Donald Trump has been busy in Africa. Look no further than airstrikes in Nigeria, travel bans on 29 countries, and chummy alliances with military juntas. But dig deep enough into the muck of second-term headlines, however, and you might find another story: the administration’s medical extortion campaign.
That might sound dramatic. But according to the New York Times, a memo drafted by the State Department outlines a plan to hold lifesaving HIV medication hostage if the south African country of Zambia refuses to meet its geopolitical terms.
Though the exact demands haven’t been made public, the plan involves withholding some $115 million in support for vital HIV treatment programs, unless the Zambian government gives US companies more access to its vast mineral wealth.
The language of the Zambia memo, prepared for Marco Rubio and viewed by the NYT, makes the Trump administration’s intentions clear: “we will only secure our priorities by demonstrating willingness to publicly take support away from Zambia on a massive scale.”
The numbers are stark. According to a 2025 fact sheet, US aid supported treatment for 98 percent of Zambians afflicted with HIV — a little over 1.3 million people. One of the rationales given in the memo, the NYT notes, is that bringing US industry in will box Chinese interests out, further aiding Trump’s hawkish geopolitical ambitions, which have increasingly centered around copper.
The Trump administration, in practice, is threatening to cut off that lifeline in order to secure access to one of the world’s richest copper deposits, which it can only access with consent from the Zambian government. Yet according to the latest UN data, only 31 percent of Zambia’s mineral exports are bound for China — Switzerland is a much larger benefactor, accounting for 62 percent of the African nations’ unrefined copper trade.
The logic looks even slimier once you zoom out. Zambia has copper, sure, but it’s the world’s seventh-largest producer of the stuff. Other countries like Chile have a lot more to go around, and they send a much bigger slice to China. Chile, however, only receives a couple million dollars in US aid each year, a much weaker bargaining chip if you’re Trump or Rubio.
In this light, the people of Zambia don’t offer a strategic advantage so much as strategic convenience. With 1.3 million people dependent on the largess of the United States, the African nation would seem to have little choice but to submit to the shakedown: a squeeze meant to inflict maximum cruelty with minimum effort.
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