On Friday, a senior Ghanaian official confirmed to the Associated Press that Accra has turned down a proposed bilateral health partnership with the United States, joining a growing list of African nations walking away from the agreement over unaddressed data privacy and national sovereignty risks. The core sticking point for Ghana was the deal’s provisions granting U.S. entities broad, unsupervised access to the country’s most sensitive health data without adequate regulatory safeguards, according to Arnold Kavaarpuo, executive director of Ghana’s Data Protection Commission, the government body directly involved in negotiation talks. Kavaarpuo emphasized that the scope of data access the U.S. demanded far exceeded the standard parameters aligned with the deal’s stated public health objectives.
The U.S. State Department has not issued an immediate response to requests for comment on Kavaarpuo’s remarks. The framework of these health partnerships was first rolled out under the Trump administration’s “America First” global health strategy, which replaced a fragmented network of older health aid agreements overseen by the now-restructured U.S. Agency for International Development. To date, Washington has finalized similar deals with close to 24 African countries, offering hundreds of millions of dollars in funding to nations that previously faced U.S. aid cuts, with the stated goal of shoring up local public health systems and strengthening outbreak response capacity.
Despite the financial incentives on offer, the agreements have sparked widespread criticism and pushback across the continent over long-standing concerns about data governance and national sovereignty. Zimbabwe became the first country to publicly reject the proposal back in February, citing identical worries around health data access, unfair terms, and threats to national sovereignty. Zambia has also pushed for revisions to problematic sections of the draft agreement, though it has not yet announced a final decision on whether to move forward.
African privacy and public health activists have repeatedly flagged that most versions of the agreement lack sufficient guardrails for sensitive personal and population health data. In some cases, the deals also include restrictive provisions: for example, in Nigeria, the U.S. has committed to prioritizing funding exclusively for Christian faith-based healthcare providers, limiting access to support for broader public health infrastructure. Jean Kaseya, Director General of the Africa Centres for Disease Control and Prevention, previously told reporters that the organization holds “huge concerns” about the deal’s terms around both health data and pathogen sharing between African nations and U.S. entities.
For Ghana, the proposed $300 million total agreement would have allocated roughly $109 million in U.S. funding to the country over a five-year period, with matching supplemental investment from the Ghanaian government. Kavaarpuo outlined that the most problematic provision allowed U.S. entities to de-identify patient data at their own discretion, a policy that effectively amounted to outsourcing Ghana’s entire national health data governance infrastructure to a foreign power. The agreement would have granted access not just to aggregated health datasets, but also to underlying metadata, public health dashboards, national reporting tools, standardized data models, and official data dictionaries. Up to 10 separate U.S. entities would have been permitted to access this full suite of data with no requirement for prior approval from Ghanaian authorities, regardless of the intended use case.
“We did not get any assurance that Ghana would retain meaningful governance and oversight over how this sensitive data would be used,” Kavaarpuo explained. “The agreement only required U.S. entities to notify Ghana after they had already completed a project involving data access, rather than establishing a mandatory prior approval framework.”
Kavaarpuo confirmed that Ghana has formally communicated its rejection of the current draft agreement to U.S. officials, and has requested revised negotiations to address the country’s core concerns around data governance and sovereignty before any new deal can be reached.