Ghana has declined a proposed five-year health assistance agreement with the United States worth approximately $109 million, after negotiations broke down over provisions that would have required the sharing of sensitive national health data, according to Reuters.
The deal was part of Washington’s broader “America First Global Health Strategy,” a policy framework introduced under the Trump administration aimed at restructuring foreign aid and encouraging recipient countries to assume a larger share of funding and responsibility for disease control programmes, including HIV/AIDS, malaria, tuberculosis, and polio.
Talks between Accra and Washington began in November 2025 and were described initially as routine, before growing increasingly strained. A source familiar with the negotiations told Reuters the process was “pretty normal dealings and negotiations in the beginning, and then increasingly there was a lot more pressure, especially at the end.”
Washington set April 24, 2026 as its deadline for concluding the agreement. Ghana ultimately determined it could not accept the proposed terms and communicated that position to the Trump administration. It remains unclear what financial contribution Ghana would have been expected to make under the co-financing structure of the deal.
Similar concerns over data governance have surfaced in US negotiations with other African countries. Zimbabwe also raised related issues earlier in 2026, while in Kenya, implementation of a comparable agreement was temporarily suspended by a court following a legal challenge filed by a consumer protection group.
Ghana’s position reflects a broader and well-documented commitment to health data sovereignty. In late 2025, Health Minister Kwabena Mintah Akandoh revealed that national health records had been stored on servers located in India under a previous contract, a disclosure that led the government to launch the Ghana Health Information Management System (GHIMS) as a state-owned replacement. The Data Protection Commission also opened a formal investigation into that arrangement. Those developments established a clear policy direction in Accra around retaining sovereign control over health data infrastructure.
According to US foreign assistance data, Washington provided $219 million in aid to Ghana in 2024, including $96 million earmarked for health programmes. As of Monday, the State Department said 32 agreements had been signed under the new global health strategy, representing $20.6 billion in funding, including $12.8 billion from the United States and $7.8 billion in co-investment from recipient countries, with additional agreements expected in the coming months.
The rejection does not affect existing bilateral health cooperation frameworks between Ghana and the United States. Ghana’s Foreign Ministry did not respond to requests for comment.
