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Ghana Read the Fine Print, Did We?
By Olusegun Adeniyi
On 25th September, while in New York for the 81st session of the United Nations General Assembly, President John Dramani Mahama of Ghana was a guest at the Council on Foreign Relations. Asked how his country had been coping since Washington shut down the United States Agency for International Development (USAID), Mahama gave a very revealing response. After USAID closed, according to Mahama, the US returned with a ‘Health Compact’ meant to replace some of the lost funding. In line with established procedure, Ghana’s Ministry of Health studied the document and prepared a Cabinet Information Paper. By the time it got to Cabinet, several clauses had been flagged. Ghana was to give the United States its pathogen profile, essentially a catalogue of diseases endemic in the country. Ghana was to make available the medical records of citizens. Ghana was to commit a specified sum of its own money as counterpart funding. And medicines and medical products brought into the country under the programme would be beyond the inspection of Ghana’s Food and Drugs Authority (FDA)!
Chuckling, Mahama said he had never seen his Cabinet throw out any document as fast as it threw out the American ‘Health Compact’. The Minister of Health was then directed to convey the rejection to the US Ambassador in Ghana. “It was humiliating,” Mahama told his American audience, before posing the question: “Who takes another country’s medical records?”
The episode recounted by Mahama happened in April this year, with Reuters reporting at the time that Accra had walked away from a deal under which Washington would provide about $109 million over five years. What was new in Mahama’s New York account was how the decision was reached. Unfortunately, the same document that Accra considered humiliating in many of its essentials appears to be the one Abuja signed without a murmur.
On 19 December 2025, Nigeria and the US signed a five-year bilateral health Memorandum of Understanding (MoU) under what Washington calls the ‘America First Global Health Strategy’. The US is to provide about $2.1 billion while Nigeria commits nearly $3 billion in new domestic health spending, a contribution the US Mission advertised as the largest co-investment made by any country under the strategy. At the time, the federal government spoke of a ‘landmark’ agreement to strengthen health security without disclosing its content. It took a report by Daily Trust, after the newspaper sighted a copy, for Nigerians to learn some of what had been signed on their behalf.
One, Nigeria is to begin sharing specimens, samples, sequencing data and related information on novel and emerging infectious diseases within five days of a request from the US government. Two, Nigeria consents to Washington passing these materials on to non-government American entities that develop diagnostics and medical countermeasures. Three, should a vaccine or drug emerge primarily from our samples, the US promises to prioritise Nigeria’s access, but only if funds are available and the law allows. And should Nigeria decide to terminate the agreement, the document is explicit that termination “shall NOT affect the use by the U.S. Government” of whatever has already been shared.
The money also tells its own story. For surveillance and outbreak response, the US is putting in about $20.9 million while Nigeria provides about $238 million. In other words, we will bear more than 90 per cent of the cost of building the very surveillance system whose harvest we have agreed to ship across the Atlantic within five days of a request. Nigeria has also committed to rolling out electronic health records in every health facility by 2030, starting with 20 per cent of facilities this year, and to funding 57,816 frontline health workers between 2028 and 2030, while the Americans pay for 64,240 from 2026 to 2029.
On 3rd December 2021, at the invitation of the Federal Ministry of Health, I moderated a Special National Council on Health session with the theme, ‘Health and the Economy – Role of Vaccines’. It was held to apply the lessons learnt from the Covid-19 pandemic at a period when the role of vaccines and its deployment was in conversation. The concept note that I was given before the session quoted an unpublished brief by the Africa Centers for Disease Control (Africa CDC), revealing that the continent accounts for 25% of the global vaccine consumption, “yet, only 1% of the 12 million vaccine doses used annually are produced in the region”. Meanwhile, Nigeria was not even listed among the five identified vaccine value chain countries with capacity for downstream manufacturing, with health authorities pledging to change that narrative. How does this American ‘Health Compact’ fit into the conclusions reached at that session which had the then Health Ministers and other stakeholders, including representatives of the World Bank and World Health Organisation (WHO) in attendance?
What is particularly more instructive is that barely seven weeks after Nigeria pledged some $3 billion in new health spending to a foreign partner, the Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate, told the House of Representatives Committee on Healthcare Services during the 2026 budget defence that only N36 million of the N218 billion appropriated for capital projects by his ministry in 2025 was released. That is less than 0.02 per cent. The minister blamed the cash planning system of the Office of the Accountant-General of the Federation and delays in counterpart contributions. Yet this is the same treasury on which we are now relying to honour commitments to a partner that has written into the specimen agreement that any failure on our part could lead it to change its planned assistance or terminate the arrangement altogether!
Then there is the matter of framing. According to the statement issued by the US Mission, the MoU was negotiated in connection with reforms by the Nigerian government “to prioritise the protection of Christian populations from extremist violence”. About $200 million is dedicated to more than 900 Christian faith-based health facilities. Washington also retains the right to pause or terminate programmes that do not align with American national interests, and has said it expects Nigeria to make measurable progress against religiously motivated violence targeting Christian communities.
Faith-based hospitals have served Nigerians of every creed for generations, and nobody should begrudge them support. But we should recall that when President Donald Trump designated Nigeria a ‘Country of Particular Concern’ on 31 October 2025 over alleged genocide against Christians, our government rejected the claim as not reflecting the reality on the ground. Some of us also echoed that position. Seven weeks later, the same government put our signature to a health agreement anchored, at least in Washington’s telling, on that same narrative.
