Addis Ababa, Ethiopia | 14 February 2026
We, Heads of State and Government and leaders of regional and global institutions, met in Addis Ababa at the Africa Centres for Disease Control and Prevention (Africa CDC), on the margins of the 39th African Union Assembly, in a hybrid high-level dialogue convened by the Republic of South Africa and the Republic of Ghana, to advance multilateral cooperation towards a reformed global health ecosystem and a strengthened global health architecture.
We convened at a time of profound and intersecting challenges, marked by declining international health financing, escalating climate impacts, worsening disease burden, protracted conflicts, and other global shocks that collectively threaten hard-won gains in health and sustainable development. We recognise that health risks do not respect borders and that resilient health systems are foundational to economic stability, human security and sustainable development.
We acknowledge and welcome the ongoing discussions on reforming the global health architecture, including regional and global initiatives, aimed at streamlining mandates, strengthening coordination, and aligning financing with coun- try-led priorities. Reform of the global health architecture must be seen in the context of reform of the multilateral development system and financing structures, including the UN80.
We value the role of WHO, as the leading normative and coordinating intergovernmental agency for health, and we sup- port its efforts to develop a proposal for an inclusive process to support the transformation of the current global architecture.
However, we remain concerned that fragmentation across global health initiatives and declining health Official Develop- ment Assistance could erode hard won gains.
We affirm that accelerated alignment around national priorities is imperative. National governments must lead with the support of harmonized, predictable, and complementary engagement from global partners. To this end we call for great- er/strengthened cooperation amongst key global health actors, and a more streamlined approach to policy shaping.
Country ownership and responsible sovereignty must sit at the centre of a reformed global health ecosystem, alongside shared responsibility and accountability for global public goods for health, including pandemic prevention, prepared- ness, and response. This reformed ecosystem must contribute to strong, integrated and resilient health systems, with universal health coverage and primary health care as their foundation.
We reaffirm our unwavering commitment to multilateralism in an increasingly interconnected and interdependent world. A rules-based multilateral system--reinforced by empowered regional institutions, including Africa CDC, the Pan American Health Organization, and the European CDC--remains indispensable to advancing solidarity, fair burden-sharing, and equitable access to life-saving tools and innovations to address our shared challenges and risks.
We commit to an open, leader-driven movement to build consensus and advance reforms by aligning with ongoing glob- al and regional processes. We will exercise high-level political stewardship to ensure practical reforms that make the global health ecosystem more coherent, country-led, equitable, resilient, and fit for present and future challenges.
We welcome continued high-level political dialogue among interested nations and key initiatives, including in the lead- up to and alongside major forums such as the World Health Assembly, the G7, and the United Nations General Assembly, and we invite other countries and partners to join this collective effort.
Adopted in Addis Ababa, Ethiopia, 14 February 2026 by the African Union Ministers of Health and the Heads of State and Government of Ghana, Kenya, Nigeria, South Africa, France, Germany, Norway and Spain.
