Zimbabwe has rejected a multi-million health funding deal offered by the United States of America — until now the southern African country’s main health and humanitarian aid donor — on account of what Harare has alleged to be the lop-sidedness of the deal.
Harare says negotiations over the $367 million health funding package wallowed on account of Washington’s insistence on having unfettered access to sensitive health data as well its demand for access to the African country’s strategic minerals.
The decision has come to light after a government memo from last December got public, in which President Emmerson Mnangagwa decided to turn down the offer on the grounds that it was “lop-sided”.
Zimbabwe government spokesperson Ndabaningi Mangwana and the US ambassador to Zimbabwe Pamela Tremont have both since confirmed the collapse of the talks. According to Mangwana, the US was demanding access to biological samples for research and commercial gain but said it was unwilling to share its own data, let alone share the benefits of future vaccines and treatments from the samples harvested from the African country.
Describing the deal on offer as ‘asymmetrical’ Mangwana also said President Mnangagwa felt the deal that the Donald Trump administration was offering under its America First Global Health Strategy was an affront to Zimbabwe as a sovereign country.
“A partnership, by its very definition, must be built on a foundation of mutual respect, transparency, and reciprocal benefit,” Mangwana said in a statement. “It was the President’s considered assessment, following rigorous inter-ministerial review, that the draft Memorandum of Understanding (MoU) presented for consideration did not meet these fundamental criteria,” Mangagwa said. “Zimbabwe was being asked to share its biological resources and data over an extended period, with no corresponding guarantee of access to any medical innovations — such as vaccines, diagnostics, or treatments — that might result from that shared data. In essence, our nation would provide the raw materials for scientific discovery without any assurance that the end products would be accessible to our people should a future health crisis emerge.”
Mangwana explained that Zimbabwe also objected to entering into a bilateral health agreement that would bypass the multilateral frameworks the country has championed on the African continent. He highlighted that the US’ concurrent withdrawal from the World Health Organization (WHO) and its pursuit of bilateral health agreements with individual nations represents a departure from the multilateral systems carefully constructed to ensure equitable pandemic preparedness.
“At recent WHO negotiations, Zimbabwe had the honour of speaking on behalf of 50 African member states in insisting that pathogen data with pandemic potential be shared exclusively through the WHO’s multilateral system—specifically the Pathogen Access and Benefit-Sharing (PABS) framework.”
Government sources were quoted as saying Harare was also miffed by provisions linking the funding to access to Zimbabwe’s critical mineral resources — in the frame of a similar controversial deal that Zambia was concerned into signing that is being described as ‘shameless’ — a move Mnangagwa’s advisors feared would give Washington strategic leverage over sectors central to the country’s future economic independence. While the Zimbabwean government’s spokesperson’s statement only focused on sensitive health data and sovereignty, it was also being said that the mineral clauses were a significant red flag for officials who saw them as a backdoor attempt to gain economic control. Zimbabwe is endowed with lithium deposits and other strategic minerals that the US is desperate to get hold of.
The US has been Zimbabwe’s main benefactor for many years, providing more than US$1.9 billion in health support to Harare in the past two decades alone. The US-funded programmes are directly credited for helping Zimbabwe achieve the UNAIDS 95-95-95 targets — the global benchmark for HIV treatment and suppression.
Describing Harare’s decision as “regrettable”, Tremont said the US is now focusing on winding up its programmes in Zimbabwe.
“We will now turn to the difficult and regrettable task of winding down our health assistance in Zimbabwe,” Tremont said in a statement. “This MoU would have provided $367 million over five years to support Zimbabwe’s priority health programs, including HIV/AIDS treatment and prevention, tuberculosis, malaria, maternal and child health, and disease outbreak preparedness. The Government of Zimbabwe has assured us it is prepared to sustain the fight against HIV/AIDS, and we wish them well.”
The US Embassy statement said 16 other African nations have so far signed similar health collaboration MoUs under the America First Global Health Strategy, unlocking a staggering US$18.3 billion in new health funding—including US$11.2 billion in US assistance alongside US$7.1 billion in co-investment from recipient countries. However, one of these deals with Kenya has been suspended by a Nairobi High Court to pave way for further scrutiny after a consumer rights lobby filed a case citing concerns about the safety of Kenyans’ health data. In Zambia, the deal has also raised some controversies over health data and attempts to link it to mining deals.
