Speaking in Accra on Monday, Mahama said the proposal included conditions relating to pathogen profiles and medical records.

“It says that we shall give the United States our pathogen profile [...] And then it also says we should give our medical records. I mean, who takes another country's medical records? And so that was strange,” Mahama said.

He also raised concerns about a condition relating to the inspection of medical products entering Ghana .

“It also says that any medications or any medical products that shall be brought into our country, our Food and Drug Administration has absolutely no right to inspect. I mean, it was humiliating,” he added. “I've never seen anything thrown out as fast as that. And so, of course, we rejected it.”

Ghana rejected the proposed $109 million, five-year deal in April, citing concerns over sensitive health data. The compact was part of the Trump administration’s “America First Global Health Strategy” and would have required Ghana to increase domestic health spending while expanding health cooperation with Washington.

Mahama placed the decision within his government's wider push for greater African control over healthcare.

He said the withdrawal of US aid had created a $74 million gap in Ghana's health budget, affecting areas including medical research, laboratories, HIV testing and antiretroviral drugs.

The funding gap helped trigger Mahama's ‘Accra Reset,’ which seeks to reduce dependence on foreign health aid while increasing local production of medicines and vaccines.

“ Africa must learn to break this dependency syndrome. What we want to do is to achieve what we call health sovereignty,” he stressed.

Mahama also pointed to Africa's experience during the Covid pandemic, saying the continent was “last in the queue” for vaccines because major vaccine producers were based in the West.