Africa-Press. The struggle for influence in Africa is no longer limited to natural resources; it has expanded to include citizens’ “health data.” By rejecting a recent U.S. grant estimated at $109 million, Ghana sent a clear message: national sovereignty is not up for trade in exchange for financial support.
This report sheds light on the technical and legal dispute between Accra and Washington, and examines how data has shifted from a tool for fighting epidemics into a diplomatic battleground—reshaping the contours of African resistance to external pressure.
Data privacy
In seeking a new agreement, Ghana rejected a proposed health deal with the United States over concerns related to data privacy, becoming the latest African country to withdraw from such an agreement for similar reasons.
The deal included provisions allowing 10 U.S. entities to access sensitive health data in Ghana without sufficient safeguards and without prior consent, according to the Associated Press, citing Arnold Kavaarpu, Executive Director of Ghana’s Data Protection Authority.
The agreement was not limited to data sharing alone; it also covered metadata, dashboards, reporting tools, data models, and data dictionaries, he added.
The core issue lies in Washington exceeding the scope of data access originally requested under the bilateral agreement. Kavaarpu agreed, stating that it “went far beyond what is typically required.”
Washington has also not disclosed details of the bilateral negotiations. A U.S. State Department spokesperson, speaking on condition of anonymity, said: “We continue to explore ways to strengthen the bilateral partnership between our two countries.”
Ghana maintains its position, emphasizing that it did not approve the use of the data, and considers such access as granting a foreign party entry to individuals’ health information.
This is particularly concerning given that the proposed agreement—valued at around $300 million—allows for identifying individuals if deemed necessary in relation to sensitive health data.
Although Ghana stood to receive about $109 million in U.S. funding over five years, along with additional investments from its own government, concerns persist that such agreements often lack adequate safeguards for data use and may impose restrictions on who benefits. In Nigeria, for example, U.S. support has been largely directed toward Christian-affiliated healthcare providers.
The “America First” approach
From cooperation to conditionality, Ghana’s stance reflects a broader shift in U.S. foreign policy. Under the “America First” approach adopted by the administration of President Donald Trump toward global health funding, Washington has concluded similar agreements with more than 30 countries, most of them in Africa.
This new approach, launched late last year, replaced previous health agreements that were managed through the U.S. Agency for International Development (USAID), which has since been dismantled.
The lure of funding vs. the sovereignty trap
The new U.S. strategy relies on offering hundreds of millions of dollars to compensate for a sharp decline in aid, targeting the most affected African countries to support their health systems and combat epidemics.
However, this financial incentive has collided with the wall of “digital sovereignty,” raising legal and ethical questions about what is demanded in return.
A contagion of continental rejection
Accra is not alone in this diplomatic resistance. In February, Zimbabwean authorities firmly rejected the U.S. proposal, citing concerns related to justice, sovereignty, and the sanctity of health data.
Similarly, reports indicate that Zambia has begun pushing back against specific clauses in its agreement, signaling the emergence of an African front rejecting the trade-off between “public health” and “national privacy.”
Diplomatic resistance
U.S. ambitions extend beyond digital data to include “biological resources.” A Zimbabwean government spokesperson revealed that Washington requested access to “pathogen samples” for up to 25 years, without guarantees of sharing resulting medical innovations. This “unequal exchange,” as Zimbabwe described it, risks turning African countries into suppliers of “raw scientific materials” without tangible benefits for their populations during crises.
These agreements also require African countries to comply with U.S. regulatory approvals for new medicines and technologies, reinforcing dependence on the American regulatory system. In Rwanda, the agreement explicitly increases U.S. private sector involvement, while activists in Kenya (such as Cofek) have warned that the country risks “ceding strategic control” over its health systems and digital infrastructure to external actors.
The agreements include clauses obligating African countries to gradually increase domestic funding to replace declining U.S. investment, with the threat of funding withdrawal in case of failure. Observers see this as an unrealistic financial burden aimed at “dismantling aid” and shifting it into a national liability.
Conclusion
Ultimately, Ghana’s position represents a pivotal turning point in the continental shift. While countries like Nigeria have faced accusations of endorsing agreements that entrench sectarian bias, and others like Kenya have turned to the courts to halt implementation, Ghana has offered a model of technical and institutional resistance.
The Ghanaian model reveals that African resistance is no longer about rejecting funding outright, but about redefining its terms—where health data is no longer just a tool of relief, but a sovereign asset as critical as natural resources.
