Twenty years of American support for Zimbabwe’s health system will end on September 30, and it was Harare that closed the door. The $367 million memorandum of understanding Washington put forward was rejected as early as February, in the name of a principle the government has kept repeating ever since: sovereignty. Behind the refusal lies a specific reading of the text, which the authorities judged contrary to the country’s interests.
The first complaint concerns what Zimbabwe was expected to give. According to Nick Mangwana, the Secretary for Information, the country would have had to share its biological resources and data over a very long period. Health Policy Watch describes, for agreements of this type, immediate access to information on outbreaks, a twenty-five-year commitment on pathogens with pandemic potential, and data exchanges over ten years, even though the memorandum itself runs for only five. That source covers Zimbabwe and Zambia together, so these durations sketch the general framework of the American offer rather than figures Harare has confirmed one by one.
Then comes the question of what the country would receive in return, which the government saw as next to nothing. Nothing guaranteed access to the vaccines, tests or treatments that might come out of those samples, and American epidemiological data would not have been opened up in return. The text was judged plainly lopsided and a threat to national independence, a view also defended by Albert Chimbindi, the Secretary for Foreign Affairs.
A third, more diplomatic argument also carried weight. The World Health Organization is running negotiations on access to pathogens and the sharing of the benefits that flow from them. In Harare’s view, signing a one-on-one deal with the United States would have weakened the collective position of Global South countries in that discussion.
Minerals remain a grey area. Several outlets, including a dispatch carried by Infobae, claim the text also gave Washington access to Zimbabwe’s mineral resources. I could only verify this through that secondary source. For neighboring Zambia, however, the documents reviewed establish a direct link between health aid and the copper and cobalt sector, which makes the hypothesis credible without proving it.
On the American side, the tone is measured. Ambassador Pamela Tremont announced that the programs backed by her country would end at the close of September following the refusal, while saying she respects Zimbabwe’s sovereign decision. Washington has concluded similar agreements with more than thirty countries, worth over $24 billion, under its « America First » global health strategy, which provides for aid tapering off over five years and a growing financial effort from recipient countries.
The bill could be steep. Between 2018 and 2020, PEPFAR financed between 32 and 42 percent of Zimbabwe’s HIV spending, and the shortfall tied to the failed agreement comes to roughly $350 million over five years. Antiretrovirals, health worker stipends, tuberculosis, malaria, maternal and child health: all of it rested in part on these funds. More than 95 percent of people living with HIV are now on treatment, and public health physicians are calling for fresh negotiations to protect that result. Within weeks, the government will have to prove it can fill, with its own resources, the gap it chose to create by refusing to pay in data.