ZAMBIA has been removed from the World Health Organization’s health workforce safeguards red list, a designation that discourages active international recruitment from countries with low health worker density and low universal health coverage.
The WHO in March 2026 reduced the list from 55 countries in 2023 to 36 countries in a technical update, saying the reduction was primarily due to improvements in the Universal Health Coverage Service Coverage Index. Zambia was among African countries dropped under the revised criteria.
The removal comes after a major recruitment drive since 2021 and a new financing deal with the United States.
Since taking office in August 2021, President Hakainde Hichilema’s administration has recruited more than 18,000 health workers, according to official figures cited by the president and the Ministry of Health.
The initial bulk recruitment of 11,276 workers in 2022 was followed by subsequent annual exercises. A 2025 exercise added 2,000 positions, bringing the cumulative total to about 20,000, the Civil Service Commission said. The ruling United Party for National Development has put the figure at 23,560 over five years.
The 2026 national budget provided for an additional 2,500 health workers, as part of 6,000 new posts for health and education, Finance Minister Situmbeko Musokotwane said last year.
Despite the gains, challenges remain. WHO’s 2024-2027 cooperation strategy for Zambia noted that the Ministry of Health’s establishment grew from 63,057 positions in 2016 to 126,831 in 2021, but only 63,878 were filled in 2021, a vacancy rate of about 52%. Government has also invested in 75 maternity annexes, 66 new health facilities and staff housing in Southern Province since 2022, and says availability of essential medicines improved from 35% to 87%.
The UHC Service Coverage Index used for the WHO list tracks 14 indicators across reproductive and child health, infectious diseases, non-communicable diseases and service capacity, not just headcount of workers.
The U.S.-Zambia pact is expected to accelerate recruitment. On Oct. 9, Zambia and the U.S. signed a five-year, $2.49 billion health cooperation memorandum of understanding in Lusaka.
The State Department said the U.S. will contribute $1.52 billion and Zambia will add $975 million over five years. The deal was negotiated under the Trump administration’s America First Global Health Strategy after the dismantling of USAID, shifting from a donor-recipient model to co-investment.
Zambian negotiators said they removed specimen-sharing and broad patient-data clauses that had stalled talks in May and decoupled the health deal from separate negotiations on critical minerals. Zambia is Africa’s second-largest copper producer.
Health Minister Roma Chilengi said the agreement will finance the recruitment of 40,000 health workers, 15,000 frontline workers and 25,000 community health workers and secure HIV, tuberculosis and malaria medicines. It will also support Zambia’s own procurement through the Zambia Medicines and Medical Supplies Agency and expansion of digital health systems.
“This partnership is about shared security and prosperity,” U.S. Chargé d’Affaires Mich Coker said. “Infectious diseases know no borders.”
Chilengi said the pact contains no clauses compromising Zambia’s security through data sharing.
For Zambia, exiting the WHO safeguards list removes a reputational barrier that restricted active recruitment by foreign employers and recruitment agencies under the UK Code of Practice. An analysis this week noted Zambia remains on the UK’s published red list as of Oct. 12 and that the UK list had not yet been updated to reflect WHO’s proposed 2026 changes.
(Mwebantu, Tuesday, 13th October, 2026)