Health systems in Africa are under considerable strain: rapid demographic change, rising non-communicable diseases, and emerging and re-emerging threats such as COVID-19 and Ebola are increasing demands on limited health services. The African Union’s admission to the G20 provides an opportunity for Africa to be recognized as a true strategic partner in development; for the continent to make critical inputs to decisions on its development, including health financing reforms; and has the potential to reinvigorate Africa’s resolve to reform domestic issues that hold back the potential for sustainable domestic financing of health.