“This growing continental reflection should not be misconstrued as anti-American sentiment,” Mangwana said. “On the contrary, it is a sign of Africa’s maturation as a geopolitical actor, one that seeks partnerships based on equality rather than patronage.”
With some 1.2 million Zimbabweans living with the HIV virus and therefore in need of antiretroviral treatment, and new infections on the rise among adolescents, health experts say the government should act fast to ensure that there is no gap in the supply of the life-saving drugs. Until recently 98 per cent of Zimbabwe’s medicines bill was paid for by donors, a situation that made the sector extremely vulnerable to external shocks.
Describing the increasing funding cuts from global donors as a wake-up call for Zimbabwe to strengthen domestic resource mobilisation, Health and Child Care minister Douglas Mombeshora has since announced the government is fast-tracking the National Health Insurance Scheme to safeguard essential health services.
“Zimbabwe has strengthened predictable domestic resource mobilisation, including through the AIDS Levy and earmarked health-related taxes, which provide funding for priority programmes. To enhance financial protection, Zimbabwe is fast-tracking the National Health Insurance Scheme.”
Mombeshora’s statement refers to existing funding streams that Zimbabwe already has in place. These includes, for example, the Aids Levy, a three per cent tax on taxable income for employed persons and a three per cent tax on profits for companies, which has been funding HIV and AIDS programmes since 1999. The government has also introduced a sugar tax to fund the health sector.
Tuberculosis is also one of Zimbabwe’s foremost public health challenges, accounting for over 200 cases per 100,000 people. Cases of malaria outbreaks are also common, especially among vulnerable communities, particularly during the rainy season. The development comes as the country is trying to recover from the declining external support following severe cuts to US’ development assistance, with USAID-funded programmes that supported rural clinics, health worker training, and medical equipment procurement now abandoned.
Only last week, the Trump administration added Zimbabwe to the list of seven Africa countries that are no longer eligible for US humanitarian assistance.
There is no love lost between Harare and Washington as Zimbabwe has been on illegal US sanctions for the past 25 years over the two countries’ political differences. As a result of these sanctions, the US has always used its veto power to block Zimbabwe’s access to development funding from international financial institutions such as the World Bank and the International Monetary Fund in addition to excluding the country from beneficial trade agreements such as the African Growth and Opportunity Act (AGOA). This ostracisation has forced Zimbabwe to adopt a ‘Look East Policy”, increasingly turning to China, Russia, India and other countries that are largely outside of the geopolitical influence of the West.
Itai Rusike, the executive director of the Community Working Group on Health (CWGH) in Zimbabwe, expressed fears that the fall-out would severely impact on the country’s fragile health sector, given the country’s long tradition of relying on external help.
“Unfortunately for far too long, Zimbabwe has been heavily reliant on external support provided by donors to fund programmes in the health sector and for humanitarian assistance,” Rusike said in a statement to Down To Earth.
“Without funds being rapidly mobilised to fill the gap left by the US withdrawal, the effect on the health of millions of Zimbabweans is at stake. Failure to prevent new infections for HIV/AIDS, TB and malaria, and the threat of drug resistance developing because of disrupted treatment will have far reaching consequences. It’s going to be a struggle for the ordinary person; many will die because of lack of medication unless there is sufficient domestic resource mobilisation for the health sector to cover the gap.”
He said Zimbabwe will need high level political will and political commitment to increase its health budget allocation, improving efficiency, ensuring equity, and strengthening governance in the health sector in order to achieve sustainable health financing. Rusike suggested that the government should establish independent funding mechanisms for health in order to reduce dependency on external partners as it is risky and unsustainable to have an overreliance on donors who can pull out anytime, should their interest change for one reason or another.
“We still believe these negotiations can be revisited with compromises from both ends,” Rusike said.
“The negotiations needed to have had both a humanitarian and a security/economic lens — and then compromise. We think restructuring the negotiating teams would help. It’s prudent to also involve non-state actors including other technocrats in such negotiations. At the end of the day — it comes down to protecting the interests of our people. Because you need other players that see things differently, that propose and analyse different options. The expertise is available, and players could have helped analyse every letter, word, line, paragraph, etc in the MoU in real-time and feedback to the negotiating team.”