MONROVIA – Liberia is stepping into a new era of international health cooperation as the United States rolls out its America First Global Health Strategy, but the historic US $176 million Memorandum of Understanding (MOU) with Liberia has drawn both cautious optimism and sharp calls for transparency. Representative Taa Wongbe of Nimba County District #9 has voiced concerns over the deal, emphasizing the need to protect Liberian sovereignty while ensuring the funding truly benefits the nation’s health system.
The America First Global Health Strategy marks a major shift in how the United States delivers foreign health assistance. After decades of funding disease-specific programs, particularly HIV/AIDS initiatives, Washington argues that only 40 percent of aid reaches frontline workers and essential commodities, with the remainder absorbed by overhead, technical assistance, and NGO-driven management. This perceived inefficiency is a central rationale for the new approach, which prioritizes direct government-to-government engagement over NGO-led programming.
Under this strategy, the US plans to sign multi-year bilateral agreements with partner governments that define priorities, responsibilities, and performance benchmarks. The agreements are intended to guarantee 100 percent coverage of commodity purchases and full funding for frontline healthcare workers, positioning governments, not NGOs, as the primary operational partners. Representative Wongbe welcomed the support but stressed that partnership does not replace national responsibility.
“The historic US $176 million health MOU, which includes up to $125 million in direct US support and nearly $51 million in required Liberian co-financing, has the potential to significantly advance our health goals,” Wongbe stated. “Our shared history with the United States is long and meaningful, rooted in partnership that has strengthened Liberia’s health systems and saved countless lives.”
Despite the promise, Wongbe called for full transparency in the agreement, particularly given that sensitive components include digital health systems, electronic medical records, disease surveillance, and data governance. He warned that Liberians have a right to know exactly what is contained in the agreement before implementation begins.
The representative highlighted regional developments as cautionary examples. He pointed to a recent decision by a High Court in Kenya, which suspended a US-Kenya $1.6 billion health deal due to concerns over data privacy, sovereignty, and constitutional oversight. “That should get our attention,” Wongbe said, urging Liberian authorities to avoid similar pitfalls.
Globally recognized institutions have also raised concerns about the America First approach. Organizations such as Africa CDC, Public Citizen, Chatham House, the Center for Global Development, Georgetown University’s O’Neill Institute, and the Council on Foreign Relations’ Think Global Health have warned that these bilateral health agreements can create structural imbalances, weaken African control over health data, and pose long-term sovereignty risks if proper safeguards are not in place.
Wongbe stressed that Liberia is particularly vulnerable because the country does not yet have a comprehensive national data protection law. “Health data is not just numbers; it is national security, privacy, and dignity,” he said. He underscored the importance of safeguarding electronic medical records, national surveillance systems, and outbreak data against potential external overreach.
To address these risks, Wongbe outlined three immediate actions. First, he called for the full public release of the complete MOU, including all annexes, appendices, data-sharing clauses, and any specimen-sharing arrangements. Second, he recommended a temporary pause on sensitive data-sharing or audit provisions until the agreement is fully reviewed and aligned with Liberian law. Third, he urged the development of a national framework to protect Liberian health data, ensuring sovereign control over all digital health information.
Wongbe emphasized that these measures are not intended to reject the partnership but to ensure it is responsible and transparent. “We can embrace this support while demanding accountability and strong protections for our people,” he said, highlighting that transparency strengthens trust, and trust strengthens partnerships.
The US strategy also emphasizes the development of robust health data systems, outbreak detection, and long-term monitoring. Washington intends to maintain a strong on-the-ground presence of US government technical staff to support surveillance and rapid response. Partner countries are expected to integrate these systems within national health information architectures, rather than allowing parallel donor-driven platforms.
Wongbe’s call for scrutiny reflects a broader concern that Liberia must balance the advantages of significant external funding with the imperatives of sovereignty and public accountability. He warned against rushed implementation of provisions that could undermine national control or place Liberia in a vulnerable position.
The representative announced that a formal letter will be sent to the Minister of Foreign Affairs requesting the immediate public release of the full MOU and all associated annexes. He emphasized that this step is critical to ensure that the health investment serves Liberia’s national interests fully and transparently.
Finally, Wongbe concluded by reaffirming Liberia’s commitment to improving its health system without compromising national sovereignty. “Liberia’s health system must improve, but not at the cost of our sovereignty. Transparency strengthens trust, and trust strengthens partnerships,” he said, urging all stakeholders to prioritize accountability alongside the benefits of the historic US investment.
