Zambia is preparing to sign a US$1.5 billion, five-year health financing agreement with the United States, with Health Minister Professor Roma Chilengi saying the deal could be signed this week after Lusaka secured major changes to provisions that had initially raised concerns.

The funding, to be disbursed over five years with U.S. allocations expected to decline annually, will be accompanied by an increased commitment from the Zambian Government to health spending to sustain programmes as external support reduces.

“We are completely aligned. We are completely comfortable with the MOU that has been finalized now. We are hoping that it can be signed this week,” Chilengi said during a Sunday Interview.

The agreement followed extensive negotiations over provisions covering health data, biological specimens, intellectual property’, benefit sharing and the duration of certain obligations.

Chilengi said Zambia rejected provisions that could have required biological specimens collected through the country’s surveillance systems to be sent to the United States.

“No specimen would leave this country as a result of that MOU,” he said.

Zambia also sought safeguards over intellectual property if research using Zambian material contributed to the development of medicines or vaccines, as well as mechanisms for benefit sharing, capacity building and collaboration between Zambian and U.S. scientists.

The minister said the original proposal contained addenda that would have run for 25 years, despite the financing agreement covering five years. Those issues were subsequently negotiated and addressed.

The financing agreement comes as Zambia seeks to strengthen governance within the Ministry of Health’s statutory institutions.

Chilengi said the ministry has 12 statutory bodies, seven of which currently do not have boards.

“We will be, in the next two, three weeks, finishing up appointments of boards. Seven of them don’t have boards. Seven out of 12,” he said.

Among the institutions are the Zambia Medicines and Medical Supplies Agency (ZAMSA), Zambia Medicines Regulatory Authority (ZAMRA), Health Professions Council of Zambia, Food and Nutrition Commission and Mental Health Council of Zambia.

Professor Chilengi said properly functioning boards would allow the minister to concentrate on policy rather than operational “firefighting” within statutory agencies.

The ministry is also accelerating the digitisation of financial transactions in secondary and tertiary health facilities, with the aim of reducing cash handling and improving revenue collection.

“It will bring transparency, accountability, and quite frankly, we can already see improved collections of revenue. We need that revenue. We need every coin of it,” Chilengi said.

The proposed U.S. package therefore arrives alongside a broader reform agenda focused on health financing, institutional governance and digital accountability, as Zambia seeks to ensure that increased resources translate into stronger and more sustainable healthcare delivery.