The Accra Reset has urged African countries to increase domestic financing of healthcare as declining international aid puts greater pressure on health systems across the continent.

The call was made at a high-level Accra Reset event held in New York on the sidelines of the 81st United Nations General Assembly (UNGA).

The meeting, titled “Full Circle: Resetting Global Development”, marked one year since the initiative was launched and brought together current and former heads of state, global health leaders and development partners.

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

The report recommended that domestic resources should form the foundation of national health financing, while external assistance should increasingly support countries in strengthening their health systems and local capacity.

It also called for stronger regional institutions, coordinated procurement, investment in pharmaceutical manufacturing, technology transfer and independent mechanisms to track commitments by governments and development partners.

Ghanaian President John Mahama said African countries needed to move beyond dependence on foreign donors for essential healthcare products and services.

He said the initiative was not advocating an end to international cooperation, but sought a relationship in which African countries exercised greater control over their health priorities and resources.

Mahama said greater control must also come with stronger accountability, urging governments to ensure that public resources were properly managed.

The blueprint proposes a “one-stop” country health compact that would bring health priorities, budgets and implementation together, alongside regional procurement arrangements to improve countries’ bargaining power.

It also recommends greater technology transfer and investment in pharmaceutical manufacturing across the continent to reduce dependence on imported medicines and other essential health products.

The Accra Reset said the decline in international assistance had increased the urgency for countries to strengthen domestic and regional capacity.

Maternal and child health was identified as an immediate test of the proposed approach, with the initiative stating that nearly seven in 10 maternal deaths globally occur in sub-Saharan Africa.

A “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 selected as the first major test of the global reset.

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 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 aimed at strengthening governments’ capacity to negotiate international economic and development agreements.