Nigeria is, of course, not alone. Kenya was the first to sign, in Washington on 4 December 2025. When questions arose about the data provisions, President William Ruto assured his compatriots that the Attorney-General had gone through the agreement “with a toothcomb”. Within a week, the High Court suspended the data-sharing components on a petition by the Consumers Federation of Kenya, and the Ministry of Health was compelled by public pressure to publish the 37-page document. Zimbabwe reportedly broke off talks on a $367 million offer on grounds of sovereignty, while Zambia’s Foreign Minister confirmed that Washington had sought to link its health money to a critical minerals deal. By the State Department’s own count, 35 countries have now signed these agreements, 24 of them in Africa. My country is one of them!
What this American ‘health compact’ has exposed is that our officials do not process document before they append their signature on behalf of the rest of us. Nobody asks what happens to our data after the money runs out or who owns the vaccine developed from a sample collected in Kano or Calabar or Ibadan. And then, did anyone care about whether the treasury can actually find the counterpart funds being pledged? Those who drafted the template in Washington knew exactly what they wanted. Those who signed on our side didn’t seem to know what they were giving away. That is how we end up with contracts that are skewed against our own people.
What distinguished Ghana in this instance was process. A ministry read the document and flagged the offending clauses. Then the cabinet deliberated. And the Executive Director of Ghana’s Data Protection Commission, Arnold Kavaarpuo, was reportedly part of the negotiating team. Nigeria has a Data Protection Act enacted in 2023 and a Nigeria Data Protection Commission established under it. Was the commission consulted before we agreed to share health data and biological samples with a foreign government? Did the Federal Executive Council deliberate on the MoU? What role did the office of the Attorney-General of the Federation play? These are not rhetorical questions. Nigerians deserve answers.
Rigour, incidentally, has its reward. At a recent town hall meeting in Goaso, Ahafo Region, Mahama disclosed that the Americans have since come back, asking to sit down with Ghana to discuss the objectionable clauses with a view to amending or removing them. When you read the fine print and say no with reasons, you are taken seriously. When you sign whatever is placed before you, others will take advantage.
To be fair, Washington is entitled to pursue its interests. What we signed is called ‘America First’, so there was no pretense about that. Let me also add that not every demand for data is sinister and there is merit in the argument that a country taking ownership of its health financing should be prepared to account for outcomes. But a partnership worthy of the name must be between parties who have both read what they are signing and conclude it’s in the interest of their respective countries.
So, what is to be done? The federal government should publish the full text of the MoU and the specimen sharing agreement. Where the terms are plainly one-sided, as the termination clause is, we should do what Ghana has shown to be possible: return to the table. And going forward, no official should sign any agreement that touches the medical records of Nigerians, their biological samples, or the authority of the National Agency for Food and Drug Administration and Control (NAFDAC).
At the end, the humiliation Mahama spoke about in New York was not really in what Washington asked for. It was in the assumption that African leaders would sign anything put before them without questioning. Sadly, in too many of our capitals, including Abuja, that assumption has been proved right.
Goodnight, Auntie Bimbo
The death of Pastor Abimbola Ajayi has hit some of us very hard. As the Head Usher for the ‘Apapa Family’ of the Redeemed Christian Church of God (RCCG) from the late nineties to the turn of the Millennium, auntie Bimbo (as most of us called her) saw the role not as a position of authority but purely for service. With that disposition, she led by example, ministering through humility, personal integrity and an uncompromising commitment to excellence. But her influence was beyond ‘Apapa Family’.
Even though the late Pastor Adetokunbo Abayomi Olorunnimbe was the RCCG National Head Usher at the time, because of his other commitments as Secretary to the General Overseer, Pastor E.A. Adeboye, auntie Bimbo was effectively in charge of ushering during the Conventions, Congresses, Holy Ghost Nights and other national programmes. In the process, she delegated responsibilities to many of us with her quiet authority. David Henshaw, Tokunbo Talabi, Kayode Alaka, Paddy Ezekiel, Fred Okuagba, Seye Kosoko, Muyiwa Adeyemo (Lemurex), Sola Fagbire, Kunle Ojo, Jide Taiwo, Osa Ezekiel, Olaoluwa Debayo-Doherty, Felix Ummuna, Abraham Adaji, Derinsola Salau, Funsho Onifade, Akeem Olayiwola, Muyiwa Adeboye (‘Our Lord, Bishop’), Elizabeth Afolabi and many others who are now Pastors in their own rights were members of this core group who drew inspiration from auntie Bimbo’s selfless leadership.
An architect by profession, Auntie Bimbo was not only kind but also had a gracious attitude which helped to inspire a sense of community within the RCCG ushering department in those days while teaching us to put the needs of others before our own. As Gideon Kyegh, one of the younger ushers at the time, wrote in his tribute on a WhatsApp platform in auntie Bimbo’s memory, “We drove your car, slept in your house, spent endless nights with you in Camp, marked the beams in the auditorium with you…your impact is beyond measure.”
May God comfort the family she left behind.
Ladbone @ 80
One of Nigeria’s finest journalists and a respected newspaper manager, Mr Lade Bonuola, will today mark his 80th birthday in Lagos with a book launch. Ladbone, as he is fondly called, has had an exceptional career spanning almost six decades. From his days at Daily Times where he was Features Editor, and authored the influential column, ‘Caught Out’, to The Guardian where he was the founding Editor (and later, Managing Director), ladbone remains one of the most respected veterans of this business and a role model for many of us. I wish him happy birthday, long life and good health.
• You can follow me on my X handle, @Olusegunverdict and on www.olusegunadeniyi.com
