President John Dramani Mahama has urged African countries to end their reliance on foreign funding and take full control of their health systems, as he opened an African Union (AU) Extraordinary Summit on Universal Health Coverage and Ending AIDS in Accra.
The three-day meeting in the Ghanaian capital has drawn African heads of state, health ministers and global health leaders under the theme: “Building a Resilient and Self-Reliant African Health System”, with delegates expected to agree the Accra Declaration at its conclusion.
Mahama warned that the continent remained dangerously exposed as external development assistance for health had fallen sharply from nearly $50bn to just over $39bn in a single year, while many African governments still depend on partners to fund close to half of their health budgets.
“This is not the time to speak the language of hopelessness but the language of determination, resilience and action,” he said, calling for a decisive shift towards domestic investment and stronger political commitment.
‘New liberation struggle’
Linking today’s health challenges to Africa’s past fight against colonial rule, Mahama recalled how Osagyefo Dr Kwame Nkrumah hosted the All-African Peoples Conference in Accra in December 1958.
“Accra has always been a city where Africa has gathered to shape its destiny,” he said. “Today, 68 years later, Africa gathers once again in Accra to confront a different struggle. The liberation we seek today is not from colonial rule but from inequality, preventable disease, maternal deaths, weak health systems and dependence on others for our healthcare.”
The President urged that the summit’s final document must lead to concrete change: “My appeal is that the Accra Declaration should become a living commitment rather than another well-written document. We must hold ourselves accountable through regular monitoring, peer review and measurable progress.”
Mahama also pressed leaders to honour the pledge made 25 years ago in Abuja to allocate 15% of national budgets to health, insisting that promise must “move beyond words and become measurable action”.
“Let history record that when the old systems began to fail, African leaders gathered once again in Accra and charted a new path towards health sovereignty and total liberation,” he added.
Accra Reset Initiative unveiled
Mahama used the summit to launch the “Accra Reset Initiative”, described as a new vision for African health sovereignty. The plan includes a High-Level Panel on Global Health Architecture and Governance, which will review the rules and structures that shape global public health decision-making.
The initiative is backed by the Health Investment National Gateway Enablers (HINGE) and the Reform Interlock Observatory, which are intended to support reforms and channel investment into national health priorities.
Outlining Ghana’s domestic measures, Mahama pointed to the Ghana Medical Trust Fund, widely known as Mahama Cares, designed to shield households from the financial impact of chronic illnesses.
He pledged full support to Tanzanian President Samia Suluhu Hassan in her role as African Union Champion for Maternal and Child Health, promising that Ghana would work with her through the Accra Reset Initiative to advance the Mother Africa Call to Action.
Push for local production
Mahama underlined the continent’s continuing dependence on imports, noting that Africa still buys about 70% of its medicines and more than 90% of its medical devices from abroad, despite recent gains in vaccine manufacturing.
“New scientific capacity is emerging in Dakar, Cape Town, Kigali and many other parts of the continent,” he said, adding that “Ghana is equally investing in vaccine production through the Ghana Vaccine Institute to strengthen Africa’s manufacturing capacity.”
He recalled how, during the COVID-19 pandemic, African nations were forced to wait while wealthier states secured priority access to vaccines, describing it as a painful lesson in the risks of dependency.
WHO chief warns of lost gains
Addressing the summit, World Health Organisation (WHO) Director-General Dr Tedros Adhanom Ghebreyesus urged African governments to treat health sovereignty as a central political priority.
He cautioned that progress made over decades against HIV, tuberculosis, malaria and other diseases could be reversed unless African states increase domestic spending to compensate for falling external support.
Dr Ghebreyesus said the WHO would continue to provide technical assistance but emphasised that the decisive choices must come from African capitals. “Only African leaders can provide the political will and investments needed at this moment,” he said.
He encouraged countries to boost primary health care, expand local manufacturing, prioritise domestic financing and use data to protect people most at risk. He also pointed to conflict, poverty, weak education, insecurity and gender inequality as drivers of ill health that must be addressed in future policy.
AU leaders call for ‘complete health value chain’
Mahmoud Ali Youssouf, Chairperson of the AU Commission, told delegates that Africa “could no longer remain dependent on external budgetary decisions” for the health of its citizens.
“The health sovereignty of the continent can no longer remain dependent on external budgetary decisions. We must finance our health, train our talents and produce our solutions,” he said.
Youssouf argued that achieving health sovereignty would require stronger domestic resource mobilisation, deeper private-sector and philanthropic involvement, and greater investment in health workers, including doctors, nurses, midwives and researchers.
He said the AU Roadmap to 2030 and Beyond could only be met if Africa built a “complete health value chain”, which he defined as including vaccine and medicine production, enhanced regulation through the African Medicines Agency and reinforced disease surveillance via the Africa Centres for Disease Control and Prevention (Africa CDC).
Call for stronger political leadership
Evariste Ndayishimiye, Chairperson of the AU and President of Burundi, urged member states to renew their continental pledge to bolster political leadership, increase domestic health funding, improve accountability and widen equitable access to quality care.
He highlighted Burundi’s community health strategy – centred on health education, vaccination, hygiene promotion and early detection of disease – as evidence that local, community-based action could improve outcomes across the continent.
He called for such examples to be shared widely and said African systems must be built to anticipate crises, not just to react to emergencies.
“The solidarity of African health should not remain an aspiration, but become an architecture; an Africa that heals itself, produces its own solutions and anticipates,” he said.
The summit in Accra continues with closed-door discussions on financing mechanisms and a roadmap to 2030, with leaders expected to adopt the Accra Declaration at the end of the gathering.
