The Trump administration is reportedly threatening to withhold life-saving HIV aid from Zambia – unless the country allows the USA expanded access to its minerals.

The long-established President’s Emergency Plan for AIDS Relief (PEPFAR) provides over 1.3 million Zambians with daily HIV medications. PEPFAR was put in place by the George W Bush administration, over two decades ago.

However, the State Department is considering slashing this support in a further escalation of Trump’s weaponisation of US foreign aid. Within days of taking office for his second term, Trump issued an executive order to freeze USAID.

Just one year on, estimates put the death toll at over 750,000 worldwide.

Trump: coercive aid

The New York Timesreported the US-Zambia proposal after seeing a draft memo prepared for secretary of state Marco Rubio. The note outlines a plan to end health support “on a massive scale” to force Zambia into compliance. It states:

We will only secure our priorities by demonstrating willingness to publicly take support away from Zambia on a massive scale.

The US government may slash HIV, malaria, and tuberculosis support for Zambia as early as May this year.

The proposal is part of a broader trend in which the Trump administration is forcing other countries to sign deals in exchange for aid. Thus far, 24 countries have signed agreements to meet various conditions in exchange for $20bn in health support over the next 5 years.

In most cases, the US requirements centre on the countries increasing their own health spending. However, this also comes with demands to turn over both data and biological samples. As the BBCreported, Zimbabwe and Kenya have already walked away from this deal:

A [Zimbabwe] government spokesman has since explained the US was demanding access to biological samples for research and commercial gain but said it was not willing to share the benefits for future vaccines and treatments. […]

In December, Kenya’s High Court suspended a similar health funding agreement the government had signed with the US after a consumer rights lobby filed a case citing concerns about the safety of Kenyans’ health data.

Mineral greed

However, unlike most of the other deals, the terms offered to Zambia include demands on access to the country’s mineral reserves. The southern African nation is a major source of copper, along with rarer elements like lithium and cobalt. These minerals have all proven vital to fuel for the green energy transition.

The exact terms of the US-Zambian deal haven’t yet been made public. However, the draft proposal has three key components:

• The US would provide $1bn for healthcare over the next 5 years, provided that Zambia spends $340m on new health funding. Notably, the $1bn is already less than half of the aid America provided before Trump came to power. In spite of the support lasting 5 years, Zambia would hand over citizens’ health data to the US for 10 years. Likewise, it would also have to provide biological specimens for 25 years. As with Zimbabwe, Zambia would have no guarantee of benefiting from any vaccines developed using these resources.
• Second, Zambia would grant US businesses greater access to its mineral reserves. As things stand, the US reportedly sees China as holding preferential access to Zambia’s deposits.
• Lastly, as reported by the New York Times, the third component is:

  a renegotiation of a contract with the Millennium Challenge Corporation, an American foreign assistance agency focused on economic governance. The original contract, signed in 2024, gave Zambia a $458 million grant to support its agricultural sector. The Trump administration wants it restructured to require regulatory changes in mining and other industries.

‘Insistence on tangible benefits’

Crucially, Rubio’s draft memo states that Zambia would need to sign by May in order to receive the health aid. In the event that it doesn’t sign, the note states that:

sharp public cuts to American foreign assistance would significantly demonstrate to aid-receiving countries the seriousness of our interest in collaboration and our insistence on tangible benefits under our America First foreign policy.

Likewise, the US has already attempted to use threats to health-aid to force Zambia to engage on mineral access. The memo says:

At every point in the negotiation, we communicated what the G.R.Z. [Government of the Republic of Zambia] would lose if they failed to act. Repeatedly, we needed to threaten or actually withdraw assistance important to the GRZ to elicit progress on our priorities.

Since the PEPFAR programme began, Zambia has received over $6bn in US aid. At the programme’s inception, the country’s healthcare system was drowning – over 90,000 people a year were dying of HIV-related illness.

When the Trump administration made further cuts to foreign aid in 2025, the Zambia government began to take over management of aspects of its HIV care. However, a great deal of the sector still relies of American support.

There aren’t words to express the heinous nature of Trump, Rubio and their cohorts. The US is holding millions of Zambian lives hostage to force the country to allow American businesses to exploit it. Human lives, in exchange for lithium and cobalt.

For comparison, the Zambian deal promises $1bn in healthcare over five years. Meanwhile, reports have suggested that Trump’s war on Iran is costing as much as $1bn a day.

It’s despicable, it’s inhuman, and it’s par-for-the-course from these rotten fascists.

Featured image via the Canary

By Alex/Rose Cocker

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