Bilateral Health Deal: Ghana Declines $20.6bn U.S.-Backed Health Agreement Over Data Sharing Concerns
Ghana has declined to sign a proposed bilateral health agreement with the United States, in a move that underscores emerging tensions around data governance within Washington’s evolving foreign aid framework.
According to a source familiar with the negotiations, the government of John Dramani Mahama raised concerns over provisions that would have required the sharing of sensitive health data, ultimately stalling discussions.
The development adds to a growing list of setbacks for the U.S. under its new aid policy approach. Similar concerns reportedly derailed negotiations with Zimbabwe, while in Kenya, implementation of a related agreement has been halted by a court following a legal challenge by a consumer protection group.
Officials from Ghana’s Ministry of Foreign Affairs and the government have not publicly commented on the matter.
For its part, the United States Department of State maintained that it does not disclose details of bilateral negotiations but reiterated its commitment to strengthening ties with Ghana.
The proposed agreement formed part of the U.S. government’s “America First Global Health Strategy,” introduced in September, which seeks to shift greater responsibility for combating diseases such as HIV/AIDS, malaria, tuberculosis, and polio onto recipient countries, while encouraging a transition toward long-term self-reliance.
The policy shift follows the dismantling of the United States Agency for International Development earlier this year, signalling a broader restructuring of Washington’s foreign assistance architecture.
Data from U.S. foreign assistance records indicate that Ghana received approximately $219 million in total aid in 2024, including $96 million allocated to the health sector. Under the proposed deal, the U.S. was expected to provide about $109 million in health-related support over a five-year period, although Ghana’s potential financial commitments remain unclear.
The source further disclosed that while initial engagements were described as routine, negotiations became increasingly strained, with heightened pressure from Washington as talks progressed. An April 24 deadline was reportedly set for concluding the agreement, but Accra ultimately declined to proceed under the terms presented.
Ghana has since communicated its position to U.S. authorities, the source indicated.
Meanwhile, the U.S. State Department reports that it has concluded 32 agreements under the new health strategy, representing a combined $20.6 billion in funding—comprising $12.8 billion from the U.S. and $7.8 billion in co-investments from partner countries. Additional agreements are expected to be finalised in the coming months.
