Reports have emerged that the United States demanded mining cooperation and the sharing of national health-care data as conditions for providing health aid to Zambia.

According to a draft memorandum of understanding obtained by the Guardian on the 25th (local time), the United States would provide $1.012 billion (about 1.44 trillion KRW) in health funding over five years on a conditional basis. In return, the Zambian government would expand access for U.S. companies to mines in Zambia and, with the aim of increasing U.S. commercial investment, report each month to the local U.S. Embassy on the status of trade and investment promotion.

The sharing of health-care data, which are sensitive national information, was also identified as a key condition. Under the draft, Zambia would share its health-care data with the United States for 10 years and share information related to novel pathogens for 25 years. Earlier, Kenya agreed to share its national health data with the U.S. government for seven years, making the terms for Zambia less favorable than those for Kenya.

The United States also set performance targets such as increasing the number of people receiving HIV treatment in Zambia and reducing maternal mortality. It said it could terminate the agreement and withdraw support if the targets were not met.

The scale of health funding has decreased. Last year, the United States planned to provide $367 million (523.6 billion KRW) for HIV elimination alone, but the Guardian reported that the total health support identified in the current draft amounts to only $320 million (about 456.6 billion KRW).

Zambian civil society organizations protested that the U.S. government was trying to trade “life-saving health aid for minerals and data.” Asia Russell, executive director of the HIV-related group Health GAP, called the agreement “immoral and brazen exploitation” and told the Guardian, “When a greedy government uses health programs as a bargaining chip, everyone suffers.”

After the Donald Trump administration abolished the foreign-aid agency last year, the health system in Zambia has experienced a gap in support. The United States had funded about 49% of the main HIV regimen in Zambia, ‘pre-exposure prophylaxis’. Following the halt in aid, 32 drop-in centers that had provided treatment to people with HIV were closed, the Joint United Nations Programme on HIV/AIDS said.

Recently, the United States has been pushing bilateral health agreements that provide funds directly to African governments without going through aid organizations. On the same day, Zimbabwe decided to suspend negotiations on a health agreement with the United States due to concerns about sharing national health-care data, which are sensitive information.