Ghana’s $109M refusal: can a nation keep its health data and still get funded?

What is the real price of a health partnership when it comes with strings attached? Accra has just answered that question in the most direct way possible: $109 million is not enough to hand over control of the country’s medical records.

The Ghanaian government has turned down a new health agreement proposed by the United States, a package that would have delivered roughly $109 million in American funding over five years. The broader program was valued at around $300 million, factoring in complementary contributions expected from Ghana.

President John Dramani Mahama confirmed and explained the rejection during an appearance at the Council on Foreign Relations in New York on September 25. His words cut straight to the heart of the matter: “Who takes another country’s medical records?”

What the proposed deal actually contained

According to Mahama, the draft agreement would have required Ghana to share pathogen profiles and medical data with the United States. He also said the text imposed a counterpart funding obligation on Ghana and included provisions affecting oversight of medical products entering the country. For the president, these conditions were simply “humiliating.”

Yet the controversy deserves a closer look beyond the headline-grabbing quote. Ghana did not reject a $100 million envelope merely because it came from Washington. The sticking point lies in the conditions attached to the financing.

The proposed agreement, valued at approximately $300 million overall, would have provided Ghana with about $109 million over five years. Arnold Kavaarpuo, executive director of Ghana’s Data Protection Commission and a participant in the negotiations, indicated that certain provisions would have allowed access to sensitive health data under circumstances that could potentially identify individuals. In his view, the scope of that access went well beyond what is normally necessary.

The BMJ reported that the Ghanaian proposal included access to health data and pathogens for 16 American companies. The journal also noted that several clauses in the new US health agreements remain difficult to examine publicly, as not all negotiated texts have been made available.

A nuance is therefore essential: it would be excessive to claim that the United States was demanding unrestricted access to “all Ghanaians’ medical data.” What is documented, however, are Ghanaian concerns about the extent of access to health data and pathogen information.

Why this data matters so much

Behind medical records lies a genuine question of power. Health data reveals which diseases are circulating, where they are spreading, which populations are most exposed, and how epidemics are evolving.

Pathogen data can also carry considerable scientific value, contributing to research on vaccines, treatments, and surveillance of emerging outbreaks. This is precisely what fuels concerns among several African governments.

In February 2026, Jean Kaseya, director general of the Africa Centres for Disease Control and Prevention (Africa CDC), had already expressed serious concerns about provisions related to data and pathogen sharing in the new US health agreements. Some agreements required rapid sharing of sensitive data without guaranteeing African countries access to treatments or vaccines that might result from that information.

Ghana is therefore not an isolated case.

Accra’s push to reduce reliance on foreign aid

The rejection also comes in a particular context. Since the suspension of a large portion of US aid programs, Ghana has been seeking to reduce its dependence on external funding. In February 2025, the Ghanaian presidency estimated the shortfall caused by the suspension of USAID funding at $156 million, including $78.2 million directly affecting essential health programs.

The Mahama government is now promoting the idea of “health sovereignty.” This direction was reinforced in September with the launch of the report A Sovereign Future for Health, presented as part of the Accra Reset initiative. The document proposes reducing Southern countries’ dependence on external financing and strengthening their own health systems.

Accra’s message is relatively clear: Ghana wants to continue working with foreign partners, but on the basis of agreements it considers more balanced.

The medicines question: another sticking point

Another element revealed by Mahama is particularly sensitive. According to the president, the draft agreement provided that certain medicines and medical products supplied under the program would not be subject to controls by Ghana’s Food and Drugs Authority (FDA).

This claim has not been publicly confirmed in detail by the US government, which, when asked, said it does not comment on the details of bilateral negotiations. But if this provision did indeed match the text presented to the Ghanaian government, it explains part of Accra’s firmness: for the authorities, health financing should not reduce the national regulator’s ability to oversee medical products used on its territory.

Washington’s response

Washington has not publicly detailed the contested clauses. A US State Department spokesperson said the United States does not disclose details of bilateral negotiations, while stating that Washington continues to look for ways to strengthen its partnership with Ghana.

This absence of full publication of the text makes it impossible to settle certain essential questions. Exactly what data would have been accessible? To which American companies or institutions? Under what circumstances could individuals have been identified? How long would the data have been retained? What legal guarantees would have protected Ghanaian patients? On these points, public information remains incomplete.

A debate that goes far beyond Ghana

The real issue in this affair may lie precisely there. For decades, many African health systems have depended on funding, medicines, equipment, and programs from abroad. These partnerships have saved lives and helped fight major diseases.

But the digital transformation of health is now changing the nature of cooperation. Aid is no longer just about money, medicines, or equipment. It can also provide access to a strategic resource: data.

And Ghana has just reminded the world that it intends to retain control of that resource. John Mahama says his government rejected the draft after review by the Ministry of Health and its passage through Cabinet. He also says the decision had the support of the entire government and was made very quickly.

Ghana will now have to demonstrate that it can fill the abandoned funding gap without compromising its health programs. But for Accra, the choice seems deliberate: better to look for other partners than to sign an agreement the government considers incompatible with health sovereignty and the protection of Ghanaians’ data.

The question Ghana is now putting to its foreign partners is simple: when Africa receives aid to treat its people, must it also surrender control of information about those people? The debate is probably only just beginning.

By Marguerite Ndongo — Political and Security Analyst