Kuda Pembere & Michael Gwarisa
Zimbabwe’s health sector faces renewed uncertainty after the collapse of a proposed US$367 million health assistance agreement with the United States, prompting Washington to begin winding down major health interventions in the country.
The development follows a directive by President Emmerson Mnangagwa instructing the Ministry of Foreign Affairs and International Trade, working with the Ministries of Finance and Health and Child Care, to abandon negotiations on a bilateral health Memorandum of Understanding (MoU) with the United States.
The proposed agreement, negotiated between the Government of Zimbabwe and the US Embassy in Harare, was intended to guide future American support under Washington’s America First Global Health Strategy. It would have provided funding over five years to support priority programmes including HIV/AIDS treatment and prevention, tuberculosis, malaria, maternal and child health, and disease outbreak preparedness.
However, negotiations collapsed after Zimbabwean authorities raised objections to several provisions in the draft MoU. Government officials cited concerns over clauses that would have allowed the United States direct access to Zimbabwe’s health data over a defined period, as well as linkages to access to the country’s critical mineral resources within the broader cooperation framework.
Authorities argued that the terms were lopsided and posed risks to Zimbabwe’s sovereignty, independence, and data privacy, leading to the decision to halt negotiations altogether.
In response, the United States confirmed it would end plans to provide the funding and begin winding down its existing health assistance in Zimbabwe.
US Ambassador to Zimbabwe Pamela Tremont described the decision as regrettable, saying the breakdown in negotiations left Washington with no alternative.
“We will now turn to the difficult and regrettable task of winding down our health assistance in Zimbabwe,” Ambassador Tremont said in a statement.
She noted that the proposed MoU would have delivered US$367 million over five years and described it as the largest potential health investment in Zimbabwe by any international funder. The agreement was built on a co-funding model that would have required Zimbabwe to gradually increase its own health financing alongside US support, with the stated aim of sustainability and long-term self-reliance.
According to the US Embassy, American health assistance has provided more than US$1.9 billion to Zimbabwe since 2006 and played a key role in strengthening the country’s HIV response. The support is credited with helping Zimbabwe reach the UNAIDS 95-95-95 targets, a global benchmark for HIV testing, treatment, and viral suppression.
Ambassador Tremont warned that the collapse of the MoU places ongoing programmes at risk, with an estimated 1.2 million men, women, and children currently receiving HIV treatment through US-supported initiatives.
“We believe this collaboration would have delivered extraordinary benefits for Zimbabwean communities, especially the 1.2 million people currently on treatment,” she said. “The Government of Zimbabwe has assured us it is prepared to sustain the fight against HIV/AIDS, and we wish them well.”
The embassy added that the United States has a responsibility to American taxpayers to invest resources where mutual accountability, transparency, and shared commitment are guaranteed. Tremont said the MoU framework set a higher standard for bilateral health cooperation, prioritising measurable outcomes and shared ownership of results.
To date, 16 African countries have signed similar health collaboration MoUs with the United States, collectively representing more than US$18.3 billion in new health funding, including US$11.2 billion in US assistance and US$7.1 billion in co-investment from partner governments.
With negotiations now terminated, the US Embassy confirmed it is winding down several health programmes worth hundreds of millions of dollars. The move affects support across HIV/AIDS, tuberculosis, maternal and child health, malaria, and disease surveillance, raising concern among health experts about Zimbabwe’s capacity to absorb the financial and operational gap left by the withdrawal.
