After the 81st edition of the United Nations General Assembly that happened in New York, West Africa’s social media space has been buzzing with one news item involving Ghana’s President, His Excellency John Dramani Mahama. President Mahama was invited to what was almost like a fireside chat with the council on foreign relations and was asked why his government refused a proposed U.S. health compact worth more than $100 million, especially after the dissolution or disbandment of USAID. President Mahama went straight to the point and cited reasons why Ghana’s government and especially the Ministry of Health rejected the US Health Compact, flagging the terms and conditions as humiliating to a sovereign state like Ghana (Ogunleye, 2026).
The U.S. had demanded Ghana’s pathogen profile and the entire citizens’ medical records. The US also instructed that Ghana’s Food and Drugs Authority would not interfere, check, or regulate foreign medical products brought in by the U.S. in whatever health products and items they deliver into Ghana. This is among 4 main points the Ghanaian President cited. Now note that this deal was declined earlier in the year—April 2026—so when he was speaking in New York, he was defending his decision.
President Mahama is not the main character here. Ghana is this episode’s cold open, not the main case. Here is the bigger catch that highlights health innovation and policies, and how they travel.
The U.S. Health Compact is a bilateral agreement and was to engage 35 countries, and if agreements were concluded by the various countries, it will take effect on October 1st, 2026. In West Africa, the U.S. State Department was hoping to work with Burkina Faso, Niger, Nigeria, Senegal, Côte d’Ivoire, Guinea, Liberia, Sierra Leone and others (U.S. Department of State, 2026). Earlier, I mentioned West Africa’s social media space has been buzzing with different views and reactions. Many are wondering why their governments went on to accept the deal after hearing the details of the deal.
Nigeria signed as early as December 2025; Senegal accepted the deal in March 2026; Guinea, Niger, Sierra Leone, and Burkina Faso all signed this deal. The big question Nigerian social media users are asking is “why did we agree to this deal if these were the terms?” President Mahama rhetorically also asked a question when he was defending his country’s rejection of the deal. He asked, “Who takes another country’s medical records?” Nigeria had a five-year, $5.1 billion agreement, and social commentators have noted that the full signed text has not been made public by Nigeria’s government.
This episode highlights series on conversations/topics we have looked at in class, including “Soft Power” and Ways of Seeing.” Why did similar offers get different answers? Now, it is tempting to cast refusers as bold and signers as captured. Caution is needed in both directions.
Stay tuned for episode 2…
REFERENCES
Ogunleye, A. (2026). Mahama explains ghana’s rejection of us health compact. Retrieved October 18, 2026, from https://theguardian.com.ng/mahama-explains-ghanas-rejection-of-us-health-compact/
Usher, B. P. (2026, July 7). US-Africa health deals: Why some nations are turning down Trump’s money. BBC. https://www.bbc.com/news/articles/ckg0921y8kdo
U.S Department of State. (2025). The global health compacts and bilateral agreements. https://www.state.gov/the-global-health-compacts-and-bilateral-agreements-being-developed-in-support-of-the-september-2025-america-first-global-health-strategy-for-all-programs-and-activities-funded-under-global-health-pro/
