The U.S Embassy in Ghana has revealed that the two nations are in the final stages of concluding a bilateral health Memorandum of Understanding (MoU) designed to support Ghana’s health sovereignty through direct U.S. investment, national ownership, and long-term system strengthening.
The anticipated agreement falls under the America First Global Health Strategy, through which the United States has accelerated the negotiation and conclusion of government-to-government health partnerships that move away from traditional aid models toward direct engagement with sovereign states.
The strategy prioritises accountability, sustainability, and the integration of external support into national health systems rather than parallel structures managed by intermediaries.
In a fact sheet outlining the policy shift, the U.S. administration described the ongoing negotiations as part of historic progress in global health diplomacy, noting that within three months, several landmark bilateral health MoUs have been concluded across Africa, with additional agreements expected in the coming weeks.
The United States says the approach is intended to save lives while enabling partner countries to stand on their own.
U.S. Secretary of State Marco Rubio said the new framework corrects long-standing inefficiencies in global health financing, arguing that previous models, which relied heavily on non-governmental organisations, often limited national ownership and diluted accountability. He said the current strategy restores government leadership, ensures results reach patients, and reinforces America’s role as a global health leader while protecting U.S. national interests.
Since early December, the United States has signed bilateral health MoUs with Kenya, Rwanda, Liberia, Uganda, Lesotho, Eswatini, Mozambique, Cameroon and Nigeria. Collectively, these agreements represent more than eight billion dollars in direct U.S. assistance, matched by over five billion dollars in co-investment commitments from partner governments over a maximum period of five years.
The agreements focus on combating HIV/AIDS, tuberculosis, malaria and polio, while strengthening maternal and child health services, disease surveillance, and outbreak preparedness.
Under the MoU framework, partner governments commit to gradually increasing domestic health expenditure, transitioning frontline health workers and procurement systems to national control, strengthening health data infrastructure, and meeting agreed performance benchmarks linked to continued U.S. support.
The United States, for its part, commits to time-bound financing, technical cooperation, and the mobilisation of American health innovation and private sector participation.
Officials familiar with the Ghana discussions say the country’s MoU is expected to reflect these core principles, with an emphasis on direct investment, co-financing, and institutional resilience.
The agreement is expected to support Ghana’s efforts to reduce long-term dependency on external assistance while strengthening its capacity to prevent, detect, and respond to infectious disease threats within its own health system.
The U.S. State Department has described the bilateral health MoUs as a cornerstone of its health diplomacy, arguing that resilient national health systems abroad reduce global disease risks and enhance international security.
It says the agreements are structured to deliver measurable results, reduce waste, and ensure that both U.S. and partner country investments translate into lasting public health outcomes.
For Ghana, the impending MoU is expected to reinforce ongoing health sector reforms, improve predictability of financing for priority programmes, and deepen bilateral cooperation with the United States on the basis of shared responsibility and accountability. The United States has indicated that more bilateral health MoUs will be announced as negotiations with additional partner countries reach completion.
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