Amid the 0ngoing war between the U.S.-Israel and Iran, The New York Times have reported that President Donald Trump’s administration is considering a policy that could affect millions of people in Zambia.
The U.S. State Department is reportedly planning to withhold lifesaving assistance to people with Human Immunodeficiency Virus (HIV) in Zambia in an attempt to pressure the country into signing a new deal. In exchange for medical support, Zambia must sign the deal to give American companies more access to its valuable minerals, such as copper, lithium and cobalt.
Originally, the deal was proposed to Zambia in mid-2025, when the Trump administration offered more than $1 billion in U.S. funding to tackle health crises in the country, in exchange for mining access and data-sharing. However, this deal would have required around $340 million in co-financing from the Zambian government.
The United States said it would cut $50 million in annual aid to Zambia’s health sector because the government had failed to stop “systemic theft” of donated medicines and medical supplies.
US President Donald Trump’s administration is finalising a broader review of its foreign… pic.twitter.com/cZmDn8ohAU
— newsnote (@newsnoteSA) May 10, 2025
According to Reuters, the deal was pushed back and put on hold by Zambia, after revised drafts allegedly showed a problematic section. Therefore, even though the deal was due to be signed in November 2025, the country awaits making a decision.
Meanwhile, a copy of the draft memo prepared for Secretary of State Marco Rubio shows how the U.S. might be planning to “cut assistance” as early as May 2026 if Zambia does not agree to the terms.
“We will only secure our priorities by demonstrating willingness to publicly take support away from Zambia on a massive scale,” the memo read.
So far, the alleged memo and the possible decision have raised serious concerns as many people in Zambia rely on U.S. health programs. According to The New York Times, around 1.3 million people in the country depend on daily HIV treatment provided through the President’s Emergency Plan for AIDS Relief.
This program has been running for years in Zambia, alongside providing medicines for diseases like tuberculosis and malaria. Therefore, health experts and activists now worry that cutting this support could lead to a major public health crisis, especially since the Trump administration’s broad cut in foreign aid last year.
Now the State Department is asking several countries to sign new agreements to continue receiving support. This means, the countries will have to spend more of their own money on health care. So far, 24 countries have agreed to such deals, which together are worth about $20 billion over five years.
The Trump administration has proposed withholding lifesaving HIV assistance to Zambia to force the country to provide the U.S. access to critical minerals. pic.twitter.com/LUf3O1TIIS
— FactPost (@factpostnews) March 16, 2026
The U.S.’ deal with Zambia is different. As mentioned earlier, the United States plans to provide Zambia with $1 billion in health aid over five years. In return, Zambia would need to spend $340 million of its own money on health services.
However, this amount is less than what the country received before recent aid cuts. In addition to that, the U.S. also wants Zambia to allow more American companies to invest in and use its mineral resources.
The agreement also includes changes to an earlier deal with the Millennium Challenge Corporation. Signed in 2024, the original contract promised $458 million to support Zambia’s agriculture sector. However, the Trump administration wishes to focus less on agriculture and instead make regulatory changes to mining and other industries.
While Zambia has not officially responded to these proposals, the country has until May 2026 to decide whether it will agree to all three terms to receive a portion of health aid or decline the conditions.
