ACCRA, Ghana — Ghana has rejected a proposed health partnership with the United States after officials raised concerns that the agreement would have granted American entities broad access to sensitive national health data without sufficient safeguards.
The decision makes Ghana the latest African country to distance itself from a series of health agreements introduced under Washington’s new “America First” approach to global health assistance. Similar concerns have already prompted resistance in Zimbabwe, while Zambia is also reported to have objected to elements of a comparable arrangement.
Arnold Kavaarpuo, executive director of Ghana’s Data Protection Commission, said the scale of access sought by the US extended far beyond standard public health cooperation and threatened the country’s ability to maintain control over its own digital health infrastructure.
“The scope of the requested access went far beyond what would typically be required,” Kavaarpuo said in an interview with the Associated Press. “In effect, it amounted to outsourcing the health data architecture of the country to a foreign body.”
According to Ghanaian officials involved in the negotiations, the proposed agreement — valued at roughly $300m (£225m) — would have provided Ghana with about $109m in American funding over five years, alongside additional investment from the Ghanaian government.
The funding formed part of a broader US effort to reshape international health assistance after the dismantling of the United States Agency for International Development’s previous framework. Since late last year, Washington has negotiated similar arrangements with more than 30 countries, most of them in Africa, offering support to nations grappling with severe reductions in US aid and mounting pressure on public health systems.
The agreements are intended to help countries strengthen disease surveillance, respond to outbreaks and maintain healthcare services. However, civil society groups and data protection advocates across Africa have warned that some of the deals contain weak safeguards governing how health information may be collected, shared and used.
Kavaarpuo said Ghana objected to clauses that would have allowed as many as 10 US entities to gain access not only to health datasets but also to metadata, reporting dashboards, analytical tools and data dictionaries. He said the agreement did not provide Ghanaian authorities with meaningful oversight or prior approval rights regarding how the information might eventually be used.
“We did not get the sense that Ghana had real governance oversight over the utilisation of the data,” he said. “It appeared to be more of a notification arrangement rather than one requiring prior consent.”
He also expressed concern over provisions that could have enabled the identification of individuals where deemed necessary in connection with sensitive health information.
A spokesperson for the US state department declined to comment on the specifics of the negotiations, citing the confidential nature of bilateral discussions. “We continue to look for ways to strengthen the bilateral partnership between our two countries,” the spokesperson said.
The debate over health data sovereignty has intensified across the continent as governments increasingly digitise medical records and disease-monitoring systems. Critics argue that poorer countries, particularly those reliant on external aid, may face pressure to exchange sensitive information in return for urgently needed funding.
Earlier this year, Zimbabwean authorities rejected a similar proposal, citing concerns over sovereignty, fairness and data protection. In Zambia, officials are also reported to have sought revisions to parts of their agreement, though no final decision has been announced.
Campaigners have additionally criticised aspects of the US funding model in countries such as Nigeria, where support was reportedly directed primarily towards Christian faith-based healthcare providers, raising concerns over equity and access.
Jean Kaseya, director general of the Africa Centres for Disease Control and Prevention, has previously acknowledged what he described as “huge concerns” surrounding the data-sharing provisions in the agreements.
Kavaarpuo said Ghana had formally informed the US of its decision and remained open to negotiating a revised deal under stronger conditions.
“We are not rejecting cooperation,” he said. “We are asking for a framework that protects Ghana’s sovereignty, accountability and the privacy of its citizens.”