The United States will terminate funding for Zimbabwe’s health programs starting Wednesday after failed negotiations over a bilateral health agreement that Zimbabwe declined due to concerns over the sharing of sensitive health data, the U.S. Embassy in Harare confirmed Friday. The decision marks a significant shift in U.S. policy, moving from direct health and humanitarian assistance toward broader economic, trade, and investment engagements with Zimbabwe.
U.S. Ambassador Pamela Tremont, speaking at a recent event titled “Beyond assistance,” emphasized that the halt in support followed Zimbabwe’s rejection of a bilateral memorandum of understanding (MOU) intended to govern future health cooperation. The embassy indicated this change aligns with Washington’s broader strategy of negotiating country-specific health agreements aimed at reducing donor dependency and promoting domestic financing.
Zimbabwe, long a major recipient of U.S. health aid, has for decades benefited from funding targeting HIV prevention and treatment, tuberculosis, malaria, clinical care, laboratory strengthening, health worker support, and community health initiatives. The withdrawal of American backing raises concerns about the future of these programs in a nation already grappling with shortages of basic medical supplies and medications.
Zimbabwean officials have attributed their refusal to endorse the U.S. deal to several conditions they found unacceptable, especially provisions requiring extensive access to the country’s sensitive health data, which includes virus samples and epidemiological information on citizens. Government spokesperson Nick Mangwana underscored issues of sovereignty and fairness, as well as objections to Washington’s shift away from multilateral global health institutions.
The dispute originated in February after talks broke down over the bilateral framework, part of former President Donald Trump’s “America First” foreign aid policy. Zimbabwe is among a small number of African countries—including Namibia, Ghana, Zambia, and South Africa—that have publicly resisted or not finalized comparable U.S. health agreements. Namibia likewise declined a bilateral deal over similar data-sharing concerns and is now experiencing a phased reduction of U.S. financial support for HIV programs.
Health advocates warn the withdrawal could have dire public health consequences. Asia Russell, executive director of Health GAP, an international advocacy organization, described the abrupt funding termination as a potential trigger for a “public health catastrophe,” citing disruptions to lifesaving malaria, tuberculosis, and HIV services.
The situation unfolds amid broader calls across Africa for “health sovereignty,” a movement emphasizing increased domestic financing and management of health systems to reduce reliance on external aid. The Africa Centers for Disease Control and Prevention has highlighted a deepening financing crisis on the continent, noting that official development assistance for Africa has been halved over the past five years.
Under the new approach, the U.S. aims to negotiate bilateral agreements with individual countries to promote sustainable health financing, with 35 countries reportedly having signed such accords, mostly in Africa. However, continued resistance by some nations underscores the challenges inherent in balancing donor conditions with national sovereignty and data privacy concerns within health diplomacy.