Nigeria’s $2.1bn US health deal under scrutiny: Ghana rejected similar pact over medical data, sovereignty concerns

• Olusegun Adeniyi’s ThisDay article raises questions over Nigeria’s $3bn health commitment, five-day deadline for sharing disease samples, and alleged gaps in legal and executive scrutiny.

Nigeria’s five-year health agreement with the United States has come under renewed scrutiny following revelations that Ghana rejected a similar American proposal over concerns about access to citizens’ medical records, biological samples and national regulatory authority.

The concerns were highlighted by veteran columnist Olusegun Adeniyi in his ThisDay newspaper article, “Ghana Read the Fine Print, Did We?”, in which he questioned whether Nigerian authorities adequately examined the implications of the agreement before committing billions of dollars in public funds and agreeing to share sensitive health information with Washington.

The article draws a sharp contrast between Ghanaian President John Dramani Mahama’s account of his government’s rejection of the proposed American Health Compact and Nigeria’s decision to sign a five-year bilateral health Memorandum of Understanding (MoU) with the United States on December 19, 2025.

At stake are questions about the protection of Nigerians’ medical data, ownership and use of biological samples, domestic health financing, regulatory independence and the extent to which the government considered the long-term consequences of the agreement.

Adeniyi’s account also raises questions about whether the Nigeria Data Protection Commission, the Federal Executive Council and the Office of the Attorney-General of the Federation were involved in reviewing the agreement.

The complete signed documents and official approval records would be needed to establish what safeguards were negotiated and what consultations took place.

HOW GHANA REJECTED THE AMERICAN HEALTH COMPACT

According to Adeniyi, Mahama recounted Ghana’s experience on September 25 while speaking at the Council on Foreign Relations in New York during the 81st session of the United Nations General Assembly.

Asked how Ghana had responded to the closure of the United States Agency for International Development (USAID), Mahama explained that Washington subsequently proposed a Health Compact intended to replace some of the lost funding.

Ghana’s Ministry of Health examined the document and prepared a Cabinet Information Paper identifying several objectionable provisions.

Among the concerns were requirements for Ghana to provide its pathogen profile, effectively a catalogue of diseases endemic in the country, and make citizens’ medical records available.

The proposed arrangement also required Ghana to provide counterpart funding and reportedly exempted medicines and medical products supplied under the programme from inspection by the country’s Food and Drugs Authority.

Mahama said his Cabinet rejected the proposal and directed the health minister to communicate the decision to the American ambassador.

Recalling the episode, the Ghanaian president told his American audience:

“It was humiliating.”

He then posed a question that has become central to the debate over the agreements:

“Who takes another country’s medical records?”

Adeniyi reported that the episode occurred in April 2025, when Ghana walked away from a proposed arrangement under which Washington would have provided approximately $109 million over five years.

The significant difference, he argued, was not merely that Ghana rejected the offer but that its officials examined the document, identified the problematic provisions and subjected them to Cabinet scrutiny before making a decision.

NIGERIA SIGNS $2.1BN US HEALTH AGREEMENT

Nigeria signed its five-year health MoU with the United States on December 19, 2025, under Washington’s America First Global Health Strategy.

Under the arrangement described by Adeniyi, the United States pledged approximately $2.1 billion, while Nigeria committed nearly $3 billion in additional domestic health spending.

The US Mission in Nigeria reportedly described the Nigerian contribution as the largest co-investment by any country under the strategy.

The federal government initially presented the agreement as a landmark partnership intended to strengthen health security and improve healthcare delivery.

However, according to Adeniyi, the government did not initially disclose the full terms of the agreement.

Nigerians subsequently learned some of its provisions through a report by Daily Trust, which obtained and examined a copy of the document.

The disclosure has raised questions about the transparency surrounding an agreement involving substantial public expenditure and commitments relating to disease surveillance, health information and biological materials.

Adeniyi argues that the terms should have been subjected to the same rigorous scrutiny he says Ghana applied to its proposed agreement.

FIVE DAYS TO SHARE BIOLOGICAL SAMPLES WITH THE US

One of the most consequential provisions identified in Adeniyi’s article concerns Nigeria’s obligation to share information and biological materials relating to emerging infectious diseases.

According to his account, the agreement requires Nigeria to provide specimens, samples, sequencing data and related information on novel and emerging infectious diseases within five days of a request from the United States government.

The arrangement also reportedly allows the American government to transfer these materials to non-government entities in the United States involved in developing diagnostic tools and medical countermeasures.

The provisions raise questions about the future use of biological materials collected in Nigeria and the safeguards governing any research or commercial development arising from them.

Adeniyi also drew attention to the agreement’s reported commitment to prioritising Nigeria’s access to vaccines or medicines developed primarily from its samples.

That commitment, however, is subject to the availability of funds and applicable legal requirements.

More significantly, the article highlights a clause stating that termination of the agreement would not affect the American government’s use of materials already shared.

The provision reportedly states that termination:

“shall NOT affect the use by the U.S. Government”

of materials previously supplied.

