No Mineral Access, No HIV Drugs: US Considers Pulling Life Saving Treatment For 1.3 Million Zambians

US Considers Withholding HIV Medication Aid Over Zambia Minerals Deal

The United States government is reportedly considering withholding life-saving HIV assistance to Zambia unless the southern African country expands access to its critical minerals. A draft memo from the U.S. State Department indicates that officials are weighing a plan to reduce or cut major health funding in order to push Zambia to sign an agreement that would give American companies greater access to the country’s vast mineral resources.

The proposal has raised alarm because more than a million people in Zambia depend on HIV medication funded through American aid programmes.

According to The New York Times, the draft memo suggests the United States could remove health assistance “on a massive scale” if negotiations over mineral access do not move forward.

“We will only secure our priorities by demonstrating willingness to publicly take support away from Zambia on a massive scale,” the memo states.

Millions Depend On US-Funded HIV Treatment

Zambia has been one of the largest beneficiaries of the United States’ long-running HIV programme, the President’s Emergency Plan for AIDS Relief (PEPFAR). The programme has delivered billions of dollars in assistance to fight HIV/AIDS across Africa.

According to The New York Times, around 1.3 million Zambians currently rely on daily HIV treatment funded through the American programme.

Over the past two decades, the United States has reportedly provided more than US$6 billion (approximately R111 billion) in HIV-related assistance to Zambia. The funding has supported medication supply chains, prevention programmes and treatments designed to stop babies from contracting HIV at birth.

However, the memo suggests Washington may consider significantly cutting assistance as early as May 2026 if negotiations fail.

The document reportedly outlines a proposed deal in which the United States would provide Zambia with US$1 billion (approximately R18.5 billion) in health funding over five years. In return, Zambia would commit US$340 million (approximately R6.3 billion) in additional health spending and agree to broader reforms linked to mining and economic governance.

Minerals At The Centre Of Negotiations

The dispute is centred on Zambia’s mineral wealth.

The country is one of the world’s leading copper producers and also holds large deposits of lithium and cobalt. These minerals are considered essential for the global green-energy transition and the production of batteries for electric vehicles.

According to The New York Times, U.S. officials are also seeking measures that would give American companies greater access to Zambian mines, while reducing what Washington sees as China’s dominant presence in the country’s mining sector.

The negotiations are also tied to a US$458 million (approximately R8.5 billion) Millennium Challenge Corporation grant signed in 2024 that supported Zambia’s agricultural sector. The United States is reportedly pushing to restructure that agreement so that Zambia introduces regulatory reforms affecting mining and other industries.

A State Department press office declined to comment on the alleged memo.

Zimbabwe Previously Walked Away From Similar Talks

The negotiations with Zambia come as the United States pushes several African countries to sign new agreements tied to foreign health funding.

24 countries have already signed agreements worth about US$20 billion (approximately R370 billion) in health assistance over five years.

However, Zimbabwe is among the countries that have reportedly declined to proceed with the proposed arrangements.

Zimbabwe’s government recently walked away from negotiations, citing concerns about the conditions attached to the funding.

The Zimbabwean government objected to requirements related to sharing health data and biological samples, arguing that such provisions would infringe on the country’s sovereignty.

The move placed Zimbabwe among the few countries that have refused to sign the agreements tied to American health aid.

As of March 16, 2026, Zambian authorities had not publicly commented on the details of the negotiations.