Zimbabwe has turned down a major health funding agreement proposed by the United States, rejecting what officials described as an imbalanced arrangement that would have required the country to hand over sensitive biological data without guarantees of fair access to future medical benefits.
The deal, worth $367m (£272m) over five years, would have supported Zimbabwe’s programmes for HIV/Aids treatment and prevention, tuberculosis, malaria, maternal and child health, and preparedness for disease outbreaks. But the government ultimately refused to sign after concluding that the terms favoured Washington at the expense of Zimbabwe’s sovereignty and long-term public health interests.
The decision became public after a confidential government memo from December was leaked. In the document, President Emmerson Mnangagwa reportedly described the proposed agreement as “lopsided”.
Responding to the disclosure, government spokesperson Nick Mangwana said the United States had demanded access to Zimbabwean biological samples and health data for research and possible commercial use, while offering no binding assurance that Zimbabweans would benefit from any resulting vaccines, diagnostics, or treatments.
“Zimbabwe was being asked to share its biological resources and data over an extended period, with no corresponding guarantee of access to any medical innovations that might result from that shared data,” Mangwana said in a statement. “In essence, our nation would provide the raw materials for scientific discovery without any assurance that the end products would be accessible to our people should a future health crisis emerge.”
Following Zimbabwe’s refusal, US ambassador Pamela Tremont said Washington would begin withdrawing its health assistance.
“We will now turn to the difficult and regrettable task of winding down our health assistance in Zimbabwe,” Tremont said, adding that the US had provided more than $1.9bn in health funding to the country over the past two decades.
The funding would have been delivered through government-to-government agreements following the closure of USAID, which had previously administered US development assistance. Since returning to office last year, Donald Trump has sharply reduced foreign aid spending, arguing that it was wasteful and insufficiently accountable. His administration has instead pursued bilateral deals aimed at increasing transparency and oversight.
According to the US embassy in Harare, 16 African countries have already signed similar health agreements with Washington, collectively representing more than $18.3bn in new funding commitments.
Tremont said the rejected package would have delivered “extraordinary benefits” to Zimbabwe, particularly the estimated 1.2 million people currently receiving HIV treatment through US-supported programmes.
However, Zimbabwean officials said the deal clashed with emerging global standards on data sharing and benefit distribution. Mangwana pointed to Washington’s decision to withdraw from the World Health Organization, arguing that it had disrupted multilateral frameworks designed to ensure fairness during future pandemics.
He cited the WHO’s Pathogen Access and Benefit Sharing system, which aims to ensure that countries contributing health data or biological samples receive equitable access to vaccines and treatments developed from that information.
“This system is designed to ensure that when a country contributes its data, the benefits are shared equitably, not commercialised exclusively by those with the resources to develop them,” Mangwana said.
He stressed that Zimbabwe’s position should not be interpreted as hostility towards the United States. “We welcome continued dialogue with our American counterparts on how future co-operation might be structured in a manner that respects the sovereignty and dignity of both nations,” he added.
The rejection of the deal has raised concerns among health professionals in Zimbabwe, where key HIV programmes depend heavily on foreign funding. The Zimbabwe College of Public Health Physicians said it understood the government’s reservations but urged both sides to continue talks.
“Where technical issues exist, including those relating to data governance or implementation frameworks, these can often be addressed through technical clarification and negotiated safeguards,” the group said, warning that the loss of funding could place additional strain on the country’s health system.
Zimbabwe’s stance follows similar developments elsewhere in Africa. In December, Kenya’s High Court suspended a comparable health agreement between Nairobi and Washington after a consumer rights group raised concerns about the protection and use of citizens’ medical data.
As negotiations stall, the future of US-backed health programmes in Zimbabwe remains uncertain, with officials on both sides acknowledging the potentially severe consequences for HIV treatment and disease prevention efforts if no compromise is reached.
