Africa is confronting a growing and changing disease burden with limited financial and other resources. In addition, African health systems have not responded adequately to changing demands. For health and finance ministries, the challenge is to find and agree on the reform options or policy alternatives that they should jointly advance to improve health service delivery prospects. There is general agreement that more resources are needed. However, a number of African governments often depend on official development assistance (ODA) to finance health that, in many cases, is outside of their control. Increased funding (domestic or external) will not be effective if the resources are not spent wisely. Understanding the complementary role of finance and sector ministries in policy and budget cycles, and making the processes more efficient and better integrated, should foster the provision of quality services for better health outcomes.