A leaked State Department memo reveals the U.S. is threatening to cut PEPFAR funding for 1.3 million Zambians living with H.I.V. to leverage a deal for preferential access to the country’s critical mineral reserves.
The U.S. State Department is considering a high-stakes “America First” negotiating tactic that would withhold lifesaving H.I.V. assistance from 1.3 million Zambians to force the nation into a critical minerals deal. According to a draft memo prepared for Secretary of State Marco Rubio and obtained by The New York Times, the Trump administration plans to “significantly cut assistance” as soon as May if Zambia does not grant American businesses preferential access to its vast deposits of copper, lithium, and cobalt. The memo argues that the U.S. can only secure its strategic priorities—specifically countering China’s dominance in the sector—by “demonstrating willingness to publicly take support away from Zambia on a massive scale.” This pressure involves restructuring the decades-old PEPFAR program, which has provided over $6 billion in aid and currently sustains the lives of a significant portion of the Zambian population.
The proposed agreement is divided into three components: a health deal requiring Zambia to increase its own spending while receiving reduced U.S. funding, a minerals pact to end China’s “preferential access,” and a restructuring of a $458 million agricultural grant to force regulatory changes in the mining industry. While most nations have signed new health agreements, Zambia has resisted the broader mineral and data-sharing demands. The memo notes that the U.S. has already “wielded a heavy cudgel” by suspending health talks and threatening to cancel a major debt relief package, a move that recently prompted the Zambian Mines Minister to grant U.S. experts “unprecedented access to their mining database.” Despite these concessions, the administration warns that “the potential use of sticks” remains necessary to ensure Zambia does not backtrack.
The potential withdrawal of aid has sparked profound fear among health advocates and the 1.3 million citizens who rely on daily antiretroviral (ARV) treatments. Julius Kachidza, an advocate for people living with H.I.V. near Lusaka, warned that the Zambian government lacks the capacity to fill such a massive funding gap, stating, “It could be quite a disaster, especially to me. And the majority of people living with H.I.V. in Zambia.” Beyond the mineral rights, activists are also alarmed by provisions requiring Zambia to share citizens’ health data for 10 years and biological specimens for 25 years. The State Department has declined to comment on the “purportedly leaked documents,” while Zambian officials remain silent as the May deadline for the “massive scale” aid cuts approaches.