How Nigeria Accepted Controversial US Health Deal Rejected By Ghana Amid Alleged Demand For Medical Records, Ban On Drug Inspections | Sahara Reporters
This is despite concerns which had led Ghana to reject the same US health compact over alleged demands for medical records, pathogen profile, and restrictions on the inspection of US-supplied medicines.
A fresh controversy has trailed Nigeria’s five-year health agreement with the United States involving billions of dollars in American and Nigerian health funding meant to replace the United States Agency for International Development (USAID).
This is despite concerns which had led Ghana to reject the same US health compact over alleged demands for medical records, pathogen profile, and restrictions on the inspection of US-supplied medicines.
Nigeria’s Federal Ministry of Health and Social Welfare, had in a statement in December 2025, after signing the deal, said the agreement is designed to strengthen health security, expand primary healthcare and move the country towards greater self-reliance.
The Nigerian government said the technical Memorandum of Understanding (MoU) was signed with the US to deepen bilateral health cooperation and improve the country’s capacity to detect, prevent and respond to infectious diseases, including HIV/AIDS and tuberculosis.
Under the Nigerian agreement, the two countries are expected to collaborate on disease surveillance, outbreak response, laboratory systems, biosafety, pathogen sample collection and testing, healthcare workers, health data systems and access to essential medical commodities.
The Federal Ministry of Health said the agreement covers a five-year period from April 2026 to December 2030, with the US expected to provide nearly $2 billion in grant funding, while Nigeria has committed to allocating at least six per cent of executed annual federal and state budgets to health.
According to the ministry, the Nigerian contribution is projected to mobilise nearly $3 billion in domestic health financing over the period.
The US Department of State, however, put the American commitment at nearly $2.1 billion and said Nigeria’s nearly $3 billion domestic contribution would represent “the largest co-investment any country has made to date under the America First Global Health Strategy.”
The US said its funding would support HIV, tuberculosis, malaria, maternal and child health, and polio programmes.
The US also said the agreement places a strong emphasis on Christian faith-based healthcare providers.
“Under this MOU, the Department of State, working with Congress, intends to commit nearly $2.1bn to expand essential preventative and curative services for HIV, TB, malaria, maternal and child health, and polio.
“Additionally, Nigeria will increase its domestic health expenditures by nearly $3bn during the term of the MOU, the largest co-investment any country has made to date under the America First Global Health Strategy,” a statement from the department read.
The US said the agreement was connected to reforms by the Nigerian government concerning the protection of Christian communities from violence and that dedicated funding would support Christian healthcare facilities.
The US Department of State said Nigeria has about 900 faith-based clinics and hospitals serving more than 30 per cent of the population, and that investments in these facilities are positioned to complement efforts in public-run facilities and strengthen Nigeria’s overall health infrastructure.
The US also warned that its assistance remained subject to review, stressing, “As with all foreign assistance, the President and Secretary of State retain the right to pause or terminate any programs which do not align with the national interest.”
Nigeria’s acceptance of the agreement contrasts with Ghana’s decision to reject the same proposed US health compact.
Ghanaian President John Dramani Mahama recently explained that his government turned down the proposed agreement after the country’s Health Ministry reviewed it and submitted concerns to Cabinet.
Speaking at the Council on Foreign Relations in New York on September 25, Mahama said Ghana was a sovereign country and that the proposed compact, which was intended to replace some health funding previously provided through the United States Agency for International Development (USAID), raised several concerns.
“We received the health compact from the US to replace USAID funding, and Ghana is a sovereign nation and we have our processes as a democratic country,” the Ghanaian President said.
“When the compact was received, the health ministry started examining it and did what we call Cabinet Information Paper. The compact was brought to cabinet, and we flagged several things in the compact.”
According to President Mahama, “One, it says that we shall give the United States our pathogen profile. It means, what are diseases that are endemic in Ghana? What are the pathogen profile of our country, whether it captures American standard?
“It also says we should give our medical records. I mean, who takes another country’s medical records? That was strange. And then, it says we will have to put a certain amount of money into healthcare as part of the programme.
“It also says that any medications or any medical products that shall be brought into our country, our Food and Drugs Administration has absolutely no right to inspect.”
Mahama noted, “I mean, it was humiliating. So, it was a compact that was thrown out in record time in our cabinet. I have never seen anything thrown out as fast as that.
“And so, of course we rejected it. We asked the health minister to inform the US ambassador that we didn’t need it. We will manage ourselves.
“For our patients and hundred and something (over 100) million Dollars. So, we said no, we don’t want it. And we are doing fine.”
Reports from Ghana indicate that the proposed compact was worth about $109 million over five years, significantly less than the funding package announced for Nigeria.
Meanwhile, the Nigerian government presented the health deal as part of a broader transition from dependence on foreign grants towards increased domestic health financing.
The Federal Ministry of Health said external grant support would gradually reduce while Nigeria increases domestic financing and develops more sustainable trade- and investment-based partnerships.
“This partnership underscores our determination to build a health system that can prevent, detect, and respond to health threats, while expanding access to affordable, quality care for all Nigerians.
“It also reflects our firm commitment to domestic investment, accountability, and long-term sustainability,” Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate, said.
The Nigerian government said the agreement builds on the Nigeria Health Sector Renewal Investment Initiative, launched in 2023, and the Health Sector Renewal Compact signed in December 2023 involving the Federal Government, all 36 states, the Federal Capital Territory Administration and development partners.
The government said the reforms are being implemented through a Sector-Wide Approach designed to bring governments, development partners, civil society and the private sector under a unified health plan and reporting framework.