“The US approached Zimbabwean authorities, promising more than $300m in funding in return for sensitive health data in negotiations that Harare felt were 'lopsided' and promptly pulled out of, according to memos leaked in recent weeks.”

“The US publicly announced $1bn in funding for neighbouring Zambia pending talks. However, Lusaka, too, called out 'problematic' clauses in the US proposal that sought access to the country’s minerals and has since requested a review, according to statements from officials in early March.”

“Boston University’s Impactcounter aid funding tracker revealed that the shocks from the cuts have since led to 518,428 child and 263,915 adult deaths from manageable diseases like HIV and tuberculosis. Close to 10 million new cases of malaria were also reported.”

“The deals have typically required governments to take on an increasing share of their own health budgets in the next four to five years in a cofinancing arrangement.”

“Zambia reportedly asked the major copper, cobalt and lithium producer for access to its critical minerals in return for $1bn over five years on the condition that Zambia would cofinance the aid with $340m in new health funding. The US also asked for a one-way data-sharing agreement for 10 years.”

“Lusaka relies on PEPFAR for more than 80 percent of its HIV funding, which provides free treatment for 1.3 million people, about 6 percent of the population. Although Zambia received $367m from the programme in 2025, funding pauses have severely disrupted drug deliveries across the country.”

“More than a dozen nations across Africa have signed memorandums of understanding with Washington since late 2025, according to tracking by the Council on Foreign Relations, a US think tank. They are: Nigeria, Kenya, Senegal, Botswana, Ethiopia, Guinea, Angola, Niger, Burkina”