President John Dramani Mahama has publicly detailed the government’s decision to reject a $109 million health compact offered by the United States, describing its conditions as an unacceptable infringement on national sovereignty and public health oversight.
Speaking at the Council on Foreign Relations in New York on September 25, President Mahama disclosed that the proposed five-year agreement—intended to plug a funding gap left by the dismantling of USAID—required concessions that Ghana’s Cabinet rejected in “record time.”
Among the most controversial provisions was a requirement for Ghana to transfer national pathogen profiles and citizen medical records to foreign entities.
“It states that we shall give the United States our pathogen profile,” President Mahama stated. “It also says we should give our medical records. I mean, who takes another country’s medical records?”
The President further noted that the compact sought to bypass local regulatory authority by exempting all imported medical supplies under the programme from inspection by Ghana’s Food and Drugs Authority (FDA).
“Our FDA has absolutely no rights to inspect. I mean, it was humiliating,” Mahama remarked, adding that he had never seen a proposal dismissed so rapidly by Cabinet.
Beyond the regulatory exemptions, analysis of the proposed compact revealed significant structural imbalances:
• Long-Term Data Exposure: Ghana would have surrendered 25 years of citizen health data—a timeline five times longer than the five-year duration of the agreement itself.
• Broad Access: Up to 10 U.S. entities would have received access to national health data without requiring prior approval from Ghanaian authorities.
• Legal and Financial Disparity: The agreement was to be governed by U.S. law. Additionally, Ghana’s $70 million counterpart funding commitment was legally binding, whereas the U.S. contribution remained subject to congressional approval.
Security and data experts have raised serious alarms over the terms. Ghana’s Data Protection Commission characterised the compact as “outsourcing the health data architecture of the country to a foreign body.” Cybersecurity experts also warned that under the U.S. CLOUD Act, American law enforcement agencies could potentially subpoena the stored health data without notifying Ghanaian officials.
Despite a $74 million deficit created in Ghana’s health sector following the withdrawal of USAID funding, President Mahama emphasised that the nation remains firm in its decision.
“For a pittance, a hundred and something million dollars, we said no, we didn’t want it, and we’re doing fine,” Mahama said.
Ghana is now pivoting toward the “Accra Reset,” a national initiative aimed at reducing reliance on foreign health aid while strengthening domestic capacity for vaccine and pharmaceutical manufacturing.
