US winds down controversial health programmes in Zimbabwe

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 move places an estimated 1.2 million HIV patients at immediate risk unless the Zimbabwean government mobilises alternative funding to sustain treatment and prevention programmes.

In a press statement issued on Monday, US Ambassador Pamela Tremont confirmed the breakdown in talks and said the consequences would be significant.

"We will now turn to the difficult and regrettable task of winding down our health assistance in Zimbabwe," she said.

Tremont, who met Foreign Affairs Minister Amon Murwira last week, said Harare had assured Washington that it was prepared to sustain the fight against HIV/AIDS.

"We wish them well," she added, signalling a shift of responsibility to the Zimbabwean authorities.

The proposed memorandum of understanding (MoU) was intended to serve as the framework for future US health support under the America First Global Health Strategy (AFGHS). However, Harare rejected the agreement, describing its conditions as unacceptable.

In a letter dated 23 December 2025, Foreign Affairs Secretary Albert Chimbindi instructed the secretaries for finance and health to halt negotiations immediately, citing 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 to provisions that would have granted the US access to Zimbabwe's national health data, which officials characterised as excessive and potentially compromising. Concerns were also reportedly raised over clauses linking the agreement to access to Zimbabwe's critical mineral resources.

The US Embassy rejected that characterisation, stating that the MoU would have provided US$367 million over five years - slightly more than earlier reported - covering HIV/AIDS treatment and prevention, tuberculosis, malaria, maternal and child health, and disease outbreak preparedness.

Washington described the proposed funding as the largest potential health investment in Zimbabwe by any international partner, structured under a co-funding model designed to gradually increase Zimbabwe's domestic health financing.

The embassy also pointed to a broader continental rollout of similar agreements, noting that 16 African countries had signed comparable deals, unlocking a combined US$18.3 billion in new health funding - US$11.2 billion from the United States and US$7.1 billion in co-investment from recipient governments.

"The United States has a responsibility to American taxpayers to invest their resources where mutual accountability, transparency, and shared commitment are assured," Tremont said.

Since 2006, the US has provided more than US$1.9 billion in health support to Zimbabwe. American-funded programmes have been credited with helping the country achieve the UNAIDS 95-95-95 targets - the global benchmark for HIV diagnosis, treatment, and viral suppression.

The 1.2 million Zimbabweans currently receiving HIV treatment through US-supported initiatives now face uncertainty as the programmes are wound down.

The Zimbabwean government has not publicly outlined how it intends to replace the funding or manage the transition of patients to alternative support mechanisms.