The State Department is considering withholding lifesaving H.I.V. assistance to Zambia as a negotiating tool to compel the southern African nation to grant the United States expanded access to its critical minerals, according to a draft memo obtained by The New York Times.
The document, prepared by the department's Africa Bureau for Secretary of State Marco Rubio, outlines a strategy that would link U.S. humanitarian aid to concessions on minerals access. Zambia possesses significant deposits of copper and cobalt, materials deemed essential for electric vehicle batteries, renewable energy infrastructure, and defense manufacturing.
"We will only secure our priorities by demonstrating willingness to publicly take support away from Zambia on a massive scale," the draft memo states.
What the Right Is Saying
Conservative supporters of the strategy argue that securing critical minerals access is a matter of national security and economic competitiveness with China. Senator Tom Cotton and other Republican foreign policy hawks have advocated for aggressive tactics to reduce U.S. dependence on Chinese-controlled supply chains.
The Heritage Foundation called the approach "a necessary recalibration of U.S. foreign policy," arguing that previous administrations were too willing to provide aid without extracting meaningful concessions. "American taxpayers deserve to see tangible strategic benefits from their investments in foreign assistance," a Heritage statement read.
Former Trump administration officials have privately expressed support for the memo's framing, noting that China has significantly expanded its influence in African resource-rich nations through infrastructure deals and loans with opaque terms. National security analysts argue that U.S. access to Zambian copper and cobalt is essential for domestic manufacturing of electric vehicles and clean energy technology.
What the Left Is Saying
Progressive lawmakers and global health advocates have condemned the reported strategy, arguing that using humanitarian aid as diplomatic leverage endangers vulnerable populations. Senator Elizabeth Warren and other progressive Democrats have called the approach "cruel" and a violation of U.S. commitments to global health.
The advocacy group Health GAP called the reported strategy "a direct threat to the lives of millions of Zambians who depend on U.S.-funded antiretroviral medication." The organization noted that Zambia has one of the highest H.I.V. prevalence rates in sub-Saharan Africa, with approximately 1.3 million people living with the virus.
Progressive foreign policy analysts have also raised concerns about the precedent such a tactic would set. The Center for Economic and Policy Research argued that linking aid to mineral access "undermines the humanitarian principles that have guided U.S. global health policy for decades."
What the Numbers Show
Zambia is home to approximately 1.3 million people living with H.I.V., representing about 6% of the adult population aged 15-49, according to UNAIDS data from 2025. The country has made significant progress in expanding antiretroviral therapy access, with treatment coverage reaching approximately 89% of those who need it.
The U.S. has provided over $6 billion in H.I.V./AIDS assistance to Zambia through the President's Emergency Plan for AIDS Relief (PEPFAR) since its inception in 2003. Annual U.S. health assistance to Zambia totals approximately $500 million, with the majority directed toward H.I.V. treatment and prevention.
Zambia holds approximately 6% of global copper reserves, making it one of the world's top copper producers. The country also has significant cobalt deposits, a critical mineral for lithium-ion batteries used in electric vehicles and energy storage systems. Global demand for copper is projected to increase 350% by 2050 as nations transition to clean energy.
The U.S. currently imports approximately 80% of its cobalt from the Democratic Republic of Congo, where Chinese investment dominates the mining sector. Zambia produces roughly 100,000 metric tons of copper annually and is seeking to expand production to 3 million metric tons by 2031.
The Bottom Line
The proposed strategy represents a significant shift in how the U.S. links humanitarian assistance to strategic economic interests. If implemented, it could affect hundreds of thousands of Zambians who receive antiretroviral medication through U.S.-funded programs.
The State Department has not confirmed whether the memo's recommendations have been adopted as official policy. A department spokesperson declined to comment on internal deliberations but emphasized that the U.S. remains committed to its global health partnerships.
The debate highlights a broader tension in American foreign policy between humanitarian commitments and strategic competition for critical resources. As the U.S. seeks to reduce dependence on Chinese-controlled supply chains, African nations with significant mineral wealth have become increasingly central to bilateral negotiations. What happens in Zambia could establish a precedent for how the U.S. approaches similar negotiations with other resource-rich nations.