditions, that clauses on sharing individual health data had been "completely removed", and that "Zambia will not be obliged to share any specimen". The BBC adds that data exchange would be limited to information needed to monitor and evaluate programmes funded under the deal. 1 2 Centre · 1The money is meant to support HIV/Aids, tuberculosis, malaria, maternal and child health, disease surveillance and wider health system work, including recruiting community health workers. The US describes it as a shift from a donor-recipient model to shared responsibility, with US funding expected to fall over the five years as Zambia raises domestic spending. 2 Mixed · 2The deal is part of the Trump administration's bilateral approach after it dismantled USAID. The US has signed new health agreements with around two dozen African nations since last year; according to the AP, the data clauses have been among the most controversial. 1 2

Left · 1Under agreements published by the US State Department, at least nine African nations must send data and specimens within five days of a request. The US can pass these to up to 10 unspecified American non-government entities to develop diagnostics and treatments. The agreements do not guarantee that the supplying country would benefit, and it would have to pay for any treatments. 1 Mixed · 2Other countries took different paths. Kenya, Tanzania and Uganda have signed, while Zimbabwe and Ghana rejected agreements over data and specimen conditions. The AP reports that the US ended all health assistance to Zimbabwe last month and that Namibia, which also rejected some clauses, is losing HIV funding, though neither country publicly tied the decisions to the data dispute. 2 1 Centre · 1In Zambia the deal drew months of public dispute. A leaked draft led civil society groups, including the Chapter One Foundation and HIV advocates, to warn that Zambia was accepting wider data-sharing terms than other countries; activists and opposition figures also cited reports that health money was linked to US access to copper and other critical minerals. 2

Centre · 1In May, Foreign Minister Mulambo Haimbe called the data terms a violation of privacy and "unconscionable" and accused Washington of tying the package to minerals; then-US ambassador Michael Gonzales rejected that as false. The row was sharpened by an earlier US suspension of drug funding after the embassy alleged theft of donated medicines, which the government disputed. 2 Centre · 1The BBC reports that critics say the USAID closure slowed detection and response to the current Ebola outbreak in the Democratic Republic of Congo; the US denies its cuts caused harm and points to $270m it has donated. 2