In the twenty-first century, Africa has regularly been a high priority on the G8's health agenda. At the 2000 Okinawa Summit, African leaders were invited to participate on the margins of the summit for the first time. This chapter argues that the G8 had, until 2011, a solid, generally strengthening performance in governing African's health. Since 1979, it addressed this area increasingly and more effectively, acknowledging the link between health and development in Africa in ever more ways. Deliberation refers to the G8's choice to discuss specific issues and help set the global agenda as a result. At Okinawa in 2000, G8 leaders recognized that infectious diseases, particularly HIV/AIDS, tuberculosis, and malaria, were major killers and obstacles to escaping poverty. The Muskoka Initiative, adopted by the G8 in 2010, was an attempt to accelerate progress in meeting targets that the other major multilateral institutions had left behind.