The wording raises questions about whether Nigeria would retain any meaningful control over biological materials after their transfer, particularly if the agreement were terminated.

It also highlights the importance of clarifying the parties’ rights regarding intellectual property, research findings, commercial products and access to resulting medical technologies.

The precise legal implications would need to be established from the complete agreement and any related specimen-sharing documents.

NIGERIA TO FUND MORE THAN 90% OF SURVEILLANCE AND OUTBREAK RESPONSE

The financial commitments outlined in Adeniyi’s article have also attracted attention.

For surveillance and outbreak response, the United States is reportedly contributing approximately $20.9 million, while Nigeria is committing about $238 million.

Based on those figures, Nigeria would bear approximately 92 per cent of the combined expenditure in that category.

The arrangement therefore raises questions about the balance between the financial responsibilities undertaken by Nigeria and the benefits expected from the partnership.

Nigeria has also reportedly committed to implementing electronic health records across every health facility by 2030, beginning with coverage of 20 per cent of facilities in the first year.

Under the workforce component, Nigeria is expected to fund 57,816 frontline health workers between 2028 and 2030, while the United States would finance 64,240 workers between 2026 and 2029.

These commitments come at a time when Nigeria faces significant challenges in healthcare financing, infrastructure and the release of approved budgetary allocations.

Adeniyi highlighted remarks attributed to the Coordinating Minister of Health and Social Welfare, Professor Muhammad Ali Pate, during the 2026 budget defence before the House of Representatives Committee on Healthcare Services.

According to the article, Pate disclosed that only ₦36 million of the ₦218 billion appropriated for capital projects by his ministry in 2025 had been released.

That represents approximately 0.017 per cent of the allocation.

The minister reportedly attributed the shortfall to the cash-planning system operated by the Office of the Accountant-General of the Federation and delays in counterpart contributions.

The disclosure has prompted a fundamental question: how will Nigeria meet nearly $3 billion in additional health commitments if the government struggles to release appropriated funds for existing projects?

Adeniyi also noted that the agreement reportedly allows Washington to modify its planned assistance or terminate the arrangement if Nigeria fails to meet its obligations.

The juxtaposition of the reported budgetary shortfall and the new international commitments raises questions about the financial planning behind the agreement.

DATA PROTECTION COMMISSION, ATTORNEY-GENERAL UNDER SPOTLIGHT

A central issue in Adeniyi’s article is whether Nigerian authorities with relevant legal and regulatory responsibilities participated in reviewing the agreement.

In Ghana, Adeniyi reported that Arnold Kavaarpuo, executive director of the country’s Data Protection Commission, was part of the negotiating team.

Nigeria, meanwhile, has a Data Protection Act enacted in 2023 and a Nigeria Data Protection Commission established under the law.

The commission’s potential role is particularly relevant because the agreement reportedly covers sensitive health information and the transfer of biological materials to a foreign government.

Adeniyi questioned whether the commission was consulted before the agreement was signed.

He also asked whether the Federal Executive Council deliberated on the MoU and what role the Office of the Attorney-General of the Federation played in examining its legal implications.

These questions have not been answered by the information contained in the article.

Without the relevant official records, it would be premature to conclude that the agencies were excluded from the process. Nevertheless, the questions highlight the need for the government to explain how the agreement was reviewed and approved.

The answers would help establish whether Nigeria’s data-protection framework, public-finance requirements and regulatory responsibilities were adequately considered before the country entered into the arrangement.

US HEALTH FUNDING AND RELIGIOUS VIOLENCE: QUESTIONS OVER THE POLICY CONNECTION

Adeniyi’s article also examines the political context surrounding the agreement.

According to the US Mission’s statement cited in the article, the MoU was negotiated in connection with Nigerian government reforms intended to prioritise the protection of Christian populations from extremist violence.

Approximately $200 million is reportedly earmarked for 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 indicated that it expects Nigeria to make measurable progress against religiously motivated violence targeting Christian communities.

The provisions have raised questions about the relationship between healthcare assistance and the foreign-policy objectives of the United States.

Faith-based health facilities have historically provided medical services to Nigerians across religious lines, and funding for them does not in itself establish discrimination against other communities.

However, Adeniyi questioned the connection between the agreement’s framing and the Nigerian government’s earlier rejection of Washington’s characterisation of religious violence in the country.

On October 31, 2025, President Donald Trump designated Nigeria a Country of Particular Concern over allegations of genocide against Christians. The Nigerian government rejected that characterisation as inconsistent with the situation on the ground.

Adeniyi noted that approximately seven weeks later, Nigeria signed a health agreement that Washington publicly connected to protecting Christian populations.

The sequence raises questions about how the stated policy objectives influenced the agreement’s funding priorities and conditions.

Establishing the extent of that influence would require examination of the complete agreement, the negotiating record and relevant government statements.

KENYA’S COURT CHALLENGE AND OTHER AFRICAN COUNTRIES’ RESPONSES

Nigeria is not the only African country facing questions about the American health agreements.

