Ghana has rejected a bilateral health deal with the U.S., a source familiar with the negotiations told Reuters, the latest stumbling block to the Trump administration's effort to overhaul foreign aid.

The government of President John ‌Dramani Mahama balked at terms requiring the sharing of sensitive health data, the ​source said. The same issue sank talks with Zimbabwe this year and also prompted a court to suspend implementation of Kenya's deal pending the hearing of a ⁠case filed by a consumer protection group.

Spokespeople for Ghana's foreign ministry and government did not respond ​to requests for comment.

The U.S. State Department said that it does not disclose details of ⁠bilateral negotiations.

"We continue to look for ways to strengthen the bilateral partnership between our two countries," a spokesperson said.

The Trump administration in September announced a new "America First Global Health Strategy" that calls for poorer nations to play ‌a bigger role in fighting HIV/AIDS, malaria, tuberculosis, and polio in their countries ​and eventually transition from ‌aid to self-reliance.

The U.S. Agency for International Development was dismantled earlier this year.

The U.S. has ‌disbursed $219 million in foreign assistance to Ghana, including $96 million specifically for health, for 2024, the year before the Trump administration's cuts to foreign aid, according to government foreign assistance data.

The deal ⁠that the two sides started negotiating ‌last November would have called for $109 ⁠million in U.S. assistance for health over five years, the source said. It was unclear how much Ghana would have ⁠been ⁠expected to pay.

"They were pretty normal dealings and negotiations in the beginning, and then increasingly there was a lot more pressure, especially ‌at the end," the source said.

Washington then set April 24 as the deadline to conclude the negotiations, and Accra decided it could not agree to what was being proposed, the source said.

Ghana has ‌communicated its ​position to the Trump administration, the ‌source said.

As of Monday, the State Department had signed 32 deals under the "America First Global Health Strategy" representing $20.6 billion in funding, made up of $12.8 billion from the ​U.S. and $7.8 billion in "co-investment from recipient countries," the State Department spokesperson said.

Washington expects additional memorandums of understanding to be signed in the near future, the spokesperson said.