At an October meeting, signed copies of the health cooperation memorandum of understanding between the U.S. and Zambia are displayed by U.S. Embassy Chargé d'Affaires Mich Coker (left) and Zambia's Minister of Finance and National Planning Situmbeko Musokotwane (center). Minister of Health Roma Chilengi (right) applauds. U.S Embassy in Zambia hide caption

U.S Embassy in Zambia

By all appearances, it was a classic government ceremony. Officials in suits. Big black chairs around a wooden table. A cluster of microphones. It happened on October 8 in Lusaka, Zambia. Amid applause, U.S. and Zambian officials signed a global health agreement, called a Memorandum of Understanding or MOU.

But Mich Coker — the Chargé d'Affaires at the U.S. Embassy in Zambia — said this agreement was anything but classic.

"This MOU represents a fundamental shift," he said, speaking at the signing ceremony .…