The global health landscape is undergoing rapid change. Declining international financing, influenced by protectionist policies and shifting government priorities, has weakened global cooperation in addressing health crises. These developments underscore the need to reassess global health financing, which has historically reflected donor interests. Africa must strengthen its health sovereignty to address the risks posed by reduced multilateral collaboration. In this Commentary, we aim to inspire transformative change for women, children, and adolescents in Africa. In 2023, sub-Saharan Africa accounted for about 70% of global maternal deaths and 56.2% of deaths in children under five, despite representing only 30% of global live births. The region also had the highest neonatal mortality rate, at 26 deaths per 1,000 live births.