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Zambia accused the United States of linking $2 billion in health assistance to access to Zambia’s critical minerals, escalating tensions over how Washington is reshaping foreign aid to Africa under President Donald Trump’s “America First” strategy. Zambia’s foreign affairs minister, Mulambo Haimbe, said the U.S. was effectively demanding more than health support as the two sides tried to finalize negotiations. He also criticized the outgoing U.S. ambassador, Michael Gonzales, for comments Zambia called improper and inconsistent with mutual respect.
In a statement on Monday, Haimbe described Gonzales’s allegations of Zambian corruption and negotiation inertia as “mischievous” and “deeply regrettable, undiplomatic and inconsistent with the spirit of mutual respect.” Haimbe said the U.S. was tying access to critical minerals to the conclusion of the health deal, after Gonzales dismissed what he called “alarmist allegations,” describing them as “disgusting” and “absolutely and patently false.”
The dispute follows months of talks that Zambia said have stalled. Haimbe said the sticking points included what he called “unacceptable” data-sharing demands, which he said violated Zambia’s citizens’ right to privacy. He also said the U.S. insisted on “preferential treatment” for U.S. companies over Zambia’s critical minerals, an arrangement Zambia rejected.
Zambia’s officials pointed to the broader diplomatic context, where U.S. engagement has shifted from earlier models of assistance. The U.S. approach replaces decades of engagement rooted in the now-dismantled United States Agency for International Development and the President’s Emergency Plan for AIDS Relief, or PEPFAR, according to the report. In place of that structure, U.S. officials are pursuing agreements negotiated country-by-country that recast aid as a transaction tied to conditions that can include commercial provisions, domestic financing commitments, and disease surveillance and pathogen-sharing requirements.
The U.S. says the goal of the shift is to reduce donor dependency, promote local ownership, and safeguard American interests, including in light of China’s role in Zambia and across Africa’s mineral trade. Critics, including some health experts, have argued that the data-sharing conditions would largely move in one direction, with countries contributing sensitive health and biological information while U.S. access expands.
Health GAP’s Asia Russell said the U.S. wants “to understand what’s actually happening,” but through a “very different way” after the U.S. withdrew from the World Health Organization in January. Russell said the U.S. is pursuing direct access because countries currently report disease outbreaks primarily through the WHO, which coordinates responses and negotiates frameworks on pathogen sharing and equitable access to vaccines. A separate criticism raised in the report is that U.S. demands could create a “parallel global health system” rather than reinforcing the multinational mechanisms designed to distribute innovations such as diagnostics and vaccines.
Jen Kates of KFF said U.S. efforts would still collect information, but she characterized the approach as distinct from earlier partnerships. She and other advocates warned that the agreements could risk unequal benefits, arguing that countries that share data and samples could remain behind in access to medical innovations. In the report, advocates pointed to past experience during the COVID-19 pandemic, when African countries contributed data and samples but were largely last in line for vaccines.
Critics also challenged the way negotiations were conducted, saying deals have been shaped through closed-door talks with limited public scrutiny. Russell said, “Secrecy is at the center of this. That puts accountability for results at risk,” adding that it is “impossible to evaluate these deals properly without seeing the full terms.” She also said transparency had been central to PEPFAR’s success, while she argued it has been “taken away” under the new framework described by the U.S.
The report said some agreements also include tighter financial conditions, with funding reduced compared with previous levels and requirements for countries to increase domestic health spending—while aid could be at risk if targets are not met. Kates characterized the conditions as difficult for countries already under strain, saying, “These are going to be very heavy lifts,” and pointing to how limited local capacity can affect compliance. Russell warned that the shift blurs the line between aid and transactional diplomacy, saying, “When health becomes a bargaining chip, everyone becomes less safe.”
Zambia’s latest comments arrived after Gonzales, in late April, accused Zambian leaders of letting the United States pay for health care while officials diverted government funds, and said Zambia ignored U.S. overtures. The U.S. Embassy did not immediately respond to a request for comment, according to the report.