Ghana has rejected a proposed health compact with the United States that would have provided an estimated $109 million in US health funding over five years, with President John Dramani Mahama saying the agreement raised serious concerns over health data, financing obligations, and Ghana’s regulatory authority.

The decision places Ghana among a few African countries that have pushed back against new US health agreements introduced as Washington restructures its foreign assistance following the dismantling of USAID. Zimbabwe has also rejected a similar agreement, while Zambia has raised concerns over provisions in its negotiations with the United States.

Ghana raises concerns over health data

Speaking at the Council on Foreign Relations in New York on September 25, Mahama said the proposed compact was presented to Ghana as a replacement for health funding previously provided through USAID.

He said Ghana’s Ministry of Health reviewed the document before preparing a Cabinet Information Paper.

“Ghana is a sovereign nation, and we have our own processes. We are a democratic country,” Mahama said.

According to the President, the Cabinet identified several provisions that raised concerns, particularly those relating to Ghana’s health information.

“One, it says that we shall give the United States our pathogen profile,” he said, adding that the agreement also required Ghana to provide medical records.

“It also says we should give our medical records. I mean, who takes another country’s medical records? And so that was strange.”

Concerns over health-data sharing have been central to resistance to the new US health agreements in several African countries. 

No FDA inspection

Mahama also raised concerns about the treatment of medicines and other medical products supplied under the proposed arrangement.

He said Ghana would have been required to contribute funding to the program while, according to his account of the compact, the country’s Food and Drugs Authority would not have been able to inspect medicines or other medical products entering Ghana under the program.

“And then 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 said.

“I mean, it was humiliating.”

Ghanaian officials had previously cited concerns about the proposed handling of sensitive health information as a reason for rejecting the agreement. Reporting on the negotiations also indicated that the proposed arrangement would have required additional investment from Ghana alongside the US contribution.

Cabinet rejected the agreement

Mahama said the proposal was rejected after the Health Ministry presented its assessment to the Cabinet.

He described the decision as unusually swift.

“It was the compact that was thrown out in record time in our Cabinet. I’ve never seen anything thrown out as fast as that.”

He said the government subsequently instructed the Health Minister to communicate Ghana’s position to the US ambassador.

“And so, of course, we rejected it. And we asked the health minister to inform the US ambassador that we didn’t need it. We’ll manage ourselves.”

The proposed agreement would have provided Ghana with about $109 million in US health assistance over five years. The negotiations had begun in late 2025.

A wider concern over health sovereignty

Ghana’s decision comes as the United States seeks to shift its approach to global health cooperation. The new US strategy places greater emphasis on recipient countries taking responsibility for financing and delivering health programs, while Washington reduces its traditional aid commitments.

Kenya became the first African country to sign the agreement which was challenged in court, followed by similar arrangements with Rwanda, Liberia, Uganda, Lesotho and Eswatini, among other countries. Ravi Ram from the People’s Health Movement (PHM) East and South Africa, told BreakThrough News in December 2025, that  “Bilateral agreements between the US and Kenya and other African countries are meant to limit the ability of any one ‘partner’ country to challenge the terms of implementing the agreement, due to the unequal power relations.”

The concerns among health activists and concerned Africans is the ability of African states to determine their own health priorities, regulate medicines, control sensitive health information, and collectively negotiate the terms of international health cooperation.

On the evening of Wednesday, September 30, Bolivian police arrested Attorney General Roger Mariaca and raided the Attorney General’s Office in Sucre and Santa Cruz. The police action comes just days after the US State Department sanctioned and revoked the visas of Mariaca and 21 other Bolivians.

Analysts suggest that the timing of the US sanctions, Mariaca’s arrest, and the raids, are no coincidence, calling it “political pressure” related to a high-profile case.

Mariaca is leading the investigation into Argentine political consultant Fernando Cerimedo. The influential political advisor to Latin America’s far right allegedly influenced elections through social media bot farms, may be involved in drug trafficking, and was accused of ordering an assassination attempt on his ex-partner, Nadia Beller. She was shot three times but survived after undergoing emergency surgery.

Cerimedo has been in custody in Bolivia after attempting to leave the country by plane following the attack on Beller. Messages were found on his cell phone that, according to the prosecution, directly link him to the attempt on her life. Despite the emerging evidence against him, not only in ordering the hit on Beller, but also in crimes of corruption and drug trafficking, Cerimedo seems to have friends in high places, both in the Bolivian president’s office, and in the United States, that may have set the stage for the arrest of his investigator, Attorney General Roger Mariaca.

Read more: Attempted murder accusations, troll farms, and presidential connections: the notorious case of Fernando Cerimedo

Argentine outlet Página 12, reported that, according to Beller, the sanctions against Mariaca were “a move by Donald Trump’s team to protect Cerimedo. As the Washington Post noted this week: ‘Cerimedo is the MAGA (Make America Great Again, Trump’s slogan) man across the entire continent.’”

In the report, Beller is quoted as saying: “Is this decision by the United States part of the fight for the Shield of the Americas or is it about protecting the MAGA network?…If the reason is corruption and drug trafficking, then they need to explain why the visa is being revoked for the attorney general who is investigating a network of that nature. Are they going after the investigator, or are they protecting part of the network?”

As evidence mounts against Cerimedo, the US instead accused his investigator, Mariaca, of allegedly soliciting and accepting bribes to facilitate drug trafficking and helping people involved in violent crimes escape justice.

After news broke of the US actions against him, Roger Mariaca had said he will not back down and will continue the investigations until the end: “[I received the news] with great surprise … I will not back down even one centimeter from the investigations that fall under my jurisdiction.”

He highlighted that while it is clear that the Cerimedo case has generated international intrigue, “no political pressure, whether national or international, can become an impediment to clarifying the facts which must be investigated.”

He was arrested two days later.

Involvement in the drug trade?

In addition to Cerimedo’s well-documented ties to high profile right-wing politicians across Latin America, including in Bolivia, recent revelations from ex-partner Beller, suggest that the powerful political consultant may have also been involved in the drug trade. In a leaked audio message, Cerimedo is allegedly speaking with a woman with whom he is arranging payment so that several flights can operate without excessive pressure from the authorities. Cerimedo mentions a man named Cabrera, whom the Bolivian media suspect is Franz Cabrera, the former head of the Special Force to Fight Against Drug Trafficking (FELCN), who was recently dismissed.

According to the investigations, they allegedly “were paid” for nearly 45 flights, amounting to $700,000, raising significant suspicions about the source of the funds that the political consultant is said to have handled.

The timing of the sanctions against Mariaca and his arrest have raised questions about US interference in the Bolivian justice system. But, as pressure escalates over the investigation into Cerimedo, the case is also revealing a far deeper web of political connection and influence than was initially known, placing it under renewed scrutiny. Wether the investigation is further disrupted or allowed to proceed, what happens next could expose even more about Cerimedo and the network of the Latin American far right.

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