Powerful foreign governments and international organizations frequently exercise influence over African governments, affecting policies and decisions that do not always correspond with the quality of healthcare in African countries. This chapter investigates the relationship between neocolonialism and public health in Africa, with a special emphasis on how global health initiatives affect health outcomes across the continent. The study examines how external entities such as international organizations, donor countries, and pharmaceutical businesses impact health policies and initiatives in African countries. It also investigates the power dynamics at work in global health governance, focusing on how neocolonial institutions and ideologies influence the prioritization of specific health issues and the allocation of resources in ways that may exacerbate inequality and perpetuate reliance. The chapter further evaluates the impact of global health initiatives on health systems, disease prevention and treatment, and overall health outcomes in Africa by using case studies and other empirical evidence, considering the agency and resistance of local communities and governments in navigating these dynamics. By throwing light on these complex interactions, this chapter hopes to contribute to important discussions about health equity, social justice, and deneocolonial approaches to public health in Africa.