By Nana Karikari, Senior Global Affairs Correspondent
The opening of the 80th UN General Assembly this week set the stage for a clash of two starkly different worldviews. While President John Mahama of Ghana championed a new era of African self-reliance and global health equity at a high-level side event in New York, United States President Donald Trump presented a nationalist, America First agenda in his formal address to the General Assembly on Tuesday, September 23. The juxtaposition of these two moments offers a unique angle for Ghanaians and Americans to analyze a world at a crossroads. The global landscape was already defined by a sense of urgency. UN Secretary-General António Guterres opened the session by warning that the world is in “turbulent—even uncharted—waters” and that “geopolitical divides [are] widening.” In this context, the speeches by Mahama and Trump are not just rhetorical displays; they are direct responses to a world in crisis, each offering a fundamentally different solution.
The Accra Reset Versus Trump’s Global Scolding
Ahead of the opening of the General Debates of the 80th UN General Assembly Tuesday, September 23, 2025, President Mahama presented a compelling vision of African health sovereignty, a concept he has termed the “Accra Reset.” He joined his colleague Presidents in a meeting of Heads of State and Government of the Africa Centre for Disease Control on Securing Africa’s Health Sovereignty, Political Leadership for Sustainable Health Financing, Local Manufacturing, and Pandemic Preparedness. This initiative aims to transform the global governance architecture, starting with the health sector, by ensuring Africa is a co-designer and co-owner of solutions, not just an invited guest. During his speech, he declared, “The outdated notion that health drains our economies must be rejected. In truth, health is the engine of productivity and the bedrock of inclusive growth.” This vision is articulated in a document known as the Accra Compact, which outlines a framework for national ownership and investment. Mahama’s message directly counters a global trend of declining international assistance, citing specific cuts by the US and other NATO allies.
In contrast, President Trump’s wide-ranging speech was less a global address and more an internal political rally, filled with digressions on topics from US crime to windmills. He reiterated his skepticism of international bodies and multilateralism. Trump told the delegates, “The U.N. has such tremendous potential, but it’s not even coming close to living up to that potential. All they seem to do is write a really strongly worded letter and then never follow that letter up—it’s empty words.” His claims that renewable energy is a “green energy scam” and that the UN is “funding an assault on Western countries” with migration directly challenge the global consensus on climate change and humanitarian aid. This is a crucial point for Ghanaian audiences, as climate change disproportionately affects African nations, and migration is a significant issue for many young Ghanaians. For Americans, Trump’s remarks at the UN reflect his administration’s foreign policy and budgetary priorities, a stark departure from previous administrations that championed international cooperation and foreign aid.
The Vision and Its Tangible Example
As part of the UNGA, President Mahama formally launched “The Accra Reset: Reimagining Global Governance for Health & Development.” He called for a fundamental reset of the global development agenda, stating, “If we are to heal our health systems, we must first reset development itself.” He provided a powerful example of this vision by highlighting Ghana’s decision to uncap its National Health Insurance Fund (NHIS). This innovative move generated an additional GHS 3.5 billion (approximately $300 million), which helped bridge the funding gap created by cuts from the United States Agency for International Development (USAID).
Mahama emphasized that over 18 million Ghanaians now have NHIS cards, providing access to free healthcare. He underscored this as a clear example of how “resources can be shifted from less urgent areas into critical needs like health,” a strategy he urged other global leaders to adopt. He also provided crucial context for this approach, highlighting that while the world has made significant progress in reducing extreme poverty and increasing life expectancy, these gains are fragile, as evidenced by the COVID-19 pandemic, which reversed nearly two decades of progress in under two years.
A Tale of Two Futures: Collaboration vs. Isolation
The speeches by Presidents Mahama and Trump highlight a fundamental tension in global politics. Though delivered at separate events at the UN, Mahama called for a united Africa to demand fairness and equity from global bodies like GAVI and the Global Fund, urging leaders to invest in their own health systems. His vision is one of collaboration and collective strength. He has consistently championed this approach, as seen in his role as the African Union Champion for African Financial Institutions, which has positioned him to advocate for alternative financing models. He urged his fellow leaders to “move from words to action,” emphasizing that “as this world steps back, let Africa step forward.”
Trump’s approach, however, prioritizes a nation’s destiny in its own hands, often through isolationist policies. His warnings to European nations about migration and his threats of tariffs on Russia demonstrate a transactional, zero-sum view of international relations. He bluntly stated, “If you don’t stop people that you’ve never seen before that you have nothing in common with your country is going to fail.” While his remarks were met with groans and uncomfortable laughter from some delegates, they were also received as a clear signal of his administration’s intent to prioritize national interest over multilateral consensus. For Ghanaians, the question is which path offers a more hopeful future: a collective African voice in a reforming global order, or a retreat into national self-reliance in a world where major powers are pulling back.
Ghana’s Domestic Efforts: Hopes and Headwinds
President Mahama’s comments on Ghana’s domestic efforts toward health sovereignty provide a tangible example of his vision. He pointed to the Ghana Medical Trust Fund Act (MahamaCare), a new law designed to provide sustainable financing for non-communicable diseases. He also highlighted the establishment of the National Vaccine Institute, backed by 75 million cedis, to make Ghana a regional hub for vaccine research and manufacturing. These bold steps are a source of national pride and a testament to Ghana’s commitment to solving its own problems.
