President John Dramani Mahama of Ghana has called for a new global development bargain that gives countries in the Global South greater control over decisions affecting their health and development priorities.
Mahama made the call at a high-level Accra Reset: Global Reset Dialogue on the sidelines of the 81st United Nations General Assembly (UNGA81) in New York, monitored by reporters via webinar on Tuesday.
He said countries could not be expected to take ownership of development outcomes when critical decisions on financing, programme design and implementation remained outside their control.
“There can be no ownership without control,” Mahama said, arguing that political independence had not always translated into sufficient control over global systems shaping trade, finance and health.
He said the Accra Reset was founded on three interconnected challenges — geostrategic marginalisation, geopolitical vulnerability and donor dependence — which continued to constrain development choices in the Global South.
Mahama said overcoming the challenges required stronger links between political authority, productive capacity and financial resilience.
He urged countries in the Global South to build greater capacity to define, finance and sustain their development priorities rather than remain dependent on external financing and externally designed programmes.
The President, however, stressed that greater national control must be matched by stronger accountability, responsible governance and fiscal discipline.
He drew parallels between the Accra Reset and Ghana’s domestic Resetting Ghana Agenda, which he said focused on economic self-reliance, local value addition, stronger public health infrastructure, transparent governance and the 24-Hour Economy initiative.
“A national reset without a global reset leaves us building on shifting sand,” he said.
On health, Mahama called for greater domestic pharmaceutical production, supported by predictable government purchasing and access to regional markets.
He said Ghana’s health reset should go beyond constructing facilities and relying on external partners for essential medicines and supplies.
“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,” he said.
He said stronger local production would build industrial capacity while improving access to essential health commodities across Ghana and the wider region.
At the event, Mahama unveiled the High-Level Panel report, “A Sovereign Future for Health,” which proposes reforms to the global health architecture.
The report outlined five political shifts and 10 recommendations aimed at strengthening national and regional capacity while preserving functions that require international cooperation.
Among the recommendations were country-led health compacts, sustainable financing transitions, stronger regional institutions and equitable health innovation. It also proposed regional health manufacturing, improved procurement and commodity security, protection of global public goods, humanitarian continuity, reform of global health institutions and independent accountability.
Mahama said the publication of the report marked the beginning of implementation rather than the conclusion of the initiative.
“We are now moving from design to execution,” he said.
He said Ghana and the Accra Reset Presidential Council would engage governments, global health organisations, development finance institutions, philanthropic organisations and the private sector to translate the recommendations into practical country-level agreements.
Mahama stressed that the Reset was not a call for isolation from international partners, but what he described as “pragmatic interdependence” — cooperation among countries as equals while strengthening domestic and regional capabilities.
He said stronger and more self-reliant countries in the Global South should not be viewed as a threat to the Global North, arguing that stronger health systems and productive capacity would contribute to global health security.
Mahama said health had been selected as the first major area of the global reset because its impact could be measured directly in human lives.
He identified maternal and child survival as an immediate test of whether proposed changes in financing and governance could deliver tangible results.
He said the Mother Africa initiative and Business United for Mothers, Babies and Youth (BUMBY) campaign would bring public policy and corporate responsibility together to improve health outcomes for women, newborns and children.
Mahama said Ghana’s maternal mortality remained above the Sustainable Development Goal target and that the initiatives would provide an opportunity to test the new financing and governance approach against measurable outcomes.
He also announced that Ghana would seek to take the Accra Reset into Africa’s collective policy framework when it assumes the chairmanship of the African Union in 2027.
He said Ghana would also work with the Non-Aligned Movement and the Group of 77 plus China in advancing the agenda.
Mahama expressed appreciation to international partners supporting the initiative, including the World Health Organisation and its Director-General, Dr Tedros Adhanom Ghebreyesus.
He called for a new global bargain based on ownership backed by real control, cooperation centred on human dignity and commitments that translate into tangible protection for people.
The Accra Reset was launched in 2025 as an Africa-led initiative focused initially on health sovereignty and has since expanded to cover global development cooperation, institutional reform, financing, skills, industrial capacity and shared prosperity.
