By Monica Kayombo/ Lusaka,
ZAMBIA and the United States have reached agreement on a US$3.623 billion five-year health-sector co-financing package, with Government saying concerns over patient data, specimen sharing and possible linkages to the country’s mineral resources have been resolved.
Health Minister Prof. Roma Chilengi said the 2026–2030 Memorandum of Understanding (MOU) would provide a new framework for strengthening Zambia’s health system while progressively increasing domestic financing and national ownership of healthcare.
Under the agreement, Zambia will contribute US$2.107 billion, representing 58.2 percent of the total investment, while the United States will provide US$1.516 billion, or 41.8 percent.
Prof. Chilengi said the agreement marked a shift towards greater health-sector self-reliance, with Zambia’s domestic health financing expected to rise from US$627.9 million in 2026 to US$1.028 billion annually by 2030.
The Minister said the agreement was designed to ensure continuity of essential health services across all 10 provinces and 116 districts, while strengthening national systems and reducing historical dependence on external financing.
A major component of the agreement is the strengthening of Zambia’s health workforce.
Government will provide financial and operational support for at least 15,000 frontline health workers, including doctors, clinical officers, nurses, midwives, laboratory scientists and pharmacists.
The agreement will also facilitate the formal integration of 25,000 community health workers into the Government health system, with dedicated domestic financing.
Prof. Chilengi said more than 100 field epidemiologists would also be trained and deployed across districts to strengthen disease surveillance, early warning systems and outbreak response.
The MOU sets several health targets for 2030, including reducing maternal mortality from a stated baseline of 187 deaths per 100,000 live births to fewer than 103.
Government also targets reducing under-five mortality from 42 to fewer than 25 deaths per 1,000 live births, while mother-to-child HIV transmission is expected to fall from six percent to three percent.
The agreement further targets a reduction in under-five malaria case fatality from 11 to fewer than five per 1,000 and tuberculosis mortality from 38 to 27 deaths per 100,000 population.
On health security, Zambia will adopt the 7-1-7 framework, which requires public health threats to be detected within seven days, notified to public health authorities within one day and responded to effectively within seven days.
Prof. Chilengi said Zambia had also secured safeguards around health data and biological specimens.
“There is no specimen sharing in the MOU,” the Minister said, adding that data to be shared would consist of performance matrices and not personal information.
He said the agreement would contain no linkage whatsoever to Zambia’s mineral rights, mining assets or natural resources.
The Minister said the concerns that had previously delayed the agreement had therefore been resolved following stakeholder engagement and further discussions between the two governments.
He said both the Ministry of Justice and Cabinet had approved the agreement.
The agreement will also give Zambia greater control over its health supply chain, with medical procurement and distribution to be integrated under the Zambia Medicines and Medical Supplies Agency (ZAMMSA).
The Government will further take full ownership and management of the SmartCare Pro electronic health platform, with the Ministry maintaining that personally identifiable information and patient health data will not be exported or shared externally.
Prof. Chilengi said the agreement would also promote local procurement and indigenous pharmaceutical manufacturing under the Grow Zambia agenda, with the aim of supporting local industry and creating jobs.
The Minister said the United States remained an important health partner to Zambia, noting that American support had contributed to improvements in the country’s health outcomes over the years.
He cited an increase in life expectancy from about 33 years in the early 2000s to 67 years currently, alongside increased productivity.
The new agreement, he said, would seek to protect those gains while building a nationally led and financially sustainable health system by 2030.
The Ministry of Health and the US Government are expected to proceed with implementation of the five-year agreement.
