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"The State Department is threatening Zambia with an embargo on essential medicines in order to plunder its minerals," said one HIV prevention advocate.
The US State Department is threatening to strip HIV/AIDS and other disease prevention funds for more than a million people in the African nation of Zambia in a bid to extort the country for greater access to its mineral wealth.
The New York Times reported Monday on the draft of a memo prepared for Secretary of State Marco Rubio, which states that "we will only secure our priorities by demonstrating willingness to publicly take support away from Zambia on a massive scale."
The Trump administration is considering whether to "significantly cut assistance" from the President’s Emergency Plan for AIDS Relief (PEPFAR), which provides daily HIV treatment to around 1.3 million Zambians and other funds for tuberculosis and malaria medications that save tens of thousands of lives each year.
At the time that PEPFAR was created, under the administration of President George W. Bush, HIV was killing around 90,000 people per year in Zambia. That number had been reduced to 16,000 in 2024, according to data from the Joint United Nations Program on HIV/AIDS (UNAIDS).
"Things are not okay," said Justin Wolfers, an economics professor at the University of Michigan and a Brookings Institution fellow.
Threats to cut PEPFAR are part of a broader push by the Trump administration to wield desperately needed foreign medical aid as a tool of coercion against impoverished nations, whose health systems have been thrown into turmoil by the Trump administration's massive cuts to the US Agency for International Development (USAID) last year.
According to the Times, 24 African nations have signed memoranda of understanding (MOU) under the Trump administration's so-called "America First Global Health Strategy" in order to unlock some US funding that has been cut.
Many of the deals require nations to increase their own health spending in order to restore just a fraction of what the US previously provided:
"According to an analysis by the nonprofit Partners in Health, health funding under the agreements would drop by 69% to Rwanda, 61% to Madagascar, 42% to Liberia, and 34% to Eswatini, where a quarter of adults live with HIV," the Times reported in January.
Meanwhile, the deals have come with other, often ideological, strings attached. Kenya's memorandum requires it to provide data guaranteeing that no funding is being used for abortion care, and to direct funds to certain Christian faith-based providers, even though they refuse services like HIV care to LGBTQ+ people.
Nigeria's agreement likewise requires more than $200 million to over 900 Christian faith-based healthcare facilities across the country and emphasizes protecting Christian victims of violence from the Islamist group Boko Haram, even though the majority of the group's victims are Muslim.
Some countries have rejected the deals, calling them one-sided and exploitative. Last month, Zimbabwe walked away from a deal that would have provided $367 million over five years because it required the country to give the US unfettered access to citizens' health data and biological samples.
The deal offered to Zambia is similar to those offered to other countries in that it requires the government to commit $340 million in health spending in exchange for $1 billion from the US over five years, less than half of what it received under previous US administrations. It also demands that Zambia provide citizens' health data to the US for 10 years, longer than the deals agreed to by other nations.
But the deal also stipulates that, to receive any funding, Zambia must provide US corporations with easier access to the nation's vast mineral wealth.
Zambia has some of the world's largest reserves of minerals such as copper, lithium, and cobalt, which are essential to green energy technology. The Trump administration says the country has given China greater access to its mines than it has given to the US.
Zambia would also be required to share mining databases with US experts and renegotiate a massive 2024 contract with the Millennium Challenge Corporation, a US-based foreign assistance agency, to reduce mining regulations.
After the terms of the deal leaked to The Guardian last month, Asia Russell, director of the HIV advocacy organisation Health GAP, derided it as a proposal for the "shameless exploitation" of Zambia.
In February, Zambia rejected the deal, with a spokesperson for the Ministry of Health saying it "did not align with the position and interests of Zambia."
Now the Trump administration is using HIV treatment funding in an effort to force its leaders back to the table and make an example of them for other countries that may seek to go their own way.
The memo describes threats to AIDS funding as a way to demonstrate the "use of sticks" to other countries with which it seeks to negotiate.
If Zambia refuses to sign, it says, “sharp public cuts to American foreign assistance would significantly demonstrate to aid-receiving countries the seriousness of our interest in collaboration and our insistence on tangible benefits under our America First foreign policy."
Zambia has already been stripped of more than half its annual PEPFAR funding from the US since the Trump administration returned to power last year through a combination of foreign aid freezes, rescissions, and budget cuts that stripped billions from the program.
A survey of 76 HIV clinics across 32 mostly African countries that received PEPFAR funds, conducted by the International Epidemiology Databases to Evaluate AIDS (IeDEA) consortium, found that, as a result of cuts, many experienced disruptions to testing and treatment, including drug shortages and staff layoffs.
Citing modeling studies, the researchers estimated that funding disruptions to PEPFAR just last year "resulted in more than 120,000 deaths by November 2025, including more than 13,000 child deaths."
Another study by Imperial College London predicted that just the three-month disruption at the beginning of President Donald Trump's second term would result in more than 37,400 excess deaths by 2060.
In a statement posted to social media on Monday, Republicans on the House Foreign Affairs Committee defended the threats to cut PEPFAR, saying that "Just like every other country, Zambia is free to walk away from these negotiations." The REpublicans said it was "ridiculous to assume the United States should fund entire health systems for countries that turn around and give priority access to critical supply chains to China."
