A policy brief by retired Colonel Festus B. Aboagye has backed the decision by President John Dramani Mahama’s Cabinet to reject a proposed US$109 million United States health compact, warning of potential implications for Ghana’s health data, biological resources, regulatory authority and national sovereignty.
The September 2026 brief, titled “Health Data, Pathogens and National Sovereignty”, examines Ghana’s proposed agreement under the United States’ America First Global Health Strategy.
The strategy seeks to provide health assistance while requiring recipient countries to assume greater financial and operational responsibility for their health programmes.
Ghana rejected the proposed five-year compact following concerns over provisions relating to sensitive health information, pathogen data, counterpart funding and the regulatory authority of the Food and Drugs Authority (FDA).
President Mahama subsequently confirmed that Cabinet had rejected the proposal after a review by the Ministry of Health.
Speaking at the Council on Foreign Relations in New York on September 25, 2026, Mr Mahama said the proposed arrangement would have required Ghana to provide its national pathogen profile and citizens’ medical records, commit counterpart funding and accept restrictions on the FDA’s inspection of certain medical products supplied under the programme.
According to Col. Aboagye’s brief, the proposed compact raised questions across four areas of what it describes as health sovereignty — biological, informational, regulatory and financial.
On biological sovereignty, the brief argues that a national pathogen profile could constitute a strategic asset because it contains information about diseases circulating in Ghana and the characteristics of pathogens.
It says such information could have implications for Ghana’s bargaining position in future pandemics, particularly in an environment where countries are increasingly negotiating access to pathogens, vaccines and other biological materials.
On information sovereignty, the report raises concerns about long-term access to population health data.
It argues that large health datasets could have strategic value because they may reveal patterns relating to disease burden, genetic characteristics, occupational groups and other attributes of a population.
The brief cites a 2026 Lancet correspondence concerning access to electronic medical records at a Ghanaian referral hospital during a contractual dispute with an electronic records provider.
According to the author, the episode demonstrated that control over health information could have implications beyond individual privacy and become an issue of national resilience.
On regulatory sovereignty, the report focuses on the proposed exemption from FDA inspection for medical products supplied under the compact.
It argues that independent inspection provides a safeguard against substandard and falsified medicines and helps preserve national regulatory control over the pharmaceutical supply chain.
An exemption, it says, could have placed part of Ghana’s medicine supply chain under the judgement of a foreign regulator.
The brief, however, makes a distinction between the provisions that Ghanaian officials have publicly confirmed and model terms contained in templates associated with the US global health strategy or agreements involving other countries.
It says some of the model terms discussed in the report were not confirmed as part of Ghana’s proposed compact.
Among the model provisions examined is a potential 25-year data and specimen-sharing arrangement, under which countries could be required to provide pathogen specimens and epidemiological data.
The author stresses that such provisions should not automatically be treated as confirmed terms of Ghana’s proposed agreement.
The report compares the proposed health compact with two earlier forms of US-Ghana cooperation — the Medical Exercise (MEDFLAG) programme and the 2018 Defence Cooperation Agreement (DCA).
It argues that the three frameworks involved different forms of access.
MEDFLAG, according to the report, provided temporary operational access for joint medical exercises, while the 2018 DCA institutionalised US military access to specified facilities and areas in Ghana.
The proposed health compact, by contrast, would have involved access to health information and pathogen specimens, together with financial and regulatory commitments.
The brief describes this as a movement from more visible forms of physical and military access towards less visible forms of access involving information, biological material and regulatory authority.
It also argues that the proposed arrangement would have been less reversible because of the long-term nature of some of the data and specimen provisions outlined in the model terms.
The report also acknowledges the financial consequences associated with the withdrawal of US health assistance.
It says President Mahama has indicated that US$174 million had been programmed into the national budget following the withdrawal of US assistance, while the health sector faced a funding shortfall of about US$74 million.
According to the brief, the funding gap could affect HIV testing and antiretroviral treatment, laboratory services and malaria commodities.
It therefore argues that any effort to protect Ghana’s control over health data and biological materials must be accompanied by measures to safeguard the continuity of essential health services.
Rather than ending health cooperation with the United States, Col. Aboagye proposes a framework under which Ghana would continue engaging Washington while establishing clearer conditions governing access to health information and biological materials.
The brief’s principal recommendation is the adoption of a tiered health data sovereignty framework under which health information would be classified according to its sensitivity.
It proposes distinguishing between aggregate or shareable information, de-identified datasets and identifiable medical records, with different conditions governing access to each category.
The report also calls for parliamentary scrutiny and approval of international agreements that provide continuing foreign access to nationally significant health data or biological specimens.
It recommends that pathogen-sharing be anchored in the World Health Organisation’s pandemic benefit-sharing system, rather than being based primarily on non-reciprocal bilateral arrangements.
The report further recommends that Ghana make the FDA’s inspection authority non-waivable in health supply agreements.
It proposes that no agreement should exempt imported medical products from FDA inspection, although Ghana could voluntarily rely on trusted foreign regulators to accelerate approvals.
The brief also calls for domestic financing for HIV, tuberculosis and malaria commodities to be ring-fenced to reduce the risk of shortages arising from changes in external funding.
It proposes that Ghana present Washington with a counter-offer based on Ghana-hosted aggregate data, rather than direct access to individual medical records.
The report also recommends that health negotiations be kept separate from defence and other diplomatic tracks.
The policy brief advocates a common African position on health data and pathogen sharing.
It recommends that Ghana coordinate its position with ECOWAS, the African Union and the Africa Centres for
Disease Control and Prevention (Africa CDC).
According to the report, a common regional framework could establish shared principles for health data and specimen sharing and reduce the likelihood of individual African countries negotiating separate arrangements with external powers.
In its conclusion, the brief says Ghana’s position should not be interpreted as a rejection of international health cooperation.
Instead, it advocates what it describes as “selective sovereignty” — continued cooperation, training and sharing of aggregate or appropriately protected information while retaining national control over identifiable medical records, biological specimens and regulatory authority.
The report says Cabinet’s rejection of the proposed compact provides an opportunity for Ghana to develop a broader framework for negotiating international health agreements.
It argues that future arrangements should balance the benefits of international assistance with safeguards for Ghana’s health information, biological resources, regulatory institutions and long-term national interests.
President Mahama has also said Ghana remains committed to cooperation with the United States and other development partners, despite the decision to reject the proposed health compact.
