The Accra Reset has called for greater domestic financing of healthcare across Africa as countries face growing pressure from declining international aid and changing global health priorities.

The call was made on Monday at a high-level Accra Reset event held in New York on the sidelines of the 81st United Nations General Assembly (UNGA), where the initiative unveiled a blueprint for reforming global health financing and governance.

The event, Full Circle: Resetting Global Development, brought together current and former heads of state, global health leaders and development partners to mark one year since the Accra Reset was launched in New York.

At the centre of the meeting was A Sovereign Future for Health, a report by the Accra Reset High-Level Panel on Reform of the Global Health Architecture and Governance.

The report recommends that domestic resources should become the foundation of national health financing, while external funding should increasingly support countries as they build stronger health systems and greater local capacity.

It also proposes stronger regional institutions, coordinated procurement, investment in pharmaceutical manufacturing, technology transfer and independent mechanisms to track whether governments and development partners deliver on their commitments.

Addressing the gathering, Ghanaian President, John Mahama said African countries must move beyond dependence on foreign donors for essential health products and services.

“When we say we are resetting Ghana’s health sector, we do not mean simply building medical facilities and waiting for foreign donors to supply the essential vaccines or IV fluids,” Mahama said.

Mahama said the Accra Reset was not advocating withdrawal from international cooperation, but a different relationship in which countries have greater control over their health priorities and resources.

“This sovereign health agenda is not a retreat into isolationism. We are seeking pragmatic interdependence: a mature, equal partnership where we see one another as equals,” he noted.

The report comes amid a period of pressure on health systems in developing countries following reductions in international assistance. The Accra Reset said the changes had increased the urgency for countries to strengthen domestic and regional capacity.

The initiative’s recommendations include a “one-stop” country health compact that would bring priorities, budgets and implementation together, as well as regional procurement arrangements designed to give countries greater bargaining power.

It also proposes a regional division of labour in health manufacturing, with greater technology transfer and investment to reduce dependence on imported medicines and other essential health products.

Mahama linked greater control over health systems with stronger accountability by national governments.

“If we demand control, we must earn it through uncompromising domestic accountability,” he said, adding that countries must ensure public resources are properly managed.

The health blueprint places maternal and child health among its immediate tests.

The Accra Reset said nearly seven in 10 maternal deaths globally occur in sub-Saharan Africa. Its Mother Africa initiative, championed by Tanzanian President Samia Suluhu Hassan, was unveiled alongside the Business United for Mothers, Babies and Youth (BUMBY) campaign, which seeks to involve the private sector in maternal and child health.

Mahama said health was deliberately chosen as the first major test of the new approach.

“That is why we selected health as the first battleground for this global reset, and why maternal and child health is our first critical test,” he said.

The Accra Reset was launched in New York during the 80th UN General Assembly in September 2025, following a health sovereignty summit convened by Mahama in Accra the previous month.

The latest meeting also launched the Global Reset Dialogues, a platform for discussions between the Global South and Global North on areas including migration, critical minerals and trade finance.

Other initiatives unveiled included Masterkey, led by Kenyan President William Ruto, to address barriers to skills and talent mobility, and SIGN, an institute intended to strengthen governments’ capacity to negotiate international economic and development agreements.

The Accra Reset said the broader objective was to move from development commitments to stronger national and regional institutions, financing mechanisms and partnerships capable of delivering measurable results.

The event formed part of the high-level activities surrounding the 81st UN General Assembly, whose 2026 theme is “Restoring Trust, Managing Transformation: A United Nations that Delivers for All.”