By Celestine Avi and Seth Eyiah
Geneva, Switzerland – President John Dramani Mahama has called for urgent and far-reaching reforms of the global health architecture, warning that declining international aid and weakening multilateral cooperation are threatening health systems across developing countries.
Delivering the keynote address at the 79th World Health Assembly of the World Health Organisation (WHO) in Geneva, Switzerland, on Sunday, May 18, 2026, President Mahama said the world was witnessing “deliberate assaults on the multilateral system” and a rapid decline in humanitarian financing.
He noted that global humanitarian assistance had fallen significantly, with some major economies cutting overseas development aid, while the WHO itself had been forced to scale down operations following funding reductions, including the withdrawal of United States support.
“In Ghana, health financing from bilateral and multilateral partners has significantly decreased since 2025. Ghana lost $78 million following the closure of USAID programmes,” he said, adding that critical interventions in malaria, maternal health, nutrition, and HIV/AIDS had been affected.
The President also cited similar challenges across Africa, including the impact of the abrupt withdrawal of PEPFAR funding in South Africa, which he said disrupted HIV treatment continuity and social protection programmes.
He warned that if the trend continues, millions could face preventable deaths and deepening poverty across the continent by 2030.
Despite the bleak outlook, President Mahama said the situation should serve as a turning point rather than a moment of despair, insisting that global health systems must evolve beyond donor dependency.
“We are not here to lament and wring our hands. We are here to decide whether the architecture we supervise is still fit for purpose,” he stated.
The President positioned Ghana as a leading voice in the “Accra Reset Initiative,” a reform agenda aimed at advancing what he described as “health sovereignty” for African nations.
He argued that countries must build the capacity to finance and manage their own health systems rather than rely excessively on external assistance.
Mahama highlighted Ghana’s domestic reforms, including the expansion of the National Health Insurance Scheme (NHIS), which now covers an estimated 66% of the population, and the introduction of a Free Primary Health Care Programme aimed at expanding access in rural communities.
He also announced improvements in NHIS financing and efficiency, including the removal of funding caps that released an additional GHS 3 billion (about $300 million) for health investment, as well as the deployment of digital systems and AI tools to reduce fraud and improve provider payments.
On non-communicable diseases, he referenced the Ghana Medical Trust Fund (MahamaCares), designed to support treatment for conditions such as cancer, cardiovascular disease, liver disease, and kidney failure.
President Mahama further disclosed that Ghana is on track to transition away from Gavi vaccine support by 2030, with plans to eventually become a donor country.
Turning to global reforms, he cautioned against proposals that could protect existing institutional mandates at the expense of meaningful restructuring within global health bodies.
He urged WHO member states not to allow reform processes to become “ceremonial exercises,” insisting that real change must include the possibility of institutional mergers and consolidation where necessary.
“WHO’s legitimacy is not served by protecting silos. It is served by fearless analysis of what works,” he said.
Mahama outlined key pillars of the Accra Reset Initiative, including an independent high-level reform panel, a coordination mechanism to improve alignment among global health agencies, and a financing platform to support local manufacturing and innovation in Africa.
He concluded by urging global leaders to prioritise execution over rhetoric, stressing that success should be measured by health outcomes at the community level rather than institutional declarations.
“The only metric that matters is whether a child in the Global South has a reasonable chance of survival as a child in the Global North,” he said.
The WHO Director-General, Dr Tedros Adhanom Ghebreyesus, and other delegates were present at the Assembly, which is considering proposals for reforms to strengthen global health governance amid evolving global challenges.
