Renewed push for Africa to have a say in global financial architecture

African leaders have continued to endorse a new initiative to overhaul outdated, selfish, and Western-centred global financial, health and development models that try to recolonise the continent.

Through an initiative, dubbed the Accra Reset, a global south–anchored platform that calls for a fundamental re-engineering of international development, global governance, and financing models, the leaders led by Ghanaian President John Dramani Mahama plan to transform the continent’s financial architecture. 

The lobby gets support from Presidents in multiple countries in Africa, Asia, and Latin America. Mahama first mentioned it during the 80th Session of the United Nations General Assembly in late September 2025, positioning it as an initiative to overhaul global health and development systems for greater African leadership and self-reliance, and building on the August 2025 Africa Health Sovereignty Summit in Accra. 

He based his argument for the transformation of the global system, starting at the United Nations itself, on his own country’s transformation. 

In his speech before the assembly, he outlined his experience of driving Ghanaian economic transformation as a second-time President, having served one term and lost, and then been reelected after one term by his successor. 

“Our currency, the cedi, was rapidly depreciating. Faced with rising inflation, a huge debt burden, and low morale amongst our citizens, my new administration quickly embarked on an ambitious programme of comprehensive transformation designed to restructure Ghana’s economic foundation and enhance our competitive standing globally. We refer to this process of recalibration as our ‘Resetting Ghana agenda’,” he said.  He challenged the UN to undertake a similar transformation, pointing out that its own structure is outdated and no longer represents its membership and priorities as envisioned at its founding in 1945, 80 years ago. 

He said the UN has to reassess its role, redefine its profile, and reshape its structures. “It should truly reflect the diversity of our universe and ensure equity among the nations in the exercise of power within the system of international relations. In general, and the Security Council in particular,” he said. 

The proposed Accra Reset builds on the outcomes of the August 5th Africa Health Sovereignty Summit hosted by President Mahama in Accra, which agreed that Africa must move from aid dependency to self-determination and fleshed out a process for reimagining a global health governance architecture in which Africa shares power and accountability.

Unfulfilled deadlines

Plans are also advanced for Accra Reset presidents to commission a high-level panel on reforming the global health architecture and its governance.

Global health experts seem to agree that the time for a recalibration is nigh, pointing out several shortcomings of the current and past global health interventions championed by the West, replete with unmet targets and unfulfilled deadlines. This has left the global south lagging in health outcomes.

Organisations that have declared their support for the Accra Reset Mission include the Alliance of African Multilateral Financial Institutions, AfroChampions, the Confederation of Indian Industry, Rockefeller Foundation, Georgetown University, and many others.

 Amref Health Africa Global CEO and other health researchers say this is the moment for all countries to analyse and demand what they individually need from a reconceived global health system, and not just take whatever is offered or prescribed. It is a sentiment echoed by over two dozen former Heads of State who have thrown their weight behind the Accra Reset as part of The Guardian’s Circle of the Accra Reset.

These leaders, ranging from President Olusegun Obasanjo to Helen Clark and Romano Prodi, also include many former heads of international organisations across Africa, Asia, Latin America, Europe, and the Caribbean. What brings them together is a commitment to champion the Accra Reset initiative.

This creation of the circle has gone hand in hand with the launch of a High-Level Panel tasked with producing a report on restructuring global governance and financing for development, and the alignment of over $1 billion (Sh130 billion) in reset-compatible pledges from African development finance institutions and private banks to fill the gap increasingly left by Western agencies as their countries start to look more inward.

Speaking at the G20 Leaders’ Summit in Johannesburg, Former Nigerian President Olusegun Obasanjo announced the formal commencement of the Accra Reset’s interim Secretariat in Ghana.

“The initiative aims to transform development cooperation into a system that is ‘country-led, regionally empowered, and globally coherent,’ marking a departure from decades of top-down approaches that have characterised North-South relations,” he said.

“The Accra Reset stands ready to work closely with the G20,” Obasanjo said.

The tone set by African leaders is, however, different from matters ongoing on the continent, as well as the tone highlighted by American President Donald Trump at the same UN assembly, pushing forward with his America First rhetoric and espousing the US’s place in the future of the global health and development order. Since taking office, President Trump dismantled the US Agency for International Development, a mainstay of global health program financing and terminated the majority of its programs.

The administration has also made significant cuts to the US Centres for Disease Control and Prevention, put in motion the withdrawal of the US from the World Health Organisation, and cut funding to Gavi, the Vaccine Alliance, among other actions.

It is a move that has left the global health sector reeling and many countries badly exposed in health and scrambling for programme financing and implementation solutions, especially for HIV, Tuberculosis and Malaria. On December 4, 2025, Kenya became the first African country to sign a Health Cooperation Framework with the Trump administration, the first of many dozens that are lining up to ink a deal that may see a new door of health financing reopened.

The signing opens up a new phase of US involvement in global health governance. The five-year agreement, worth $2.5 billion (Sh322.5 billion), under the America First Global Health Strategy is intended to replace previous aid mechanisms while openly prioritising US strategic interests in health cooperation.

Data privacy

And while Kenya’s deal has since been suspended in the courts, other countries like Rwanda, Uganda, Lesotho, Liberia and eSwatini have signed on the dotted line with over 40 others said to be in the pipeline. Concerns have mounted rapidly over the speed of the deals, the lack of public participation and their implications for data privacy.

The lack of public participation is a particular sticking point, especially because the model utilises a co-financing approach. In Kenya, for example, the country will have to put up $850 million or Sh109.5 billion from its own coffers over the duration of the deal.

“These agreements would require African governments to grant the US government expansive access to data systems and to provide the US government with access to pathogen information,” a letter sent by some 50+ African and Global Civil Society Organizations to their Heads of State notes.

“These terms also raise serious potential human rights violations, including with respect to breaches to the right to privacy, discrimination, reproductive health, and states’ responsibility to ensure equitable access to the benefits of scientific progress,” it adds.

Echoing this sentiment while writing in the September 26 edition of the Think-Global-Health Newsletter, Chatham House’s Ebere Okereke outlines how Africa should respond to the strategy, manoeuvring to retain more control of its own destiny in health and development.

“By privileging US commodities and innovations, the plan conflicts directly with continental initiatives such as the African Medicines Agency and the Partnership for African Vaccine Manufacturing. By demanding co-financing without flexibility, it threatens to impose fiscal burdens that could crowd out investment in other health priorities,” he notes in part.

The ideals he espouses for Africa to reclaim control of its health, reclaim the narrative and negotiate collectively and accelerate domestic investment.

This will propel and develop Africa’s own industrial policy to ensure African-owned and African-driven solutions and not imported ones are front-loaded.

The leaders affirmed their shared commitment to advancing the principles of enhanced sovereignty, structural transformation, and equitable development for the Global South.