Health: Zambia signs $1.5 billion deal with Washington, while Zimbabwe and Ghana refuse

Zambian Minister of Health, Roma Chilengi, announced on October 6, 2026, that his country would sign a $1.5 billion, five-year health agreement with the United States on October 8, following months of deadlock over the sharing of medical data, according to Reuters. Zambia will contribute $2.1 billion of its own funds, the minister specified.

The breakthrough is due to two concessions. According to Reuters, information sharing is now limited to data necessary for the monitoring and evaluation of programs funded by Washington. Most importantly, a clause that required Lusaka to hand over medical samples from Zambian patients to the United States upon request was removed from the text.

The question of minerals remains. Earlier in the year, Washington had sought to link its health support to access to Zambian critical minerals, which had initially led Lusaka to reject the offer. Roma Chilengi asserts that the signed agreement does not mention minerals and says he is unaware of any separate negotiation on the subject.

Harare and Accra say no

Zimbabwe, for its part, has refused a $367 million package. According to the Zimbabwean newspaper New Zimbabwe, Harare deemed the conditions unbalanced and contrary to its sovereignty: the United States had reportedly requested unrestricted access to epidemiological data and biological samples from citizens for research and commercial purposes. Ghana issued the same refusal, also according to New Zimbabwe, while Kenya, Tanzania, and Uganda have signed.

The price of this refusal is immediate. U.S. bilateral health funding for Zimbabwe was set to end at the end of September 2026, just before the malaria season. Without a replacement, researchers cited by New Zimbabwe fear more than 75,000 new HIV infections in the country within a year.

Three countries, three decisions, and the same question posed to the continent: what is the value of aid that is paid for in health data and blood samples from one's own citizens? Zambia managed to rewrite the most intrusive clause before signing, proof that negotiation was not a lost cause from the start. Zimbabwe preferred to protect its patients at the risk of losing its treatment stocks.

Both gambles will be judged on the ground, in the clinics: in Lusaka, on the actual implementation of the agreement and its safeguards, and in Harare, on the state's ability to self-fund HIV and malaria programs that have long been supported by donors.