HARARE — The United States has announced it will begin winding down health assistance to Zimbabwe after President Emmerson Mnangagwa walked away from negotiations over a proposed bilateral health agreement.
The diplomatic rupture puts 1.2 million HIV patients at immediate risk, unless the Zimbabwe government steps up to fill the funding gap.
In a press statement issued after ZimLive on Monday revealed the breakdown in talks, US Ambassador Pamela Tremont confirmed the consequences would be swift and sweeping.
“We will now turn to the difficult and regrettable task of winding down our health assistance in Zimbabwe,” she said.
Tremont, who met Zimbabwe’s foreign minister Amon Murwira last week, said the Zimbabwe government had “assured us it is prepared to sustain the fight against HIV/AIDS.”
“We wish them well,” she added in a comment that read less as a pleasantry than a pointed transfer of responsibility.
The memorandum of understanding (MoU) was being promoted by Washington as the future framework for US health support to Zimbabwe under its America First Global Health Strategy (AFGHS). But Harare found its conditions unacceptable on multiple fronts.
A letter first reported by ZimLive dated December 23, 2025, and written by foreign affairs secretary Albert Chimbindi instructed the secretaries for finance and health to halt all discussions immediately, on direct orders from the president.
“The president has directed that Zimbabwe must discontinue any negotiation with the USA on the clearly lopsided MoU that blatantly compromises and undermines the sovereignty and independence of Zimbabwe as a country,” the letter stated.
Diplomatic sources said Mnangagwa objected specifically to US demands for access to Zimbabwe’s national health data, which officials characterised as intelligence overreach, and to provisions linking the deal to access to the country’s critical mineral resources.
The US pushed back hard on that characterisation. The embassy said the rejected MoU would have provided $367 million over five years, slightly more than the $350 million figure first reported, covering HIV/AIDS treatment and prevention, tuberculosis, malaria, maternal and child health, and disease outbreak preparedness.
It described the deal as the largest potential health investment in Zimbabwe by any international funder, built on a co-funding model intended to put Zimbabwe on a path toward self-reliance by gradually increasing its own health budget alongside American support.
Washington also pointed to the broader continental picture as a rebuttal to Harare’s framing. Sixteen African countries have now signed similar agreements, unlocking a combined $18.3 billion in new health funding – $11.2 billion from the US and $7.1 billion in co-investment from the recipient countries themselves.
“The United States has a responsibility to American taxpayers to invest their resources where mutual accountability, transparency, and shared commitment are assured,” Tremont said.
The US has provided more than $1.9 billion in health support to Zimbabwe since 2006, and American-funded programmes are credited with helping Zimbabwe achieve the UNAIDS 95-95-95 targets, the global benchmark for HIV treatment and suppression. The 1.2 million Zimbabweans currently receiving HIV treatment through US-supported programmes now face an uncertain future as those programmes are wound down.
Mnangagwa’s government has not said publicly where it intends to source replacement funding, nor detailed a timeline for transitioning patients to alternative support.
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