Ranking Member Shaheen, Senators Schatz and Coons Press State Department on Reports of Conditioning HIV Aid on Economic Concessions in Zambia

WASHINGTON - Yesterday, U.S. Senators Jeanne Shaheen (D-NH), Ranking Member of the Senate Foreign Relations Committee, Chris Coons (D-DE) and Brian Schatz (D-HI) sent a letter to Secretary of State Marco Rubio raising alarm over reports that the State Department is considering withholding critical HIV/AIDS treatment and economic assistance to Zambia unless the country agrees to favorable economic reforms for U.S. businesses. The Senators warned that conditioning lifesaving assistance on economic concessions would undermine bipartisan global health efforts, disrupt treatment for millions and weaken U.S. standing in Africa. They urged the Department of State to reject this approach and ensure that U.S. foreign assistance supports long-term health, development and strategic interests without coercion.

"We are alarmed by reports that officials at the U.S. Department of State are proposing to withhold U.S. support for HIV treatment for 1.3 million HIV positive Zambians, and previously pledged economic assistance by the Millenium Challenge Corporation unless Zambian officials agree to provide the United States favorable economic reforms for U.S businesses. We urge you to reject this tactic of economic coercion," wrote the Senators.

"Holding lifesaving assistance hostage for American access to Zambian copper mines is a disturbing break from the long held bipartisan support for PEPFAR. In that environment, this added development that the State Department may begin conditioning health assistance on economic concessions would again risk disrupting health access for people whose lives depend on daily treatment," continued the Senators.

"We believe any concessions secured by leveraging health or development assistance will be unsustainable, cost lives, and undermine U.S. interests on the continent in the long-term. We urge you to update guidance to foreign service officers in the field and in Washington, D.C., to make clear that commercial diplomacy must do no harm and must support other foreign policy and national security priorities," concluded the Senators.

Full text of the letter is available HERE and provided below.

Dear Secretary Rubio,

We are alarmed?by?reports?that?officials?at the U.S. Department of State are proposing to withhold U.S. support for HIV treatment for 1.3?million?HIV positive Zambians, and previously pledged economic assistance by the Millenium Challenge Corporation unless?Zambian officials?agree to?provide the United States favorable economic reforms for U.S businesses. We urge you to reject this tactic of economic coercion.

Holding lifesaving?assistance?hostage for American access to Zambian copper mines is a disturbing break from the long held bipartisan support for PEPFAR. In the wake of the chaos created by the stop work orders in early 2025, confusion over the narrow definition of what constitutes "lifesaving" aid, and a lack of transparency around U.S. global health assistance budget and performance data, Congress has reaffirmed near full funding for such assistance. However, we remain disturbed that PEPFAR and other health programs are not fully operational. In that environment, this added development that the State Department may begin conditioning?health assistance?on economic concessions would again risk disrupting health access for people whose lives depend on daily treatment.?

We support your commitment to the Lobito Corridor which will traverse through Zambia to enhance regional connectivity, secure critical mineral supply chains, and drive sustainable economic growth. That is why we are surprised to learn that funding to Zambia through the MCC and DFC are also contingent on critical mineral related negotiations. We agree that critical minerals are essential to?our strategic?national security and economic?future, and we share your goal of encouraging greater reforms and an even playing field for U.S. businesses in Zambia, which would be mutually beneficial to both countries. But?we believe any concessions secured by leveraging health or development assistance will be unsustainable, cost lives, and undermine U.S. interests on the continent in the long-term. The pursuit of?commercial diplomacy at all costs, including at the cost of?the lives of?people who depend on HIV, malaria, TB, and other medical treatment, is not an effective long-term strategy. It also will not advance our health security interests or the U.S.-Zambian relationship, which is critical for American companies to access Zambian markets.

We urge you to?update guidance to foreign service officers in the field and in Washington, D.C., to make clear that commercial diplomacy must do no harm and must support other foreign policy and national security priorities.

We thank you for your attention to this?important issue?and look forward to your response.

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