The five-year deal is worth $3.6 billion in total, combined funding from both countries for the African nation’s health services, Zambian Minister of Health Roma Chilengi said at a press briefing on Tuesday.

He didn’t say how much the U.S. would commit. However, he told Zambian state broadcaster ZNBC on Monday the U.S. would provide $1.5 billion over five years.

The U.S. has signed new bilateral health agreements with around two dozen African nations since last year, but some have pushed back on requirements to provide patient data.

The African deals follow USAID cut

The Trump administration is pursuing bilateral agreements with African nations under U.S. President Donald Trump’s “America First” approach after dismantling the U.S. Agency for International Development, once the world’s largest humanitarian donor.

The new agreements aim to commit African nations to gradually increase spending on health services while the U.S. gradually phases out its assistance.

However, the clauses that commit African countries to hand over health data and specimens to the U.S. government on request have been some of the most controversial.

“I want to announce here that the (agreement) as it stands now … has no reference to any specimen sharing conditions,” said Zambia’s Chilengi, adding that clauses committing Zambia to share individual health data had also been “completely removed.”

“Zambia will not be obliged to share any specimen,” he said. He called the U.S. a critical partner and said Zambia was grateful for the assistance.

The agreement will be signed on Thursday, Chilengi said.

The data sharing clauses have been controversial

The U.S. has already signed health data and specimen-sharing agreements with at least nine African nations, committing them to send data and specimens within five days of a request, according to agreements published by the U.S. State Department.

The U.S. says it can then give the health data and specimens to up to 10 American “non-government entities” to develop diagnostics and medical treatments. The entities are not specified.

The agreements say the information will help it track and prepare for new and emerging infectious diseases that have “epidemic or pandemic potential.” But they do not guarantee that the African nation that provided the data would benefit from any medical treatments developed.

They would only receive treatments developed “subject to the availability of funds” and “behind the U.S. government’s domestic need,” according to the agreements. The African nation would also have to pay for them.

Some countries have rejected the US terms

In February, Zambia’s neighbor, Zimbabwe, rejected a U.S. health deal partially over the data and specimen-sharing requirements.

“In essence, our nation would provide the raw materials for scientific discovery without any assurance that the end products would be accessible to our people should a future health crisis emerge,” Zimbabwe government spokesperson Nick Mangwana said at the time.

The U.S. announced it ended all health assistance to Zimbabwe last month.

Namibia, another southern African nation, also rejected some of these clauses, according to local media reports. The U.S. announced it would phase out funding for Namibia’s HIV treatment and prevention program last month, though neither country publicly tied the decision to the disagreement over health data.

Ghana has also issued a similar rejection.

Ghanaian President John Dramani Mahama said last month while in New York for the United Nations General Assembly that the U.S. wanted information about endemic diseases and the country’s medical records, but Ghana would have no right to inspect medications or medical products brought into the country.

Mahama said Ghana’s Cabinet inspected the proposal and it was “thrown out in record time.”

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Imray reported from Cape Town, South Africa.

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