Why did Ghana reject the US health deal?

What the deal was

The Trump administration struck health compacts with nearly two dozen African nations under an "America First" approach to global health funding, replacing the patchwork of agreements that previously ran through USAID, which was dismantled. The deals offered hundreds of millions of dollars in US funding to countries badly hit by US aid cuts, to support their public health systems and help fight disease outbreaks.

Why Ghana walked away

Ghana's Cabinet flagged several conditions in the agreement, particularly those relating to health data, medical records, counterpart funding and the inspection of medical products entering the country.

Three specific demands drove the rejection:

• A requirement for Ghana to provide the United States with its pathogen profile, which contains information on diseases and disease-causing organisms present in the country.
• A requirement to hand over medical records, which the government considered unacceptable.
• Powers for the US FDA to inspect medical products, alongside counterpart funding obligations Ghana would have to meet.

President John Dramani Mahama justified the decision publicly, describing the compact's conditions as humiliating and an affront to the country's sovereignty. Ghana communicated its rejection to the US and sought improved conditions for a better deal.

Ghana wasn't alone

In February, authorities in Zimbabwe said they rejected the proposed deal over issues around health data, fairness and sovereignty. A Kenyan court also temporarily suspended the agreement pending the hearing of a case filed by a consumer protection group. The Democratic Republic of Congo and Uganda, by contrast, embraced Washington's new bilateral financing model.

The bigger picture Mahama is pushing

Mahama argued that Africa needs to develop the capacity to produce essential medicines and vaccines to better prepare for future health emergencies, a lesson he drew from the COVID-19 pandemic, when African countries were last in the queue for vaccines because major producers were in the West. Ghana said it would manage its health priorities independently while continuing cooperation with the US and other development partners.