Accra Reset report proposes closing some global health bodies to boost health sovereignty

Ghanaian President John Mahama launched the Accra Reset report, 'A Sovereign Future For Health,' on September 21, 2026, in New York. Prompted by a nearly 70% drop in external health financing for Africa between 2021 and 2025, the report outlines a blueprint to end aid dependence in the Global South. It proposes the strategic reform, consolidation, or closure of major global health bodies like Gavi and the Global Fund, alongside disease-specific partnerships, while transitioning health governance and financing directly to national authorities.

Launch and Development of the Report

• ▪The Accra Reset report was developed by a 23-member High-Level Panel on the Reform of the Global Health Architecture and Governance.
• ▪Ghanaian President John Mahama launched the Accra Reset report, titled 'A Sovereign Future For Health', in New York on September 21, 2026.

Context and Drivers of the Initiative

• ▪The Accra Reset report notes that external financing for health in Africa fell by almost 70% between 2021 and 2025.
• ▪Ghanaian President John Mahama initiated the Accra Reset in 2025 following massive and immediate cuts to health aid implemented by the Trump administration.

Proposed Global Health Institutional Reforms

• ▪The Accra Reset report suggests the potential closure, merger, or sunsetting of disease-specific partnerships and product development partnerships, including UNAIDS, Roll Back Malaria, Stop TB, and the Global Polio Eradication Initiative.
• ▪The Accra Reset report states that global entities in charge of normative guidance, such as the World Health Organization, and those providing global public goods and humanitarian support must continue to operate.
• ▪The Accra Reset report proposes the strategic reform of five major global health institutions: Gavi, the Global Fund, the World Bank's Global Financing Facility, the Pandemic Fund, and Unitaid.

Framework for National Health Sovereignty

• ▪The Accra Reset report recommends that countries develop National Health Plans within a year to map domestic and external resources, establishing domestic resources as the foundation for core national responsibilities.
• ▪The Accra Reset report outlines a five-step framework for 'practical sovereignty' where countries own their health decisions, financing frameworks, and data rather than merely endorsing externally financed programs.

Global Health Governance

• ▪Ministries of health in low- and middle-income countries remain accountable for health outcomes while external partners retain authority over priorities, financing channels, indicators, and data.
• ▪The Accra Reset report highlights a global health governance failure where low- and middle-income countries must coordinate external inputs while having little control over the mandates, boards, funding, or incentives of global health institutions.

Debatable claims

• ▪Disease-specific global health partnerships should be phased out or merged
• ▪Global health financing institutions should cede decision-making power to recipient nations
• ▪Developing nations should fund their core health systems primarily through domestic resources