The U.S. ambassador to Zambia — Michael Gonzales — began his Thursday press conference on a somber note. After 29 minutes, he was wiping away tears.
His distress goes back to a discovery made in late 2021: Medications and medical supplies donated to Zambia by the U.S. were being stolen. After 13 months of demanding change and 33 meetings with senior members of the Zambian government, he said he had no choice but to cut $50 million in aid for medications and medical supplies.
"I view this as a heart-wrenching worst case scenario," he said at the press conference. "I've lost sleep over this. I've cried over this because I know that it's not going to be senior officials or the senior people who are getting rich from this, who are going to hurt. I know it's going to be the poor family in rural Zambia whose baby gets malaria and they won't have access to anti-malarials. It breaks my heart."
"But," he continued. "I also have a duty to the American people, to the American taxpayer, to safeguard and ensure the good use of these resources."
What happened
Between 2021 and 2023, Gonzales said his team at the embassy sent "buyers" to visit more than 2,000 pharmacies in every province and district in Zambia. They focused on stores that sold the same type of medications being donated by the U.S. and others like the Global Fund and the Zambian government. They found that 95% of those pharmacies were selling stolen drugs. And 45% of these pharmacies were selling products the U.S. "had provided to Zambia for free for Zambians in need."
"The scope, the frequency, the patterns of the theft leave me with zero doubt that this is an organized criminal endeavor that includes fairly senior people," Gonzales said.
Annually, the U.S. provides roughly $600 million in aid to Zambia with $450 million going to health related efforts. That includes $128 million for medicines and medical supplies.
The results of such investments have been impressive, Gonzales said proudly: 98% of HIV-positive people in Zambia know their status and 99% are on HIV medication that suppresses the virus. Roughly 11% of Zambians have HIV.
"Today, millions of Zambians are living longer, healthier lives because of this assistance," he said.
At the press conference, Gonzales said he was alarmed by the theft – and frustrated by the Zambian government's lack of action.
What didn't happen
On April 3, 2024, Gonzales said he and his team of investigators met with "very senior" government officials to discuss the findings of their operation. They also offered to supply U.S. experts in supply chain management and law enforcement to help stop the thefts and bring the culprits to justice.
There was "minimal action," Gonzales said, noting that "only a few mid-level officials" were arrested.
He described repeated efforts to get the Zambian government to stop the theft and hold the culprits accountable before making the decision to cut the amount of aid provided for medications.
This cut in aid is entirely distinct from the Trump Administration's sweeping changes to foreign assistance, said Gonzales, who was appointed by former President Joe Biden and sworn in as ambassador to Zambia in August 2022. In the first few weeks of his term, President Trump dismantled the U.S. Agency for International Development, which led to additional and significant medication disruptions in Zambia and elsewhere.
Gonzales said the $50 million in support for medications would not stop flowing at the end of the year, giving the current Zambian government time to procure medications in the hope of avoiding shortages.
That approach to cutting aid is noteworthy, said Dr. Paul Spiegel, director of the Center for Humanitarian Health at the Johns Hopkins Bloomberg School of Public Health.
"What stands out in this case is that, unlike the recent massive funding cuts from the U.S. administration to global health – which have been abrupt, severe and not targeted to minimize harm – the U.S. Ambassador to Zambia noted that they are allowing Zambia time to develop alternatives to mitigate disruptions to health services," he wrote in an email to NPR, calling the period between now and January 2026 "a critical window" for any efforts to seek alternative funding.
But that won't be an easy task for the government, said Spiegel, given that countries in Europe have also slashed aid budgets recently. "If they are unable to [secure alternative funds], the consequences to these cuts for treating malaria, tuberculosis and HIV will be dire – and people will die," he said.
After the Gonzales announcement, the Zambian Minister of Health — Elijah Muchima —- released a statement, saying "the Zambian Government wishes to reaffirm its commitment to resolving this unfortunate issue."
Muchima acknowledged the theft of medication is a long-standing issue in the country, saying it predates the current administration, which came to power following the 2021 election. He outlined steps the government has taken thus far, including the creation of a Joint National Drug Task force and a digital system to track medications. He also said several senior members of the Zambia Medicines & Medical Supplies Agency or ZAMMSA were suspended or removed from their positions, including the director general in February 2025. Muchima said that "all the suspects will go through the entire legal process."
Spiegel said that theft of medical supplies is "not uncommon, especially in countries with weaker health systems and inadequate oversight mechanisms." He said there have been similar cases in Nigeria, Kenya and South Africa. Indeed, drug theft and resale is a global problem that has been reported in the U.S. as well.
What now
News of the stolen medications and the $50 million cut in U.S. aid reverberated around Zambia. Chris Zumani Zimba, a Zambian political scientist affiliated with the University of Central Africa, said there were two simultaneous reactions.
On the one hand, he said, many were deeply grateful to the U.S. ambassador and America.
"In the eyes of many Zambians today, the United States government is being seen as a hero government. It is the [U.S.] government that is exposing gross and grand corruption and looting in the [Zambian] public health sector," said Zimba, who was an adviser to the previous Zambian administration. "Zambian people are looking to the American government as a political savior and a political redeemer."
On the other hand, he said, there is a sense of fear about what lies ahead.
The news that the U.S. is cutting $50 million in health aid "was received as if it was a declaration of a household funeral in many parts of Zambia, because it is going to be a health crisis," said Zimba. More than half of Zambians live below the international poverty line, and Zimba said that those most in need of help will suffer the greatest from the aid cut.
Echoing the words of Ambassador Gonzales, he said, "It's just heartbreaking."
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