Ghana has rejected a proposed United States health assistance agreement worth about $109 million over five years, citing concerns over data governance, sovereignty, and the structure of the proposed arrangement, according to Reuters.
Sources familiar with the matter said negotiations, which began in November, initially progressed as “pretty normal dealings and negotiations in the beginning,” but later became more pressured, with “a lot more pressure, especially at the end,” as both sides moved toward a deadline.
The agreement was expected to support health system strengthening, including cooperation in disease surveillance, digital health systems, and broader public health coordination. However, Ghanaian authorities raised concerns over the management, storage, and sharing of sensitive public health information, with particular focus on control of the national health data infrastructure.
Officials ultimately did not endorse the framework, citing the need to safeguard national data integrity and ensure compliance with domestic regulatory standards. Government considerations reportedly centred on ensuring “robust data protection safeguards” and maintaining sovereign control over health information architecture.
It was also “unclear how much Ghana would have been expected to pay” under the proposed co-financing arrangement, the source said, as the deal formed part of Washington’s broader “America First Global Health Strategy,” which links U.S. assistance to recipient country contributions.
The United States reportedly set April 24 as the deadline for concluding negotiations. Ghana ultimately decided it could not agree to the proposed terms and declined to proceed with the agreement. The source added that Accra has communicated its position to the Trump administration.
As of Monday, the U.S. State Department had signed 32 agreements under the “America First Global Health Strategy,” representing $20.6 billion in funding. This includes $12.8 billion in U.S. contributions and $7.8 billion in “co-investment from recipient countries,” according to a State Department spokesperson, who added that Washington expects additional memorandums of understanding to be signed in the near future.
The rejection does not affect existing bilateral health cooperation frameworks between Ghana and the United States but signals a more cautious approach by Accra toward new agreements involving expanded data access and integrated digital health systems.
