Ghana has become the latest African country to reject a new bilateral health funding deal with Donald Trump’s administration, after objecting to data-sharing terms.

The West African nation has reportedly joined Zimbabwe and Zambia in turning down a new ‘America First’ agreement to receive United States aid money.

President John Dramani Mahama’s government objected to a requirement to share sensitive health data, sources told Reuters.

Similar misgivings hit talks with Zimbabwe this year, and led a Kenyan court to halt implementation of its own deal until a case filed by a consumer protection group could be heard.

A deal with Zambia worth $1bn (£0.7bn) has been in limbo since late last year after Washington linked the money to gaining mineral rights in the copper-rich country.

Mr Trump and his secretary of state, Marco Rubio, have rebooted America’s vast international aid spending, claiming it was wasteful, ineffective and was just keeping poor countries dependent on handouts.

The overhaul has disrupted long-standing funding to HIV/Aids programmes leading to worries the virus is poised to make a rebound in parts of the continent.

Mr Trump’s administration dismantled the $40bn (£30bn)-a-year United States Agency for International Development (USAID) almost overnight, throwing aid programmes across Africa into turmoil.

Washington has instead pivoted to a new “America ⁠First Global Health Strategy” using aid more directly as a bargaining chip to secure Washington’s policy and national security interests.

US health aid money will now fund governments directly and cut out large United Nations agencies and international aid groups.

African governments will also be expected to contribute more of their own money to their health systems, and quickly prepare to stand on their own feet as US funding declines.

The final cost of closing down USAID and winding up its contracts may be as much as $19bn (£14bn), Devex reported this week, as America has to settle cancelled awards, pending invoices and termination expenses.

Washington says it has so far signed 32 new bilateral deals across the world, worth $21bn (£16bn), made up of $13bn (£10bn) in US money, matched by $8bn (£6bn) from recipient countries.

African nations who have signed up include Angola, Botswana, Burkina Faso, Burundi, Cameroon, Côte d’Ivoire, the Democratic Republic of the Congo, Eswatini, Ethiopia, Guinea, Kenya, Lesotho, Liberia, Madagascar, Malawi, Mozambique, Niger, Nigeria, Rwanda, Senegal, Sierra Leone and Uganda.

The new agreements to provide funding for HIV/Aids, malaria, tuberculosis and polio will partly make up for steep aid cuts brought in after Mr Trump was elected.

But countries’ US funding will still be an average of 49 per cent down on 2024 levels according to analysis of early deals by the Centre for Global Development.

The failed Ghana deal would have called for $109m in US health aid over five years, Reuters reported.

Data-sharing has become a sticking point in several negotiations.

Zimbabwe earlier this year rejected a $367m deal saying it was “lopsided” and a loss of sovereignty. The government accused Washington of demanding access to biological samples for research and commercial gain without sharing the benefits for future vaccines and treatments.

Dealing with the aid overhaul, which has also seen countries like Britain and France slash spending, has been high on the agenda for African leaders this week at the World Health Summit in Nairobi.

Leaders have said the cuts should force countries to fund more of their services directly.

“Rather than congratulating Trump, I would say: never spoil a good crisis,” World Health Summit president Axel Pries told AFP.

He said the steep aid cuts would probably have happened at some point anyhow, but the immediate halt had been “completely unacceptable”.

Mr Pries said he was also concerned by the data-sharing demands in the new American deals.

He said: “So I’m a little worried about individual treaties which make... data a commodity which is no longer available to the broader family of nations.”

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