Humanitarian Aid Should Never Be a Negotiating Chip

For more than 2 decades, the United States has been a global leader in the fight against HIV/AIDS. Programs such as the US President’s Emergency Plan for AIDS Relief (PEPFAR) have saved more than 25 million lives worldwide and helped transform HIV from a death sentence into a manageable chronic disease for millions of people. That legacy has been one of America’s proudest bipartisan achievements.

A recent report in the New York Times¹ suggests that HIV treatment funding for Zambia could be leveraged in negotiations over access to critical minerals, raising troubling questions about the role of humanitarian health assistance in geopolitical disputes. According to the report, US officials have considered withholding lifesaving HIV support as a tactic to encourage Zambia to grant greater access to its mineral resources. Using lifesaving medical treatment as leverage crosses moral boundaries that should never be compromised.

As infectious diseases pharmacists, health care professionals, and researchers who are dedicated to advancing patient care, we at the Society of Infectious Disease Pharmacists (SIDP) see firsthand the impact of HIV treatment programs. These do more than supply medication—they sustain entire public health systems, including laboratory infrastructure, medication supply chains, trained clinicians, and prevention programs that protect current and future generations. In Zambia alone, more than a million people rely on HIV medications supported by US programs. Interruptions in treatment will translate to viral rebound, drug resistance, preventable transmission, opportunistic infections, and death. It is undisputed that these US-sponsored programs save lives.

The fight against HIV and AIDS has long been one of the rare areas of global cooperation that transcends partisan divides. Both Republican and Democrat administrations alike have supported these programs because they advance both humanitarian values and global stability. Strong public health systems abroad reduce the spread of infectious diseases, strengthen international partnerships, and reinforce the United States’ leadership in global medicine and public health. Using medical care as leverage in geopolitical negotiations risks undermining decades of progress.

We recognize that hard bargaining is part of international diplomacy. Governments will continue to negotiate access to strategic minerals, technology, and markets; however, lifesaving HIV treatment programs should remain outside of these negotiations. Humanitarian medicine must never become collateral in diplomatic bargaining. SIDP believes strongly that trade policy and global health policy should remain distinct.

At a time in which the world still faces evolving infectious diseases threats, global health collaboration is more important now than ever. Sustaining the integrity of humanitarian aid for infectious diseases such as HIV ensures that the United States continues to lead not just in science and innovation, but also in compassion and ethical leadership. The impact of US leadership and funding for HIV initiatives has saved countless lives. That legacy is worth protecting.

REFERENCE

1. Nolen S. U.S. considers withholding H.I.V. aid unless Zambia expands minerals access. The New York Times. March 16, 2026. Accessed April 9, 2026. https://www.nytimes.com/2026/03/16/health/zambia-hiv-aid-minerals-trump.html?unlocked_article_code=1.ZlA.1lmV.BNs0LrLJbb6t&smid=url-share