According to Adeniyi, Kenya signed its agreement in Washington on December 4, 2025.

When concerns arose over the data-sharing provisions, President William Ruto reportedly assured Kenyans that the Attorney-General had reviewed the document “with a toothcomb”.

Within a week, Kenya’s High Court suspended the data-sharing components following a petition by the Consumers Federation of Kenya. Public pressure also led the country’s Ministry of Health to publish the 37-page agreement.

Adeniyi further reported that Zimbabwe broke off negotiations over a proposed $367 million package amid sovereignty concerns.

In Zambia, the country’s foreign minister reportedly confirmed that Washington had sought to link its health assistance to a critical minerals agreement.

The developments illustrate the range of responses African governments have adopted, from signing agreements to seeking judicial intervention or withdrawing from negotiations.

Adeniyi cited figures from the US State Department indicating that 35 countries had signed agreements under the strategy, including 24 African countries.

The broader question is whether governments have sufficiently examined the legal, financial and strategic consequences before accepting the proposed terms.

WILL NIGERIA BENEFIT FROM VACCINES DEVELOPED FROM ITS SAMPLES?

Adeniyi also questioned whether the agreement advances Nigeria’s longstanding ambitions to strengthen domestic vaccine production and pharmaceutical manufacturing.

He recalled a Special National Council on Health session he moderated on December 3, 2021, at the invitation of the Federal Ministry of Health.

The session, themed Health and the Economy – Role of Vaccines, examined lessons from the COVID-19 pandemic and the role of vaccines in national health preparedness.

According to Adeniyi, a concept note supplied to him before the event cited an unpublished brief by the Africa Centres for Disease Control indicating that Africa accounted for 25 per cent of global vaccine consumption, while only one per cent of the 12 million vaccine doses used annually were produced in the region.

Nigeria was not among the five countries identified in the brief as having capacity for downstream vaccine manufacturing.

The session brought together health ministers and stakeholders, including representatives of the World Bank and the World Health Organization.

Against this background, Adeniyi questioned how the new American agreement aligns with Nigeria’s aspirations to develop local vaccine production and improve its capacity to manufacture essential medical products.

If Nigerian biological samples contribute to the development of a vaccine, diagnostic tool or treatment, what arrangements would enable Nigerian researchers and manufacturers to participate in the resulting research and production?

Would Nigeria gain access to relevant technologies and manufacturing expertise, or would the country primarily provide samples, data and funding?

The agreement’s reported provision prioritising Nigeria’s access to products developed from its samples does not, by itself, establish what rights Nigeria would have over intellectual property, commercialisation or domestic production.

Those issues would need to be clarified through the full agreement and any related research or benefit-sharing arrangements.

ADENIYI CALLS FOR FULL DISCLOSURE AND POSSIBLE RENEGOTIATION

Adeniyi’s central argument is that Nigeria should not accept international health agreements without carefully examining their long-term implications.

He acknowledges that the United States is entitled to pursue its national interests and that international health partnerships can deliver important benefits.

However, he argues that such arrangements must be based on a clear understanding of the obligations undertaken by both parties.

He recommends that the federal government publish the full text of the MoU and the specimen-sharing agreement.

Where provisions are found to be one-sided, he argues, Nigeria should seek amendments through renewed negotiations.

He also calls for stronger safeguards against the signing of agreements affecting citizens’ medical records, biological samples or the authority of the National Agency for Food and Drug Administration and Control (NAFDAC) without appropriate scrutiny.

Ghana’s experience, he argues, demonstrates that a government can reject unacceptable provisions without necessarily abandoning the prospect of cooperation.

At a town hall meeting in Goaso, in Ghana’s Ahafo Region, Mahama reportedly disclosed that American officials had subsequently returned to seek discussions on the disputed clauses, with a view to amending or removing them.

The development, as described by Adeniyi, suggests that a government willing to question proposed terms may retain an opportunity to negotiate changes.

The precise status of those discussions and any proposed amendments would need confirmation from official sources.

WHAT DID NIGERIA AGREE TO?

The controversy surrounding the US-Nigeria health agreement has placed transparency, data protection, public spending and national health sovereignty at the centre of a growing public-interest debate.

Adeniyi’s comparison with Ghana raises a fundamental question about whether Nigerian officials subjected the agreement to sufficient scrutiny before signing it.

The key issues include the transfer of biological samples, the use of health information by third parties, the allocation of financial responsibilities, the ownership of medical innovations and the conditions under which Washington can suspend assistance.

The federal government now faces calls to publish the full agreement and explain the legal and administrative processes that led to its approval.

Adeniyi’s warning captures the central argument of his article:

“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.”

For Nigeria, the immediate task is to establish what the agreement requires, what safeguards it contains and whether its terms adequately protect the country’s interests.

Ultimately, the question is not simply how much money the United States has promised Nigeria.

It is what Nigeria has committed to provide in return, what protections it secured, and whether the agreement advances the long-term interests of Nigerians.