Zambia signs revised US health accord without specimen-sharing clauses

Zambia and the United States signed a revised five-year health financing agreement in Lusaka on 8 October, after disputed provisions on sharing patient data and biological specimens were removed. The combined package is valued at about $3.6 billion for 2026 to 2030, with the United States providing about $1.5 billion, according to the BBC.¹

Revised terms

The revised agreement addresses concerns over privacy, intellectual property and benefit-sharing, according to the BBC. Data exchange is now confined to information required to monitor and evaluate programmes financed under the arrangement. The revised text also removed clauses that would have required Zambia to send biological specimens to the United States and prevents the sharing of individual patient records.¹

Roma Chilengi, Zambia's health minister, had said on 6 October that the revised document contained no specimen-sharing conditions. “Zambia will not be obliged to share any specimen,” he said. Chilengi told ZNBC that the US would contribute $1.5 billion over five years, while the overall package would total $3.6 billion with Zambian funding included.²

Dispute over earlier proposals

A leaked earlier draft had envisaged broader data-sharing, including long-term US access to pathogen information and specimens, according to the BBC. Human rights organisation Chapter One Foundation cautioned that the government could surrender control of citizens' health data. The Treatment Advocacy and Literacy Campaign argued that the planned information exchange would benefit only one side and urged release of the agreement's text.¹

Mulambo Haimbe, Zambia's foreign minister, described the data terms as a privacy violation in May and alleged that Washington had linked the health package to access to minerals. Michael Gonzales, then the US ambassador, rejected that account as “false”. The Washington Post reported that the administration abandoned disputed data-sharing and resource-access provisions before the agreement was signed.¹³

A wider bilateral approach

The US says the arrangement moves health assistance away from a donor-recipient structure and towards shared responsibility. Under that approach, US funding would fall during the five-year term as Zambia raises domestic health spending, the BBC reported. The Trump administration has pursued bilateral health agreements with African countries after closing the US Agency for International Development, according to the BBC and The Independent.¹²

Since the year before, the United States had reached bilateral health deals with roughly 24 African nations, The Independent reported. It also reported that at least nine countries had agreements requiring data and specimens to be provided within five days of a request, and that such material could be shared with up to 10 US non-government entities. Those terms were presented as supporting preparedness for infectious disease outbreaks, but the agreements did not assure provider countries access to treatments developed from the material, according to the report.²

Other governments have objected to similar proposed terms. Zimbabwe rejected a US health agreement in February partly over data and specimen-sharing requirements, while Namibia rejected some clauses, according to local media reports cited by The Independent. Ghana also rejected similar terms, the newspaper reported.²