ABUJA — Nigeria’s health cooperation agreement with the United States has come under renewed scrutiny following revelations by Ghanaian President John Dramani Mahama about why his government rejected a proposed US health compact containing provisions he described as unacceptable.
Nigeria and the United States signed a five-year health Memorandum of Understanding on December 19, 2025, aimed at strengthening disease surveillance, primary healthcare, laboratory systems, health data infrastructure and responses to infectious diseases. The arrangement runs from April 2026 through December 2030.
Under the agreement, Washington is expected to provide about $2 billion in grant funding, while Nigeria committed to significantly increasing domestic health financing, projected at nearly $3 billion over the five-year period.
However, Ghana’s disclosure about a similar US proposal has raised new questions about precisely what obligations accompany such health partnerships.
Ghana Says It Rejected US Proposal
President Mahama said Ghana rejected its proposed US health compact after the country’s Ministry of Health reviewed the document and presented its findings to Cabinet.
According to Mahama, Ghanaian officials objected to provisions that would have required the country to provide its pathogen profile and medical records to the United States.
He also said Ghana would have been required to provide counterpart funding and that medicines and other medical products supplied under the programme would not have been subject to inspection by Ghana’s Food and Drugs Authority.
Mahama described the proposed conditions as “humiliating” and said Cabinet rejected the compact rapidly.
The disclosure has inevitably drawn attention to Nigeria because Abuja had already accepted its own bilateral health agreement with Washington.
What Nigeria’s Agreement Says
Nigeria’s Federal Ministry of Health says its agreement covers disease surveillance, outbreak response, laboratory systems, biosafety procedures for pathogen sample collection, transportation, testing, storage and disposal, as well as stronger health-data systems.
The ministry has presented the arrangement as a major step toward strengthening Nigeria’s health security while gradually reducing dependence on foreign assistance.
But health-data and pathogen-sharing provisions have attracted concern from critics.
The broader arrangement includes plans for a regulated data-sharing framework, with Nigerian authorities saying any exchange of information must comply with applicable laws governing privacy, data protection, ownership, access rights and hosting requirements.
Concerns over privacy have already reached the courts. A lawsuit filed at the Federal High Court in Abuja in March challenged the agreement on constitutional, privacy and transparency grounds. The allegations in that case remain claims to be determined by the court.
Ghana’s Terms Should Not Automatically Be Assumed to Be Nigeria’s
Despite the similarities between the programmes, Ghana’s account does not by itself establish that Nigeria accepted every condition Ghana rejected.
Available information indicates that Nigeria’s arrangement involves health-data systems, disease surveillance and pathogen-related cooperation. However, this does not by itself establish that Nigeria agreed to surrender all Nigerians’ individual medical records to the United States or that the National Agency for Food and Drug Administration and Control, NAFDAC, surrendered its general authority to inspect US-supplied medicines.
That distinction is important as debate over the agreement intensifies.
Questions Over Transparency
The controversy nevertheless raises questions about transparency surrounding international health agreements involving sensitive health information.
For Nigerians, the central issues include what categories of health data may be shared, whether information will be anonymised, under what circumstances pathogen samples may leave the country, who can access the information, how long it may be retained and what safeguards exist against misuse.
There is also the question of whether Nigeria’s existing privacy, health and drug-regulatory laws retain full authority throughout implementation of the agreement.
The Federal Government has emphasised the benefits of the partnership, saying it will strengthen Nigeria’s ability to detect outbreaks, improve laboratories, support healthcare workers and expand access to essential health services.
Those could be significant gains for a country still confronting malaria, tuberculosis, HIV/AIDS, maternal mortality and other major public-health challenges.
But Ghana’s decision demonstrates that financial assistance is only one part of the debate.
A Wider African Debate
Ghana is not alone in raising concerns about the new US approach. Other African governments have resisted similar agreements amid disagreements over data sharing and sovereignty. Zimbabwe, for example, failed to reach an agreement with Washington following disputes that reportedly included sensitive health-data provisions.
Nigeria, meanwhile, has made one of the largest financial commitments under the US initiative, with roughly $3 billion in projected domestic health investment alongside American funding.
The emerging debate therefore goes beyond whether Nigeria should cooperate with the United States on healthcare.
It centres on the precise terms governing that cooperation — particularly the treatment of Nigerians’ health information, pathogen samples, regulatory authority and the safeguards surrounding them.
Ghana chose to reject the proposal placed before it.
Nigeria chose to sign its agreement.
The question now being raised is whether Nigerians have been given enough information to understand exactly what their government agreed to — and how the country’s health data, regulatory independence and national interests will be protected throughout the five-year partnership.
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