Ghana reportedly rejected a health deal with the US over terms that would require sharing citizens’ personal data, the latest sign of mounting privacy concerns around the agreements being pursued by Washington.

More than a dozen African countries — including Nigeria, Rwanda, and Uganda — have signed up to the Trump administration’s America First Global Health Strategy, which asks countries to share data about pathogens that could spark epidemics, as a condition of receiving the funding. But data-sharing concerns prompted Zimbabwe to abandon talks this year over a similar deal to Ghana’s, and led a Kenyan court to suspend implementation of an agreement between Washington and Nairobi. The head of the Africa Centres for Disease Control and Prevention has previously expressed “huge concerns” over data and pathogen-sharing between African countries and the US.

Washington’s pursuit of deals comes after last year’s shuttering of the US Agency for International Development, which had disbursed $40 billion a year across 130 countries. USAID’s closure, along with aid budget cuts by other Western countries, has left some African governments struggling to cover health budget shortfalls.