The Trump administration is reportedly considering cutting back on HIV aid to Zambia unless the country agrees to a deal giving the United States more access to its minerals.

Last year, the Trump administration suspended billions of dollars in foreign aid, disrupting humanitarian efforts worldwide. Following those cuts, the State Department has been trying to pressure countries into signing new agreements pledging to meet certain conditions in order to receive aid.

According to a report by the New York Times, a draft memo from the State Department outlines plans to “significantly cut assistance” in May to pressure the Zambian government into a deal. The US is allegedly trying to use the deal to gain more access to Zambia’s mineral wealth, which includes huge reserves of copper, lithium and cobalt.

In Zambia, around 1.3 million people rely on HIV treatment to survive. 42% of those drugs are provided through PEPFAR, the US President’s Emergency Plan for AIDS Relief. Zambia has been one of the top beneficiaries of PEPFAR assistance, which began under the George W. Bush administration at a time when 90,000 people a year were dying of AIDS-related complications in the country and the health system was collapsing.

The New York Times obtained a copy of a draft memo prepared for Secretary of State Marco Rubio by the department’s Africa Bureau staff. “We will only secure our priorities by demonstrating willingness to publicly take support away from Zambia on a massive scale,” the memo stated.

The document went on to outline how getting the Zambian government to sign the deal would involve “the potential use of sticks”, adding that the country should not be allowed to backtrack because other countries are watching.

If the Zambian government refused to sign, “sharp public cuts to American foreign assistance would significantly demonstrate to aid-receiving countries the seriousness of our interest in collaboration and our insistence on tangible benefits under our America First foreign policy,” the memo stated.

According to the New York Times report, the deal proposes to give Zambia $1 billion in health aid over five years, which is less than half the amount of assistance the country received before the Trump administration took office. Zambia would also need to commit $340 million in new health spending of its own to receive the funding.

A second part of the deal would give American businesses increased access to Zambia’s mineral resources, while a third part would see the renegotiation of a contract with the Millennium Challenge Corporation, requiring regulatory changes in mining and other industries.

As the memo suggests, Zambia will need to agree to all three parts of the agreement by May in order to maintain the portion of HIV aid it now receives through PEPFAR. The memo was approved by a number of officials who are informing the American side of the negotiations.

The State Department has declined to comment on the memo, replying to the New York Times’s request by stating that it would not comment “on purportedly leaked documents or on deliberative diplomatic discussions.”