However, some experts question the sustainability of these programs. The Ghana Medical Trust Fund Act, for instance, has drawn criticism for allocating 20 percent of the National Health Insurance Fund, which some argue could destabilize the existing health financing system. Dr. Kwame Asiedu, a public health expert, highlighted the urgency driving the policy despite the concerns, stating, “I would rather we run with that money,
save lives, than say we’re going to hold an argument as to what is adequate, and see people pass away because they couldn’t afford dialysis.” This debate shows that while political will is crucial, the success of these ambitious programs will depend on sound implementation and transparent management.
Many in Ghana are watching closely. “We have always relied on international aid for big projects. Seeing our leaders take bold steps to solve our own problems, especially in health, gives us hope that our future is in our own hands,” said Elorm Baeta, a community health worker in Accra, reflecting the national pride and cautious optimism that this agenda has inspired.
The Wider Geopolitical Context: Navigating a Multipolar World
Beyond the rhetoric, the core of the diplomatic challenge for Ghana and Africa is economic. The sudden and steep cuts to foreign aid, which Trump’s policies have accelerated, are creating a “cliff edge” for health systems across the continent, as warned by the World Health Organization (WHO). This financial vacuum makes initiatives like Ghana’s “Accra Reset” not just a policy choice but a necessity for survival. Furthermore, the global stage is defined by a shift in power, with countries like Russia, China, and major European nations forming new alliances and economic blocs. Mahama’s call for a united African voice is therefore a direct response to a multipolar world where Africa must assert its collective strength to avoid being marginalized or exploited by competing global agendas. The ongoing diplomatic efforts of the Africa CDC to secure transparent and direct funding, bypassing traditional aid channels, further underscore this point.
While the Mahama-Trump clash dominated headlines across Africa, it is important to note the broader context. Other leaders used their platforms to address different global crises. The conflict in Gaza and the push for a two-state solution were prominent themes, with several European nations announcing their recognition of a Palestinian state in defiance of Washington. The ongoing war in Ukraine and the escalating need for humanitarian aid were also central to many discussions. This makes Mahama’s message of health sovereignty even more resonant, as it provides a clear, actionable alternative to the geopolitical gridlock on other issues.
A Counterpoint from the Global South
A powerful counterpoint to Trump’s agenda was provided by South African President Cyril Ramaphosa, who directly challenged Trump’s remarks on climate change during his address to the UN General Assembly.
Ramaphosa stated, “Climate change is reversing economic growth and development gains in many countries especially in the global south, although Africa carries the least responsibility for climate change, many countries on the continent of Africa experience much of its harshest effects.” This statement directly supports the argument that Trump’s climate change denial disproportionately harms African nations, making Mahama’s vision for African self-reliance not just a political choice but a necessity for survival in a world where major powers are pulling back.
Support from African Leaders and the Diaspora The Ghanaian diaspora in the US has shown strong support for President Mahama’s agenda. When he arrived in New York, a group of Ghanaians resident in the US gathered to welcome him, cheering for his administration’s reforms. “We are very proud of this achievement… we the women too we now have a say in Ghana,” a supporter said. This enthusiasm demonstrates the diaspora’s emotional and political investment in the new administration’s “Resetting Ghana” agenda.
Mahama’s “Accra Reset” has also garnered significant support from other African leaders. The Africa CDC’s Committee of Heads of State and Government commended his leadership and requested Africa CDC to host the Africa Health Sovereignty Initiative under his guidance. Former Nigerian President Olusegun Obasanjo, a key proponent of the summit, appealed to leaders to find their own solutions, stating, “Africa needs health without aid,” a powerful quote that encapsulates the core of the Accra Reset.
The Stakes for Young Ghanaians
Trump’s remarks on migration and climate change hit close to home for young Ghanaians. Climate-induced migration is a growing issue, with many young people leaving their ancestral homes due to erratic rainfall and coastal erosion. “Climate change is not a distant threat for young Ghanaians; it is already reshaping their livelihoods, education, and even the peace in their communities,” noted a policy brief by the Youth Bridge Foundation. While Trump derided green energy and migration, young Ghanaians are at the forefront of the fight, using their voices to advocate for climate
justice. “Youth don’t just deserve a seat at the table; they belong at the center of the conversation,” a youth leader from the Ghana Youth Environmental Movement emphasized. This sentiment directly challenges the top-down, nationalist approach favored by Trump.
Ghana’s Diplomatic Dance
Ghana will watch closely as President Mahama delivers his formal speech to the General Assembly on Thursday, September 25. As the 12th speaker of the 80th session, his address will likely expand on the themes of the Accra Reset, providing a powerful counter-narrative to the isolationist rhetoric heard yesterday and offering a roadmap for Africa’s future. The diplomatic challenge for Ghana’s policymakers remains clear: how to secure the nation’s interests and advance its vision for global health equity in a world with a declining appetite for foreign aid and a growing push for isolationism. The contrast between Mahama’s call for collective strength and Trump’s “America First” philosophy defines a critical moment for a nation seeking to become a leader on the world stage.
