As African leaders departed Accra following the African Union’s Extraordinary Summit on Health, one message stood above the diplomatic speeches and ceremonial declarations: Africa’s quest for health sovereignty can no longer survive on promises alone.

In a powerful post-summit reflection, Dr. William Nii Ayitey Menson, Director of Health Financing for Africa at The ONE Campaign, argues that the continent has reached a decisive moment where citizens must demand measurable results instead of repeated commitments.

Writing after attending the summit, Dr. Menson acknowledged that many of the challenges discussed—including inadequate domestic health financing, weak primary healthcare systems, dependence on external donors, expensive out-of-pocket payments and limited pharmaceutical manufacturing—are not new.

“We have heard these things before,” he noted, stressing that the real challenge now lies in implementation.

Mahama’s blunt challenge

One of the summit’s defining moments came when Ghana’s President John Dramani Mahama urged African leaders to move beyond speeches.

According to Dr. Menson, President Mahama’s statement that Africa’s health commitments must become “physical, not lyrical” captured the frustration shared by many across the continent.

The President also reminded leaders that the famous Abuja Declaration, which committed African governments to allocating 15% of national budgets to health, has existed for decades with limited implementation.

For Dr. Menson, the comments reflected an overdue call for accountability.

Health sovereignty must produce results

The article argues that genuine health sovereignty should mean African governments financing and managing health systems capable of delivering quality care without excessive dependence on foreign aid.

He warns that sovereignty cannot simply mean donors withdrawing while citizens bear higher medical costs.

According to Dr. Menson, sovereignty should ensure predictable healthcare financing, stronger hospitals, employed health professionals, reliable medicine supplies and affordable treatment for ordinary Africans.

He cautions that ownership without implementation risks becoming little more than political theatre.

Five receipts African governments should provide

Rather than accepting political declarations, Dr. Menson says citizens should demand five measurable indicators following the Accra Summit.

• Evidence of increased national health budget allocations.
• Proof that approved funds are actually released to health facilities.
• Protection of essential services including maternal healthcare, immunisation, HIV, tuberculosis, malaria and emergency care.
• Reduced financial hardship for families paying medical bills.
• Concrete continental action supporting pooled procurement, local pharmaceutical manufacturing and stronger regulation through the African Medicines Agency.

He argues that announcements without budget execution provide little benefit to patients who depend on functioning health systems.

Countries already taking steps

The commentary highlights Kenya’s efforts to strengthen vaccine financing through civil society advocacy and parliamentary engagement.

It also points to Ghana’s response to reductions in USAID funding, including efforts to bridge funding gaps through increased domestic financing and reforms within the National Health Insurance Scheme.

Nigeria is similarly cited for introducing policies aimed at increasing domestic investment in healthcare while reducing long-term dependence on external support.

Although these examples remain works in progress, Dr. Menson believes they demonstrate that meaningful change is achievable when political commitment is matched by financial action.

Citizens must demand accountability

Looking ahead, Dr. Menson proposes an annual “Accra Health Sovereignty Ledger” that would publicly measure whether governments are honouring their commitments.

He says finance ministers should be held accountable alongside health ministers, while parliaments, civil society organisations, the African Union Commission and Africa CDC should regularly publish measurable progress on health financing and service delivery.

The ultimate test, he argues, will not be the speeches delivered in Accra but whether hospitals become better equipped, medicines become available, health workers are employed and fewer African families are pushed into poverty by medical bills.

As Africa continues pursuing Agenda 2063 and greater self-reliance, Dr. Menson concludes that the continent has already produced enough declarations. What citizens now deserve are receipts that prove those promises are being fulfilled.

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