The global health system is at a defining moment. Mounting pressure from reduced financing, widening inequities, and the urgent call for fairness expressed in the Lusaka Agenda highlight the need for a fundamental rethink of how health is governed, financed, and delivered worldwide. Without reform, millions risk being left behind, and the system may fail to respond effectively to future global health threats.

This vision was further grounded in an African Perspective Paper on Global Health Reform. It was commissioned by the Wellcome Trust and published as one of five bold proposals for a reimagined global health architecture, each authored by an innovative thought leader from a different region of the world.

Next, Amref Health Africa, with support from Wellcome Trust, led an African dialogue on Global Health Reform. This region-wide initiative tested, challenged, and refined the ideas outlined in the paper and in other reform calls. This will help ensure that Africa’s priorities are clearly defined, widely owned, and powerfully represented in global health reform debates. Complementing existing regional and national processes, this inclusive and collective effort seeks to convene governments, regional organisations, non-governmental actors, and key stakeholders from across the continent to deliberate key priorities, proposals and implementation pathways for reforming the global health architecture.

The dialogue unfolded in three key phases:

Virtual Ideation & Refinement (September 2025): Through a series of virtual sessions, stakeholders across Africa shared perspectives on pressing priorities, challenges, and opportunities. Amref welcomed the broadest possible range of voices to stress-test core reform propositions and surface Africa’s lived realities.

In-Person Synthesis & Action Planning (October 2025): A high-level continental gathering provided space for frank, inclusive dialogue to synthesise outputs, debate contested areas, and develop concrete, actionable reform proposals.

Final Virtual Validation & Endorsement (November 2025): A focused virtual session validated proposals, secured broad endorsement, and finalised Africa’s consensus position.

The insights collected will produce a published outcome paper that reflects the collective views of African stakeholders. This document will detail the region’s priorities, points of consensus, and recommendations for practical implementation of a new global health system – one that is fairer, more effective, and more responsive to the people it aims to serve. Africa’s outcome paper will also contribute to a global synthesis paper and upcoming international gatherings, ensuring that Africa’s voice influences the direction of reforms alongside other regions.

The dialogue represented a historic opportunity: to move beyond fragmented approaches and toward a unified African vision for health equity and resilience. Amref Health Africa invited governments, civil society, private sector leaders, academia, youth networks, and development partners to actively participate in the process by contributing insights during the consultation phase, sharing evidence and perspectives, amplifying findings through networks, and committing resources to sustain momentum.

Through collective action, Africa is helping to shape a new global health architecture that reflects the needs of all people, everywhere.

(Source: Amref Health Africa)