By By: Contributing Writer
MONROVIA – Liberia secretly granted the United States sweeping authority to inspect clinics, demand patient health records, and terminate $124 million in funding with just six months’ notice, according to a new assessment released Monday by Human Rights Watch.
HRW says the unpublished memorandum of understanding, signed in Monrovia on 9 Dec 2025 by Foreign Minister Sara Beysolow Nyanti, commits Washington to about $124.4 million in health support from 2026–2030. In return, Liberia pledged roughly $50.7 million of its own money and agreed to intrusive monitoring terms that the rights group warns could put millions of patients’ care at the mercy of US policy decisions.
The most explosive clauses, HRW reported, let US officials audit up to 5% of health facilities at random or by targeting, with “data access, on-site access or other information needed” to check indicators. A separate provision forces Liberia to prove no US money is used for abortion services, per the US Helms Amendment. Failure to hand over data, the document states, could trigger cuts or cancellation of aid.
Liberia also committed to a 10-year data-sharing deal with the US Congress, to digitize all public clinics by 2030, and to punish or reward providers based on how fast they enter patient records. The government further agreed to waive customs, import and VAT taxes on US funds and to accept US FDA approval as valid for LMHRA by 31 Dec 2026. Either side can walk away with 180 days’ notice.
HRW noted Liberia’s deal omits the “specimen sharing” clause found in agreements with Rwanda, Ethiopia, Uganda, Nigeria and Mozambique that could give Washington biological samples for drug development without guaranteed access to resulting treatments.
In exchange, the US set hard health targets: cut under-5 malaria deaths from 171 to 100 annually, drop maternal mortality from 116 to 70 per 100,000, and slash measles cases from 1,283 to 100 by 2030. Miss the benchmarks or Liberia’s rising co-funding, and Washington “may substantially decrease or eliminate funding.”
Adding to the controversy, Section 6.9 says the MOU “is not an international agreement and does not create legal rights or obligations,” meaning Liberia is bound to detailed commitments without enforceable protections.
HRW obtained the deal after the US dismantled USAID in early 2025, killing over $800 million in health aid across seven African states and leaving rural clinics like those in Bong County with empty shelves. Ghana and Zimbabwe rejected similar US terms over data access, and 60+ civil society groups warned African leaders the drafts were “dangerous.” Liberia signed anyway, and the pact was only made public through leaks.
The Ministry of Foreign Affairs and Ministry of Health had not responded to HRW’s findings by press time.
Credit: Assessment published Monday by Human Rights Watch, based on the leaked Dec 9, 2025 Liberia-US health memorandum.
