U.S. to Wind Down Health Assistance to Zimbabwe After Funding Negotiations Collapse
HARARE, Zimbabwe — The United States has announced it will begin winding down its health assistance programs in Zimbabwe after negotiations on a proposed multi-million-dollar bilateral funding agreement collapsed. This decision marks a significant shift in a long-standing partnership that has provided nearly $2 billion in health aid to the African nation since 2006.
Zimbabwe's Sovereignty Concerns Derail $367 Million Deal
Zimbabwean government spokesperson Nick Mangwana stated on Wednesday that the country's decision to reject the U.S. proposal was driven by concerns over data sharing, fairness, and sovereignty. The proposed agreement would have provided $367 million over five years to support Zimbabwe's priority health programs, including HIV/AIDS treatment and prevention, tuberculosis, malaria, maternal and child health, and disease outbreak preparedness.
U.S. Ambassador Pamela Tremont described the proposed deal as "the largest potential health investment in Zimbabwe by any international partner" in a statement on Tuesday. She emphasized that it would have provided "extraordinary benefits for Zimbabwean communities — especially the 1.2 million men, women, and children currently receiving HIV treatment through U.S.-supported programs."
Data Sharing Dispute at Heart of Negotiation Breakdown
Mangwana explained that the U.S. proposal required "comprehensive access to Zimbabwe's sensitive health data, including virus samples and epidemiological information from our citizens." He said President Emmerson Mnangagwa directed that negotiations be terminated because the United States was not offering a "corresponding guarantee of access to any medical innovations — such as vaccines, diagnostics, or treatments — that might result from that shared data."
"The United States was not offering reciprocal sharing of its own epidemiological data with our health authorities," Mangwana added. "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."
Public Health Experts Warn of Consequences
Zimbabwe's College of Public Health Physicians has urged continued talks, citing the need for continued U.S. funding for "critical components" of Zimbabwe's public health system. In a statement, the college warned that "an abrupt discontinuation of such support could risk treatment interruption, increased transmission, the emergence of drug resistance, and additional strain on the health system."
The timing is particularly concerning as Zimbabwe has recently begun rolling out lenacapavir, a long-acting HIV prevention drug administered twice a year. This rollout was supported by the United States President's Emergency Plan for AIDS Relief (PEPFAR) in partnership with the Global Fund, raising questions about future deliveries under the program.
Broader Shift in U.S. Global Health Policy
The funding dispute occurs against the backdrop of broader changes in U.S. global health engagement. Under the Trump administration, the United States has pursued bilateral "America First" health funding agreements, replacing arrangements previously coordinated through multilateral institutions. The U.S. withdrew from the World Health Organization in January as part of this reconfiguration.
The U.S. embassy in Zimbabwe noted that agreements worth more than $18 billion have been signed with 16 African countries under this new framework, although recipient countries would contribute about $7.1 billion of this amount as part of the U.S. drive to get countries to invest more in their own health sectors.
Regional Context and Zimbabwe's Stance
Several African countries have already entered into the new bilateral pacts. Nigeria reached an agreement emphasizing Christian-based health facilities, while Rwanda and Uganda have also signed deals. Some agreements, including those with Rwanda and Côte d'Ivoire, include provisions for private U.S. sector investment.
In Kenya, a pact signed in December has been delayed after the High Court suspended implementation pending a case filed by a consumer rights group over data safety concerns.
Zimbabwean officials criticized the bilateral model as "a departure from the multilateral frameworks" and argued that virus data with pandemic potential should be shared exclusively through the WHO system. "This system is designed to ensure that when a country contributes its data, the benefits — including vaccines and treatments — are shared equitably, not commercialized exclusively by those with the resources to develop them," Mangwana said.
Winding Down a Historic Partnership
Ambassador Tremont stated that the U.S. will now turn to "the difficult and regrettable task of winding down our health assistance in Zimbabwe." She noted that Zimbabwe had indicated it was prepared to continue its HIV response independently, adding, "We wish them well."
The United States has been Zimbabwe's largest bilateral health donor for years, with assistance that the U.S. says "is directly responsible" for Zimbabwe's success in reaching United Nations targets for HIV treatment, testing and viral load suppression. The winding down of this partnership represents a significant moment in both countries' public health landscapes.
