Ghana's President John Mahama revealed that the US health compact was rejected in record time due to concerns over data sharing and sovereignty. The compact, worth $109 million over five years, required Ghana to hand over its disease data and medical records, and strip its drug regulator of inspection powers. Mahama described the terms as "humiliating" and stated that Ghana would manage its own healthcare instead.
The compact was part of Washington's "America First Global Health Strategy", which aims to prevent outbreaks from reaching US shores, advance American commercial interests, and compete with China's influence in Africa. Analysts describe the strategy as reframing health aid as a strategic instrument. Civil society groups have warned that the agreements' terms on pathogen access and benefit sharing favour the US and Big Pharma, not Africa.
Ghana was not the only country to resist the US health compact. At least four African countries, including Zambia, South Africa, and Zimbabwe, have publicly resisted or failed to conclude new US bilateral health agreements. Kenya's agreement has faced a legal challenge, and Namibia rejected an agreement over provisions for sharing health data and biological specimens. Despite this, Washington has concluded or advanced arrangements with several countries, including Rwanda, Uganda, and Nigeria.
The consequences of rejecting the compact are now clear. Zimbabwe will lose US funding for its health programmes at the end of September after talks collapsed over data sharing. Namibia will receive $45 million for its HIV response in fiscal 2027 before moving to "technical cooperation". Ghana's decision to reject the compact has been tied to its "Accra Reset" agenda, which aims to build stronger local production of medicines and vaccines, research capacity, and health systems less dependent on external funding.
Mahama has framed the issue as one of sovereignty and belonging. He argues that health, like heritage, is about who controls what belongs to Africans. He cited the example of looted artefacts in museums, asking why Africans should not have control over their own cultural symbols. The parallel is deliberate, as Ghana's argument is that pathogen data and patient records could be exploited for profit if shared with the US.
The compact's text has not been published, and there has been no US response to Mahama's characterisation. The question now facing every African capital is whether health sovereignty is affordable. Ghana has answered no to the deal and yes to the principle. The next few years will show whether that answer can be sustained.
The rejection of the US health compact has sparked a wider debate about health sovereignty and the role of external funding in African healthcare. As Mahama stated, "Belonging is at the heart of everything". The issue is likely to continue to be a point of contention between African countries and external partners.
Key points
- Ghana rejected a $109 million US health compact due to concerns over data sharing and sovereignty.
- The compact required Ghana to hand over its disease data and medical records, and strip its drug regulator of inspection powers.
- The rejection has sparked a wider debate about health sovereignty and the role of external funding in African healthcare.