Russell said that "the State Department is threatening Zambia with an embargo on essential medicines in order to plunder its minerals."
While she said "Zambia’s MOU text is the first we know of that explicitly ties exploitation of mineral wealth," she noted that similar "exploitative conditions" are reportedly part of other nations' memoranda as well, but that information is scarce because they have been "negotiated in secret" and texts have not been made public.
Julius Kachidza, the chair of Zambia’s Civil Society Self-Coordinating Mechanism, said that yet another massive cut in US government funding “would be apocalyptic. It could be quite a disaster, especially to me. And the majority of people living with HIV in Zambia.”
"Trump shouldn't have Greenland. Greenland is Greenland," said Denmark's foreign minister.
Greenlanders have spoken: An overwhelming majority of them do not want to leave the Kingdom of Denmark to instead become a part of the United States.
Denmark's Berlingske and Greenland's Sermitsiaq reported Tuesday that a poll conducted for the newspapers by the research firm Verian found that a whopping 85% of Greenlanders are opposed to joining the U.S., an idea that U.S. President Donald has aggressively pushed in recent weeks.
Trump has also claimed that the people of Greenland want to be a part of the U.S. "I think the people want to be with us," Trump said last week, according to the BBC.
Only 6% of Greenlanders said they want to leave the Danish Realm in favor of the U.S., and 9% are undecided, according to Berlingske. The poll, which recorded the responses of 497 Greenlandic citizens aged 18 and over, found that 45% of Greenlanders said they perceive Trump's interest in Greenland as a threat.
"Trump shouldn't have Greenland. Greenland is Greenland," said Lars Løkke Rasmussen, Denmark's foreign minister, on Tuesday, according to the Financial Times.
Since taking back the White House in November, Trump has publicly mused about not only seizing Greenland, but also retaking the Panama Canal and making Canada the 51st state.
In early January, he refused to rule out using military force to take over the canal and Greenland. "It might be that you'll have to do something. The Panama Canal is vital to our country," Trump said at a press conference. "We need Greenland for national security purposes."
Speaking on Fox News a day later, Trump's appointee for national security adviser, former Rep. Mike Waltz (R-Fla.), said that Trump's ambitions over Greenland have to do with geopolitical competition and natural resources. Greenland, the largest noncontinental island and a territory of Denmark, is mineral rich. The Arctic island is increasingly an arena of competition between China, the U.S., and Russia as ice melts and opens up new trade routes, according to the Financial Times.
During his first term, Trump directed his aides to examine whether the United States could purchase Greenland, which is home to the U.S. Space Force's Pituffik Space Base.
Last week, the Financial Times also reported on a phone call between Danish Prime Minister Mette Frederiksen and Trump, during which Trump insisted that he's serious about taking over Greenland.
"He was very firm. It was a cold shower. Before, it was hard to take it seriously. But I do think it is serious, and potentially very dangerous," said one European official who was briefed on the call and quoted anonymously by the Financial Times.
Even before the findings of the poll were reported on, Greenlanders had shown little enthusiasm for Trump's plan. "Greenland is ours. We are not for sale and will never be for sale. We must not lose our long struggle for freedom," the leftist Greenlandic Prime Minister Múte Egede said in December.
Egede has said that he wants independence from Denmark for Greenland.
Wealthy nations are responsible for most of the consumption of natural resources, according to a new United Nations report.
The world could be extracting 60% more natural resources by 2060 if current trends continue, a new United Nations report finds.
The extraction of natural resources is having calamitous effects on the climate and the environment, the report states, and demand for such resources is only rising. These natural resources range from fossil fuels to the minerals and metals used in renewable energy.
"Extraction and processing of material resources... account for over 55% of greenhouse gas emissions and 40% of particulate matter health-related impacts," says the report by the U.N. Environment Program's International Resource Panel (IRP).
The report focuses on the large amounts of resources consumed by the world's richest and largest nations, and it recommends these nations reduce their projected consumption by a third. This would reduce projected greenhouse gas emissions by 80%, benefit the environment, and improve human health.
.@UNEPIRP Global Resources Outlook launched at #UNEA6 shows rich countries use 6x more resources & have 10x the climate impact than low-income ones.
Resource extraction tripled in 50 years, set to increase 60% by 2060, challenging environmental goals.https://t.co/R3fTjcosGJ pic.twitter.com/BfO0LO2sQo
— UN Environment Programme (@UNEP) March 1, 2024
Accomplishing this goal would require making significant changes in transportation, infrastructure, food consumption, and more. That may seem lofty, but the report states this can be accomplished without sacrificing economic growth. The economy simply needs to be grown in a more sustainable fashion.
"Weak, partial, fragmented, or slow policies will not work. This can only be possible with far-reaching and truly systemic shifts in energy, food, mobility, and the built environment implemented at an unprecedented scale and speed," the report says.
The U.N. has been warning about the overconsumption of natural resources for years, and it seems the situation has only gotten more dire over time. While many wealthy nations have made progress in terms of increasing renewable energy use, less attention has been paid to the sustainable use of natural resources.
"We should not accept that meeting human needs must be resource-intensive, and we must stop stimulating extraction-based economic success. With decisive action by politicians and the private sector, a decent life for all is possible without costing the earth," said Janez Potočnik, co-chair of the IRP.