In January 2025, the Center for Global Development (CGD) and the Addis Center for Ethics and Priority Setting in Health (ACEPS) hosted a roundtable with policymakers from 14 African countries to discuss a New Compact for health financing. This note on the roundtable emphasises locally led priority-setting, domestic-first resource allocation, and consolidated supplementary aid. While there was cautious optimism about its potential, challenges such as fragmented donor alignment and political constraints were also highlighted.
The roundtable insights underscore the importance of political will, governance reforms, and stronger country capacity for the Compact’s success. Participants called for better coordination among stakeholders, with a particular focus on strengthening country ownership and improving donor accountability. Moving forward, CGD aims to refine and operationalise the proposal, collaborating with policymakers, donors, and experts to ensure the Compact’s principles lead to meaningful, sustainable reforms in global health financing.