Ghana Rejects US $109m Health Compact, Citing Sovereignty

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Ghana rejected the proposed US $109 million health funding compact because some of its conditions would undermine the country’s health sovereignty. The decision followed a review by the Ministry of Health and Cabinet, which found several provisions unacceptable.

The Health Minister, Hon. Kwabena Mintah Akandoh, explaining the reasons during an interview, he said the conditions touched on drug regulation, patient data and national law, areas where Ghana cannot accept terms set from outside.

The agreement was meant to replace health funding the country previously received through the United States Agency for International Development (USAID). Mr Akandoh said the government remains committed to partnerships that respect Ghana’s dignity and national interests.

“We need partnership, but we need partnership with respect and dignity. So these fragmentations and tendencies and promises of partnership, no, we will have to move from dependency to dignity, from fragmentation to solidarity.”

Hon. Akandoh said the Ministry of Health first received a memorandum of understanding (MoU) from the US delegation. He insisted that both parties should review and amend the document, rather than Ghana accepting it in its original form.

The ministry studied the text and identified several concerns. These were set out in an information paper for Cabinet. The Minister said President John Dramani Mahama had directed ministers to refer to Cabinet any decision about which they were unsure.

After deliberation, Cabinet decided that Ghana would not proceed with the agreement as it stood. Mr Akandoh and the Minister for Foreign Affairs were asked to communicate the decision to their US counterparts.

Cabinet also concluded that several provisions of the agreement were inconsistent with Ghana’s domestic laws, he said.

One concern, Hon. Akandoh said, was a provision that would exempt US pharmaceutical products covered by the agreement from verification or certification by Ghana’s Food and Drugs Authority (FDA).

The FDA checks that medicines sold in Ghana meet national standards. An exemption would place some products outside that check, which the Minister regarded as a threat to the country’s authority over what enters its health system.

Hon. Akandoh also questioned provisions requiring Ghana to share health data with the United States. He rejected the argument that the arrangement involved only summarised, or aggregated, information.

“I’ve heard some people saying it is not individual data. They were looking for aggregated data. Whether aggregated data or individual data is data,”

His point was that health information belongs to the country and its citizens, and that the form in which it is shared does not remove the need for safeguards.

The Minister further questioned the name of the proposed compact, which he said reflected the US policy of “America First”.

“So you also must tell yourself Ghana first. So we came from Ghana first to meet America First,”

The remark indicated that the government wants any agreement to give equal weight to Ghana’s interests.

Hon. Akandoh disclosed that the United States has since resubmitted a revised MoU, following Ghana’s rejection of the first proposal.

“As of the last time I checked, they resubmitted another MoU because we decided not to go with the first one. And we are looking at it, and we’ll go to Cabinet for consideration.”

His comments follow President Mahama’s disclosure that the United States had asked for further discussions with Ghana to amend or remove some provisions of the proposed agreement.

The Minister dismissed any suggestion that the government was under pressure to accept the terms. “No, I’m never under any pressure” Trust us to take the best decision in the interest of the country.

The revised MoU will now go before Cabinet. The test will be whether it addresses the concerns raised on drug regulation, health data and conformity with Ghana’s laws. The outcome will also determine how the funding once supplied through USAID is replaced.

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