President John Dramani Mahama has called for a fundamental shift in the global health system, arguing that countries in the Global South cannot achieve genuine ownership of their health systems without greater control over financing, resources and production capacity.
He made the call in New York on Monday, September 21, after launching the High-Level Panel Report of the Accra Reset, titled “A Sovereign Future for Health,” on the sidelines of the 81st United Nations General Assembly.
The report proposes reforms to the global health architecture aimed at strengthening national and regional capacity, increasing domestic ownership and promoting more accountable partnerships between developing countries and international development institutions.
President Mahama said the initiative was intended to move developing countries away from a model in which critical health programmes remain heavily dependent on external funding and decisions taken outside their jurisdictions.
“One year ago, through the Accra Reset, we rejected the idea that the health, dignity, and future of our people should remain perpetually tied to foreign donor magnanimity,” he said in a Facebook post announcing the report.
He argued that the concept of “country ownership” had often failed to give developing countries meaningful control over the resources and decisions that shape their health systems.
“To put it plainly, we were handed a broken cauldron and asked to own a soup cooked entirely in someone else’s kitchen,” he said.
“Today, through the Accra Reset, we declare unequivocally that there can be NO ownership without control.”
Mahama links health sovereignty to accountability
While advocating greater control for developing countries, President Mahama stressed that sovereignty must be accompanied by stronger domestic accountability.
He said Ghana’s reform agenda would focus on improving fiscal management, combating corruption and strengthening local productive capacity.
“However, sovereignty is not a blank check. If we demand control, we must earn it through uncompromising domestic accountability,” he said.
According to the President, the Resetting Ghana agenda includes measures to strengthen fiscal management and expand local industrial capacity, particularly in the pharmaceutical sector.
He said the goal was to enable Ghanaian pharmaceutical companies to produce essential medicines locally and reduce excessive dependence on external assistance.
The High-Level Panel report similarly recommends stronger regional health manufacturing, coordinated procurement, improved commodity security, sustainable financing transitions and independent mechanisms to track governments and development partners against agreed commitments.
Maternal mortality at centre of health agenda
President Mahama said health had been selected as the first major area of focus under the Accra Reset, with particular attention to maternal mortality across sub-Saharan Africa.
He highlighted initiatives including Mother Africa and Business United for Mothers, Babies and Youth (BUMBY) as part of efforts to translate the commitments into practical interventions for women, children and young people.
“We are selecting health as our first battleground with a direct focus on ending the unacceptable maternal mortality rates across Sub-Saharan Africa,” he said.
The Accra Reset’s Full Circle programme in New York placed the health report at the centre of discussions on a proposed new global development framework, alongside initiatives focused on maternal and child health, skills development, fair deal-making and shared prosperity.
Report proposes new global health bargain
President Mahama said the report provides a framework for what he described as a New Global Bargain, built around three key principles: ownership backed by meaningful control over resources and production capabilities; cooperation based on human dignity and equal partnerships; and domestic accountability to ensure public resources benefit citizens.
“The report sets out a clear path for a New Global Bargain built on Ownership backed by real control over our resources and production capabilities, Cooperation defined by human dignity, [and] mature, equal partnerships with global allies, and Absolute domestic accountability to ensure public resources serve our citizens down to the last pesewa,” he said.
Among its proposals, the High-Level Panel report calls for a country-led “one-stop” health compact, sustainable financing transitions, stronger regional institutions, expanded regional health manufacturing and improved procurement systems.
It also recommends independent follow-up mechanisms to monitor commitments, with the process expected to begin within six months, while country-led health compacts are proposed to be developed within 12 months.
The report does not advocate an abrupt end to international assistance. Instead, it proposes a managed transition in which external support continues to protect essential health services while countries progressively develop stronger national and regional health capabilities.
President Mahama expressed gratitude to former Nigerian President Olusegun Obasanjo, former Liberian President Ellen Johnson Sirleaf and former Costa Rican President Laura Chinchilla, as well as the High-Level Panel’s co-chairs and other partners, for their contributions to the initiative.
