Zambia and the United States signed a health cooperation agreement worth 2.49 billion dollars over five years on Thursday, 8 October 2026, after removing contested provisions on sharing biological samples and patient data.
Washington is to provide 1.52 billion dollars and Lusaka is to commit a further 975 million dollars to its health system, according to the US State Department as cited by the Associated Press. The Zambian government confirms a US contribution of more than 1.5 billion dollars and a national commitment of 975 million.
The agreement covers maintaining essential services, recruiting and funding staff, the supply of medicines, disease surveillance and data systems. Zambian Health Minister Roma Chilengi said it should support the recruitment of 40,000 health workers over five years, according to the Associated Press.
The amounts are multi-year commitments rather than an immediate payment. Implementation will be tied to agreed programmes and targets, while Zambia must gradually increase its national health spending and take on more functions currently supported by external aid.
The signing includes a memorandum of understanding and a separate agreement on data. The Zambian Ministry of Foreign Affairs says only data directly linked to the operation of the programme will need to be shared. The Associated Press reports that clauses providing for the transfer of samples and patient data were removed after they delayed the conclusion of the pact.
Lusaka has also separated this agreement from discussions with Washington on critical minerals. Zambian authorities say no mining provisions are included in the health text, a sensitive point for Africa’s second-largest copper producer.
The partnership follows the US decision to withdraw about 50 million dollars in annual health sector aid in 2025, citing diversion of medicines and medical supplies. The Zambian government has since replaced the 150 staff of the agency responsible for distributing these products.
For Zambia’s public finances, external funding may protect programmes against HIV, malaria, tuberculosis and maternal health while freeing up some resources in the short term. However, the commitment of 975 million dollars increases the national budget burden as US aid is due to decline.