.png)
U.S. Threats to Hold Back H.I.V. Aid in Zambia Expose Trump Administration’s Priorities
- Mar 29
- 4 min read
Written by Tanner Drant
Edited by Saneya Mohamed, Francesca Howard, and Annika Lilja
After Zambia pushed back on a deal where the U.S. would have sent over $1 billion in health aid in exchange for American access to key Zambian minerals, the U.S. State Department threatened to withhold essential H.I.V. aid from the country as soon as May. The Trump Administration’s threats endanger 1.3 million people in Zambia who rely on daily H.I.V. treatment, along with tuberculosis and malaria medications, which are given through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). Along with demands for access to Zambian minerals, the deal would have also included $340 million in co-financing from the Zambian government over the next 5 years and a 10-year mineral deposit data-sharing agreement.
Since its inception in 2003 during George W. Bush’s administration, PEPFAR assistance has been essential to Zambia. Since then, Zambia has received more than $6 billion, making it one of the system’s largest recipients among African countries. Before the system was created, 90,000 people died of H.I.V. every year in Zambia; however, as of 2023, only 15,000 die every year from the disease. Additionally, before the Trump administration, 98% of people in Zambia with H.I.V. were treated using PEPFAR-financed antiretroviral therapy—97% of which were virally suppressed. Due to the success of these systems, H.I.V. transmission has gone down dramatically in the years since the creation of PEPFAR.
After Trump discontinued the U.S. Agency for International Development (USAID) last year, his administration released an “America First Global Strategy,” in which the U.S. government would negotiate agreements with individual nations to advance American goals. This policy marked a stark change from USAID, which assisted 130 countries through a global network of international aid partners and organizations, rather than negotiating with each country individually. The Trump administration argued that U.S. global health aid under USAID was inefficient and included many unnecessary costs that would be avoided in the new system. Many health policy experts, however, have stated that these costs (i.e., training for doctors and hospital cleaning) are necessary for people to benefit from these systems and have criticized Trump’s policy for only focusing on HIV/AIDS, malaria, and tuberculosis.
Since Trump implemented the system, more than 17 African nations have signed deals with the U.S., sending a collective $11.3 billion in health aid to these countries. Still, critics have raised concerns over the morality of these deals, as the U.S.’s power in these negotiations, driven by the necessity of its health aid, has forced African countries to make lopsided concessions in return. For instance, in February, Zimbabwe suspended negotiations for $350 million in American health funding, as the country felt that the concessions demanded by the U.S. undermined the African nation’s independence and sovereignty.
Similarly, in Zambia’s negotiations, the fear of losing sovereignty was a driving force behind the country’s decision to challenge the deal that the U.S. had constructed. Zambia is Africa’s second-largest copper producer and also has large reserves of cobalt, lithium, nickel, manganese, and graphite, most of which are sold to China. Thus, through the proposal, the U.S. is attempting to gain access to Zambian minerals, as American businesses could finally obtain minerals from Zambia’s deposits and restrict China’s access to the reserves.
In addition, the data-sharing stipulation in the agreement would give the U.S. economic advantages that outlast health aid by five years, which raised concerns within the Zambian government. The last part of the proposal includes the renegotiation of a $458 million 2024 grant to support Zambia’s agriculture sector. The U.S. wants the terms of the grant amended to create regulatory changes in mining for the benefit of American mining endeavors in Zambia. Additionally, it is important to note that Trump’s proposed grants to Zambia provide less than half the amount of health aid that the country received before the Trump administration, while also introducing economic concessions that hadn’t existed prior to the suspension of USAID.
Taking a step back, although the Trump administration has taken significant foreign action to bolster the U.S. economy, most notably through the attack on Venezuela and the war in Iran, the administration’s threats to Zambia mark an unprecedented endangerment of human rights. For instance, in Venezuela, Trump unjustly captured Nicolás Maduro in order to gain access to Venezuelan oil; however, at the same time, the Venezuelan government was rampant with corruption, which fostered a humanitarian crisis for food insecurity in the country. Similarly, in Iran, even though Trump’s reasons for attacking the country were headlined by curbing Iran’s nuclear capabilities and gaining access to Iranian oil, which ended up backfiring by bringing about global economic issues, it should not be overlooked that the Islamic Republic committed repeated atrocities against protestors to maintain political power prior to the attack.
Although the Zambian government has also restricted political opposition from protesting, it is not actively attempting to restrain the health aid of its citizens: instead, as seen through the fact that the country has taken over some American H.I.V. programs since Trump began to cut aid last year, it is doing all it can to uplift its citizens who suffer from H.I.V. Still, Trump is using the country’s medical vulnerability to try to boost the U.S. economy by threatening the livelihood of over a million Zambians. This confirms that his administration values an insubstantial $1 billion in savings from the United States’ $7.01 trillion budget over the health and wellness of millions of people in a country that relied on U.S. aid for over two decades.
Sources:
