AF-1_Accelerating equitable access to medicines, health technologies, and high-quality laboratory systems boosted across Africa

The WHO African Region (WHO AFRO) has made significant progress in advancing equitable access to medicines, health technologies and quality laboratory systems across the continent. These efforts are particularly crucial in the context of antimicrobial resistance (AMR), which remains one of the most pressing global health threats, especially in sub-Saharan Africa. In 2021, AMR was linked to approximately 4.71 million deaths, including more than 1 million directly attributable deaths, highlighting the urgent need for robust interventions.

WHO AFRO’s approach has focused on strengthening regulatory systems, improving supply chain coordination, enhancing laboratory capacities and supporting Member States in overcoming barriers to access. Among the key actions undertaken, collaboration with national regulatory authorities (NRAs) in 10 countries to conduct benchmarking exercises and audit visits was vital. These initiatives are part of the strategic aim to ensure that at least 15 NRAs achieve Maturity Level 3 by 2035. Monitoring and development of institutional development plans have been critical in guiding these efforts.

The Organization also convened a regional supply chain coordination meeting, assessing support from international partners and identifying gaps for further collaboration. The 8th Small Island Developing States (SIDS) Health Ministers Meeting, held in March 2024, designated Mauritius as the host for the SIDS Secretariat, establishing a framework for improved operational support.

Further, WHO AFRO facilitated the 20th anniversary of World Blood Donor Day by mobilizing Member States to address challenges related to safe blood availability. This initiative included a successful blood drive, yielding 100 units of blood.

Laboratory quality management has seen substantial improvements, particularly through the AFRO Microbiology External Quality Assessment Programme, which bolstered diagnostic capacities in 22 national reference laboratories. In addition, genomic sequencing capabilities were enhanced in six Member States, involving over US$ 1 million of equipment, training for more than 50 personnel and the establishment of fully operational sequencing laboratories. An Assistive Technology Capacity Assessment toolkit has also been integrated into rehabilitation assessments in Côte d’Ivoire, Liberia and Namibia, helping to identify gaps and prioritize national needs.

In response to the escalating threat of AMR, WHO AFRO has focused on strengthening national AMR surveillance systems through the adoption of standardized global standards. A significant initiative included laboratory training to enhance antimicrobial susceptibility testing (AST) abilities in eight countries, which not only improved laboratory skills but also emphasized the effective utilization of laboratory data.

Moreover, WHO AFRO supported the implementation of the Bacteriology External Quality Assessment (EQA) Programme, involving 25 countries for the 2024 EQA round. Regional activities such as webinars on the Global Antimicrobial Resistance and Use Surveillance System (GLASS) have also led to the enrolment of all 47 Member States into the system, with notable growth in AMR data reporting.

The enrolment of countries participating in GLASS, growing from 20 in 2023 to 33 in 2025, demonstrates the commitment of Member States to addressing AMR issues collaboratively. Noteworthy advancements were made in Malawi and Rwanda, where national representative AMR prevalence surveys were initiated, alongside the development of regional knowledge products documenting AMR trends.

Finally, a tabletop simulation exercise conducted in December 2025 in Brazzaville, Republic of the Congo, identified critical gaps in AMR outbreak preparedness and shored up actions to enhance national and regional responses. These collectively underscore the importance of a coordinated, holistic approach to tackling AMR across multiple sectors.

AF-1_Accelerating Universal Health Coverage Through Evidence‑Driven, Equitable Health Financing Reforms

Intensification of technical assistance: WHO AFRO enhanced health financing in African countries through Health Financing Progress Matrix (HFPM) assessments in Malawi, São Tomé and Príncipe and Uganda, and National Health Accounts (NHA) analysis in Equatorial Guinea. Cross-programmatic efficiency assessments (CPEA) were conducted in Cameroon, Mozambique and Nigeria.

Responsive health financing strategies: tailored health financing strategies were developed, including Nigeria’s Health Sector Strategy Blueprint, Kenya’s Social Health Insurance reforms, and South Africa’s National Health Insurance bill, advancing social protection: WHO AFRO supported National Health Insurance (NHI) systems in Ethiopia, Liberia and South Africa, and designed a proxy-means testing system in Kenya; by stimulating health investments: costed health plans were developed for Ethiopia, Namibia and the United Republic of Tanzania, attracting investment from the European Investment Bank; through regional goods and technical products: publications like the Regional Atlas of Health Expenditures 2023 and maternal, reproductive, newborn, and child health (RMNCH) expenditure reports were produced; through health financing and policy development: National Health Strategic Plans (NHSP) were reviewed and revised in 19 countries, with finalized work by updating UHC-related laws: legal reforms were initiated in collaboration with the Inter-Parliamentary Union and the International Labour Organization, with draft assessment reports for 47 countries.

Across the African Region, WHO provided catalytic, high-value technical support that accelerated health financing reforms and strengthened national systems for equitable progress towards UHC. Using global normative guidance and regionally adapted tools, WHO supported governments to develop or update national health financing strategies in Angola, Liberia, Malawi and São Tomé and Príncipe to align with global standards and improving coherence between policy priorities, budgeting and service delivery.

Through targeted technical assistance, WHO enabled countries to institutionalise National Health Accounts and routine expenditure tracking systems, including in Angola, Guinea-Bissau, Malawi, Mauritania, Namibia and São Tomé and Príncipe. The credible outputs generated were used to analyse spending patterns, identify inefficiencies and monitor fiscal risks associated with out-of-pocket payments. Countries now have more robust data to inform policy dialogue, improve budget formulation and strengthen financial protection mechanisms for households.

WHO also played a critical role in strengthening governance and priority-setting mechanisms, supporting the establishment or refinement of health technology assessment (HTA) platforms, multisectoral financing task forces and targeting frameworks that promote equity in public resource allocation. This work advanced in Malawi, South Africa, the United Republic of Tanzania and Togo, and it helped governments improve transparency in decision-making and direct resources towards high-value interventions.

In addition, the Universal Health Coverage/Life Course Cluster (ULC) in the WHO African Region provided overarching strategic support by harmonising financing reforms with broader UHC and life-course agendas to ensure that reforms addressed population needs across childhood, adolescence, adulthood and older age. WHO also supported countries to embed equity, gender and financial protection considerations into their financing strategies, while strengthening monitoring systems to track UHC service coverage and financial risk protection indicators. This ensured that financing reforms were not only technically sound but aligned with long-term UHC acceleration pathways.

Collectively, these interventions are expected to improve health outcomes by reducing financial hardship, increasing access to essential services and fostering more transparent, accountable and evidence-driven allocation of limited resources. Over time, strengthened financing systems will enhance service coverage, improve equity for vulnerable populations and reinforce system resilience against future shocks.

AF-1_Strengthening Health Systems including Access to Essential Services by Advancing Disease Eradication, Elimination, and Control Across the WHO African Region

The WHO African Region (WHO AFRO) has made substantial progress in the fight against communicable and noncommunicable diseases, as well as in enhancing maternal, child and adolescent health. Key strategies employed to achieve these milestones include boosting vaccination coverage through two routine doses of the measles-containing vaccine (MCV) and conducting periodic supplemental immunization activities. These efforts have resulted in sustained high population immunity and robust disease surveillance systems over the years. The Maternal and Neonatal Tetanus Elimination (MNTE) initiative aims to reduce neonatal tetanus cases to fewer than one per 1 000 live births in every district annually, necessitating at least 80% coverage of pregnant women with two doses of tetanus toxoid vaccines and access to skilled birth attendance for over 70% of women. To achieve MNTE, validation surveys assess progress and ensure sustainable measures are in place.

Severe noncommunicable diseases (NCDs) such as type 1 diabetes, rheumatic heart disease and sickle cell disease continue to present significant public health challenges, disproportionately affecting children and young adults, particularly in rural and underserved regions. In response to these challenges, WHO AFRO endorsed the PEN-Plus strategy in 2022, which aims to expand integrated care for severe NCDs across 20 selected Member States from June 2024 to May 2026. This initiative emphasizes stakeholder engagement, disease management improvement, and monitoring and evaluation (M&E).

During the 2024–2025 biennium, measurable advancements took place in the areas of leadership and governance, as all 47 Member States committed to accelerating sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH). This commitment was reinforced at the 75th session of the WHO Regional Committee for Africa, resulting in a regional roadmap. Despite progress, challenges remain, including significant deficiencies in achieving Sustainable Development Goals (SDGs) health targets, with the African Region responsible for 68% of global maternal deaths and 55% of under-five mortality, driven by systemic issues such as health-care financing and workforce shortages.

Key actions taken include enhanced access to vaccinations, contraceptive measures and specialized interventions aimed at adolescent pregnancy. WHO’s engagement has been pivotal in addressing barriers to health service access. Continuous advocacy for evidence-based decision-making and strategic investments is crucial for sustaining progress. Member States also engaged in a comprehensive assessment of UHC-related laws, affecting governance and accountability. Moreover, stakeholder collaborations have strengthened resource mobilization and policy coherence.

Countries like Cabo Verde marked significant achievements, eliminating malaria, while Guinea and South Sudan eliminated maternal and neonatal tetanus. These successes reflect innovations in vector management, vaccination and improved surveillance systems. Furthermore, Namibia made strides in preventing vertical transmission of hepatitis B and HIV through integrated care approaches.

The Region boasts a notable implementation rate of vaccination campaigns, maintaining a low incidence of measles and rubella across nine countries. Initiatives like PEN-Plus have led to increased service provision, enhanced quality of care and a stronger demand for WHO technical support. The publication of UHC-related legal assessments in 47 countries has empowered advocates to drive necessary reforms, resulting in legislative changes that enhance health access for marginalized populations.

Overall, WHO AFRO has contributed significantly to placing people at the centre of health systems by translating global strategies into actionable frameworks, promoting inter-agency collaboration and strengthening national capacities, thereby paving the way for comprehensive health improvements across the African Region.

AF-2_Acting Quickly, Saving Lives: Leveraging Regional and National Capacities to Contain Disease Threats in the WHO African Region

During 2024–2025, the Secretariat added value through timely leadership, technical coordination, operational surge support and strategic resource mobilization across 31 graded public health emergencies, including infectious disease outbreaks and humanitarian crises. Nearly one third (10) were classified as Grade 3, including mpox (declared a PHEIC), the Sudan refugee crisis, Marburg outbreaks in Rwanda and Ethiopia, and Ebola in Kasai, DRC. Beyond responding, the Secretariat ensured that interventions were rapid, coordinated and aligned with longer-term health system strengthening.

Guided by the WHO Emergency Response Framework, the Regional Office activated Incident Management Systems within 24 hours for 94% of events and delivered supplies within 72 hours for 80% of emergencies. This contributed to 75% of outbreaks being contained without cross-border spread, including Marburg and Ebola events. The Rwanda Marburg outbreak was controlled within 84 days, with a case fatality rate (CFR) of 22.7%, supported by strong national leadership and rapid deployment of multidisciplinary experts.

The Ebola outbreak in Bulape, DRC, was contained within three months, with 64 cases and 45 deaths (CFR 70.3%). WHO provided US$ 6 million in emergency financing, deployed AVoHC-SURGE responders and WHO staff, established advanced clinical care and mobile laboratory capacity, strengthened IPC/WASH, and supported ring vaccination of over 47 000 individuals, leading to interruption of transmission. Ethiopia’s first Marburg outbreak (November 2025–January 2026) involved 19 cases and nine deaths and was rapidly contained through early IMS activation, deployment of 31 surge personnel, reduced diagnostic turnaround (~12 hours), training of 553 health workers, and follow-up of 857 contacts (>99%).

Across the Region, WHO deployed 318 experts, while 29 Member States utilized Emergency Medical Teams (EMTs), increasingly relying on national EMT capacities, improving timeliness and reducing dependence on external surge mechanisms. WHO also delivered a coordinated mpox response across Africa, deploying 24 experts to six countries, aligning 28 partners under a unified approach, and training over 4 000 frontline health workers. Diagnostic capacity expanded through 5 150 GeneXpert cartridges, increasing testing coverage in DRC from <20% to 65%, alongside strengthened genomic surveillance. Vaccination scaled up to 4.88 million doses, with 1.72 million administered across 16 countries, supported by catalytic funding and US$ 2.6 million in supplies.

In parallel, WHO supported cholera response in 18 countries, delivering 88 tonnes of supplies and 34.5 million oral cholera vaccine (OCV) doses, contributing to significant case reductions, including 95.2% in Zambia and 75.8% in Zimbabwe.

Through the SURGE initiative, over 2 600 responders were trained across 31 countries, with 26 countries activating national rosters, strengthening rapid response and regional solidarity.

In fragile settings, WHO coordinated over 600 partners across 12 countries and supported continuity of essential health services. Implementation of the H3 package increased service availability from ~50% to over 80%, with several countries achieving ≥90% coverage.

Overall, the Secretariat’s contribution enabled faster outbreak containment, sustained essential services, strengthened national capacity, and improved health system resilience, advancing health security and recovery across the Region.

AF-2_Integrated Digital AFP Surveillance Driving Early Detection and Faster Response for Polio Outbreak Interruption in Africa

Acute flaccid paralysis (AFP) surveillance systems across the WHO African Region achieved and sustained high sensitivity, timeliness and completeness, significantly enhancing the early detection of poliovirus circulation and enabling faster outbreak response. Certification-standard AFP surveillance was maintained in 96% of countries, with a regional non-polio AFP rate of 7 per 100 000 population and stool adequacy of 92%, alongside 100% timely case investigation and finalization. The expansion of environmental surveillance to over 500 sites in 46 countries enabled the early detection of 53% of outbreaks, allowing more rapid initiation of supplementary immunization activities (SIAs) and contributing to the successful interruption of wild poliovirus type 1 (WPV1) transmission in Madagascar and Malawi, as well as circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreaks in Burundi and Congo.

These results were enabled by strengthened and integrated surveillance systems, combining field surveillance, laboratory capacity, digital innovation and targeted country support. A robust GIS-enabled digital ecosystem hosting over 750 million data points and used by more than 15 000 users improved real-time surveillance, data quality and evidence-based decision-making. Laboratory and genomic sequencing capacity was significantly enhanced, with 98% of sequencing conducted within the Region, reducing delays in virus confirmation and characterization and enabling more targeted and efficient immunization responses.

Equity and system resilience were further strengthened through targeted surveillance among nomadic and displaced populations, which contributed 20% of AFP case notifications, improving representativeness and completeness. Capacity-building of over 1 500 national actors, alongside financial and operational support to 34 priority and transition countries, reinforced national surveillance systems and reduced the risk of undetected transmission. In parallel, strengthened certification, transition and integration efforts, including improved reporting systems (e-AUR), implementation of transition monitoring frameworks, and integration of polio SIAs with other immunization campaigns, enhanced data quality, accountability and programme sustainability.

Collectively, these interventions resulted in more responsive, efficient and integrated surveillance systems across the Region, enabling earlier outbreak detection, faster and more targeted response, and sustained progress towards polio eradication.

AF-2_Prepared, Informed, Resilient: Regional Achievements in Community Protection and Health Security

During the 2024–2025 biennium, the WHO Secretariat strengthened community protection and resilience as an essential component of emergency preparedness and outbreak response across the African Region. Working with WHO Country Offices, emergency response pillars, Africa CDC and multiple partners, WHO supported countries to institutionalize community-centred approaches within national preparedness, response and recovery systems.

A core focus was the development and operationalization of community protection and resilience strategies. Countries were supported by adapting and implementing risk communication and community engagement (RCCE) frameworks, context-appropriate health literacy tools and behaviourally informed communication approaches. These contributions enabled more timely, people-centred responses to outbreaks and public health events.

WHO further strengthened behavioural and social data systems, allowing countries to generate real-time insights into community perceptions, barriers to service uptake, trust dynamics and adherence patterns. These data informed adaptive decision-making, improved targeting of public health interventions and supported rapid adjustments in outreach, messaging and service delivery.

Capacity-building remained a major area of technical support. WHO worked with national authorities to train RCCE teams, frontline responders and community health workers in interpersonal communication, participatory engagement, rumour management and inclusive outreach approaches. Special emphasis was placed on engaging women, youth, displaced populations and underserved communities to ensure equitable access to trusted information and services. Survivor-led anti-stigma initiatives were supported to reduce discrimination, rebuild trust in health services and strengthen reintegration for affected individuals.

WHO also expanded national capacity for infodemic management and social listening. Countries strengthened their ability to monitor misinformation and disinformation trends, triangulate community feedback and refine public health messaging. These efforts contributed to improved health-seeking behaviour, increased uptake of preventive measures and greater public confidence in authorities during response operations.

Nutrition and food safety were systematically integrated into emergency preparedness and response frameworks to protect vulnerable populations and ensure continuity of health and nutrition services. WHO supported governments to maintain the management of severe acute malnutrition (SAM) and essential nutrition services throughout crises. This included strengthening food safety preparedness—critical during outbreaks and humanitarian emergencies—and reinforcing regional coordination mechanisms to improve detection and management of food-related health threats.

To address the heightened risk of malnutrition during climate or conflict shocks, WHO provided technical support for the operationalization of updated global guidance, including tools for prevention and management of child wasting. Quality of care approaches for children with SAM in inpatient settings were strengthened through WHO’s assessment and action tools, structured improvement plans, mortality reviews and corrective measures. These efforts enhanced service readiness through provision of supplies, improved monitoring and support for surge-responsive adaptations during seasonal spikes in admissions.

Collectively, WHO’s support strengthened multisectoral community protection, enhanced risk communication systems, improved social and behavioural data use, and ensured continuity of life-saving nutrition and food safety services during emergencies. These results demonstrate growing national capacity to manage outbreaks and health shocks in a more coordinated, people-centred and resilient manner, advancing progress towards universal health coverage and the Regional Strategy for Health Security and Emergency Preparedness.

AF-2_Strengthening Emergency Preparedness to Accelerate IHR (2005) Capacity Development

The Secretariat continued to strengthen emergency preparedness across the Region by supporting Member States to conduct capacity assessments, functional reviews, risk profiling and readiness evaluations. These efforts helped countries identify and prioritize health security gaps, accelerate implementation of National Action Plans for Health Security (NAPHS), and enhance their ability to predict, detect and respond to emerging threats. As a result, more Member States integrated risk-based planning into national preparedness processes and improved the coherence of readiness measures at national and subnational levels.

Negotiations on the WHO Pandemic Agreement were concluded during the Seventy-eighth World Health Assembly in May 2025. The Secretariat supported Member States to advance the operational components of the Agreement, particularly the development of the Pathogen Access and Benefit-Sharing (PABS) system. Core elements such as equity, technology transfer and access to countermeasures were agreed upon, and technical and legal discussions continued under the Intergovernmental Working Group to finalize the PABS annex and define modalities for implementation. This has strengthened Member States’ understanding of future obligations and contributed to progress towards a more equitable global health emergency architecture.

Application of the International Health Regulations Monitoring and Evaluation Framework (IHRMEF) was sustained, with all Member States submitting State Party Annual Reports (SPAR) for the eighth consecutive year. Regional IHR capacity increased from 50.1% in 2023 to 51% in 2024, reflecting steady improvements in preparedness capacities. During the reporting period, the Secretariat supported 35 simulation exercises, 11 after-action reviews, 19 intra-action reviews and four early action reviews applying the 7–1–7 approach. Nineteen countries completed Joint External Evaluations (JEE), bringing to 39 the number that have undergone a second evaluation. Findings informed NAPHS updates in 29 countries and contributed to the development of proposals to the Pandemic Fund, which awarded more than US$ 224 million to 21 countries.

Country-level risk intelligence was strengthened through deployment of the Strategic Toolkit for Assessing Risks (STAR) in 18 countries. This enabled governments to conduct comprehensive national risk profiles, identify critical preparedness gaps and align investments with risk exposure. The use of STAR significantly improved real-time analysis and prediction of public health threats, enhancing evidence-based decision-making for emergency preparedness planning.

Filovirus readiness assessments were conducted in the Democratic Republic of the Congo (DRC), Ethiopia and 11 neighbouring countries, where readiness levels reached 63%. Catalytic funding supported case investigation and reinforced border health capacity. Eight additional countries assessed readiness for floods, cyclones and La Niña, identifying major operational gaps and prompting the Secretariat to support contingency planning. Preparedness efforts were also strengthened for the African Nations Championship (CHAN) 2025 mass gatherings, and ship sanitation certification was reinforced in South Africa and the United Republic of Tanzania to improve compliance with international maritime health regulations.

All 29 cholera priority countries completed preparedness and readiness assessments, establishing a regional baseline capacity of 58% to guide targeted action. Seventeen countries identified Priority Areas for Multisectoral Interventions (PAMIs), improving coordination and resource allocation for cholera control. Six countries finalized National Cholera Plans, doubling the regional total from six in 2023 to 12 in 2025. Progress was made towards establishing a Continental Task Force on Cholera Control, creating a high-level platform to coordinate Africa-wide cholera elimination efforts.

The Secretariat supported seven countries to develop national meningitis plans, increasing the regional total to 19. Nine additional countries conducted meningitis risk assessments and received technical support to facilitate the deployment of the Men5CV vaccine in priority settings. Although yellow fever remains a significant threat, strengthened surveillance and vaccination systems have improved early detection and response capacities. However, immunity gaps and climate-related risks continue to require sustained investments in vaccination and surveillance.

Implementation of the Community Protection and Resilience (CPR) Regional Strategy (2023–2030) advanced through strengthened national capacities and development of a regional implementation plan involving 13 Member States. Support to the Economic Community of Central African States (ECCAS) resulted in a CPR/RCCE plan covering 11 countries, and a regional repository of risk-based community messages is now accessible to Member States. To enhance research readiness, operational guidance for community engagement in filovirus clinical trials was finalized.

Support to countries in strengthening One Health coordination improved multisectoral collaboration for risk detection, prevention and response. Several Member States developed or aligned their national One Health strategies with the Joint Plan of Action, enhancing capacity to reduce zoonotic, environmental and other human–animal–ecosystem risks.

Progress in pandemic influenza preparedness continued, with 24 countries updating their National Influenza Pandemic Preparedness Plans using PRET Module 1. Fifteen countries reached advanced draft stage, and one validated its plan through simulation. Three countries developed influenza vaccination deployment plans. Sentinel surveillance was expanded to 35 Member States, including new support to Congo and Lesotho.

The Secretariat enhanced national infection prevention and control (IPC) governance, strengthened health worker safety, and improved outbreak readiness through training, guidelines, assessments, digital tools and expert deployments. Emergency preparedness training was scaled through a blended model combining virtual and in-person delivery. Sixty-four virtual sessions generated 40 670 registrations and reached 12 390 participants across all Member States. The institutionalized hybrid training model has improved understanding of IHR obligations and expanded access to high-quality capacity-building.

The Elimination of Yellow Fever Strategy (EYE) Strategy, through reactive and preventive vaccination campaigns in 11 high-burden countries, protected 84.3 million people (91.2%) out of the targeted 92.4 million during the reporting period. Preventive Ebola vaccination was implemented nationally for the first time in Sierra Leone, where 20 670 frontline workers were vaccinated, achieving 84.6% coverage. In the DRC, vaccination of Ebola survivor contacts reached over 10 000 individuals with 63.8% coverage, marking an important milestone in filovirus prevention. The first component of the Ebola vaccine toolkit was completed, and preventive doses of oral cholera vaccine were shipped to DRC and Mozambique for early 2026 implementation, reinforcing early action cholera prevention strategies.

AF-3_Building the Future: Key Wins in Multisectoral Governance and Health Determinants

During the 2024–2025 biennium, the WHO Secretariat supported Member States to accelerate implementation of the Regional Multisectoral Strategy. A total of 34 of 47 Member States (72%) reported progress using agreed indicators to track advancement towards 2030 targets. Evidence shows growing institutionalization of multisectoral governance across the Region. Thirty countries (63.8%) have established formal coordination structures, while 25 (53%) have developed operational plans or road maps to operationalize multisectoral policies. Integrated approaches are increasingly embedded in national frameworks, with 25 countries (53%) applying whole-of-government principles, 23 (49%) adopting whole-of-society and people-centred approaches, and 27 (57.4%) incorporating a One Health perspective across sectors.

Progress on health impact assessment (HIA) demonstrates early uptake but highlights significant capacity gaps. Sixteen countries (34%) conducted at least one HIA between 2023–2025, while 10 show initial awareness but lack formal mechanisms or institutional arrangements. Only four countries (8.5%) have established mandatory HIA systems supported by guidelines, trained personnel and cross-sectoral coordination, underscoring the need for systematic institutionalization.

Monitoring, evaluation and accountability systems are emerging but remain limited. Fourteen countries (29.7%) reported the existence of M&E frameworks for multisectoral action, while 20 (42.5%) have mechanisms for cross-sectoral data sharing. However, 14 countries (29.7%) indicated an absence of formal systems for sharing data across sectors, limiting the ability to track health and well-being outcomes in an integrated manner. Advocacy performance is comparatively strong, with 31 countries (66%) undertaking initiatives to promote multisectoral collaboration. Sustainable financing remains the weakest area of implementation: only 13 countries (27.6%) have dedicated funding strategies, while 21 (44.6%) reported no financing mechanism for multisectoral platforms.

WHO provided strategic support across health, finance, justice, trade, agriculture, education and community systems to strengthen governance, facilitate policy dialogue and build implementation capacity. In tobacco control, WHO supported coordinated work between Ministries of Health and Finance and regional economic bodies, contributing to excise tax reforms in 15 countries. These reforms combined tax rate adjustments with structural improvements, reducing affordability and increasing domestic revenue. Whole-of-government collaboration in 14 countries strengthened legislation and regulatory frameworks, supported by WHO-led training for enforcement officers and improvements in national compliance systems. The Tobacco Free Farms initiative further extended multisectoral action by linking agriculture, health and community systems to support farmers’ transition to alternative livelihoods, improving food security and advancing sustainability.

Under the WHO SAFER Initiative, multisectoral action to reduce harmful alcohol use was strengthened through intercountry learning involving 15 countries and 68 multisectoral participants from health, transport, finance and justice. Countries reported progress in alcohol taxation and pricing, regulating availability, strengthening drink–driving laws, and restricting marketing.

Road safety efforts expanded multisectoral collaboration through the African Regional Status Report on Road Safety. Seventeen countries recorded reductions in road traffic deaths by up to 49%, supported by cross-sectoral reforms, improved data systems and capacity-building for national authorities and journalists.

WHO also catalysed multisectoral action on nutrition and food safety by integrating school-based and community-based interventions, strengthening collaboration between health and education, and embedding nutrition priorities within UHC and social protection agendas. Collectively, these achievements demonstrate strengthened governance, improved cross-sectoral coordination and growing country capacity to address health determinants through scalable, sustainable multisectoral action.

AF-3_Strengthening Health System Resilience to Climate Change and Related Nutrition and Food Safety Risks

Climate change continues to pose an escalating health threat in the African Region, despite African countries contributing less than 4% of global emissions. Rising temperatures, floods, air pollution, climate-sensitive disease outbreaks and weak infrastructure are intensifying health risks and deepening inequalities. During the biennium, the WHO Secretariat supported Member States to strengthen capacities across environmental health determinants—including climate change, chemical safety, energy and air pollution, and WASH—while integrating nutrition and food safety as core components of resilient, people-centred health systems.

Political commitment and regional leadership advanced significantly. Between 2021 and 2025, 31 countries endorsed the Conference of the Parties to the United Nations Framework Convention on Climate Change (COP26) health goals and over 20 supported the Conference of the Parties to the United Nations Framework Convention on Climate Change (COP28) Climate and Health Declaration. WHO facilitated development of the Framework for Building Climate-Resilient and Sustainable Health Systems (2024–2033), established a regional network of 12 climate and health negotiators, and convened high-level policy dialogues to guide an Africa-wide climate–health roadmap. At least nine countries conducted climate and health vulnerability and adaptation assessments and developed Health National Adaptation Plans with WHO support.

Practical system-strengthening interventions improved service delivery and environmental sustainability. Solar electrification of over 800 health facilities in Ethiopia, Uganda and Zambia now benefits roughly 8 million people, while the phase-out of mercury devices across 7 000+ facilities in Burkina Faso and Uganda strengthened chemical safety and compliance with the Minamata Convention. Air pollution efforts accelerated through promotion of clean household energy solutions; by December 2025, 17 Member States were monitoring air quality. WHO deployed new tools to harmonize air pollution tracking in four countries and trained 49 health professionals in 2024 to integrate air pollution and clean energy management into health sector planning.

WASH capacities improved across the Region. WHO supported 15 countries to develop WASH accounts for national benchmarking, while 18 countries strengthened WASH services in health facilities using the WASH FIT tool. Four countries were supported under the regional observatories and chemicals management initiative, and five additional countries introduced lead poisoning reduction actions. WHO also raised awareness of mercury risks in 13 countries and supported the development of national mercury management guidelines in three.

Recognizing the impact of climate shocks on nutrition, WHO disseminated the 2023 wasting guideline and supported regional workshops across 23 countries, enabling adaptation and implementation road maps. Quality of care for children with severe acute malnutrition (SAM) improved through rollout of a regional assessment and action tool and structured quality improvement processes in 18+ countries. Between January and July 2025, stabilization centres admitted 7 380 children with SAM and medical complications, recording a mortality rate of 3.78%, below the WHO emergency threshold. WHO further strengthened food safety and environmental health systems through risk assessment, regulatory capacity-building, and support maintaining essential nutrition services in fragile and climate-affected settings, reinforcing resilience and preventing excess mortality.

AF-4_Strengthening Data Systems for Health Equity in Africa

The WHO African Region (WHO AFRO) faces significant challenges in effectively analysing and utilising data for decision-making, particularly in the context of achieving universal health coverage (UHC) and the health-related Sustainable Development Goals (SDGs). Contributing factors to this challenge include the scarcity of quality data, a lack of skilled data analysts, and weak connections between data analysts and decision-makers. Moreover, the absence of disaggregated health data relating to equity stratifiers has hampered efforts to monitor health inequalities, making it difficult to identify the most vulnerable populations needing targeted interventions.

To address these issues, WHO has taken several key actions aimed at strengthening country data systems. Initiatives have led to significant improvements in data generation, analysis and utilisation across 44 countries, where the implementation of the District Health Information Software 2 (DHIS2) has now reached 94% coverage. The introduction of DHIS2 has transformed the landscape of routine health information management, making high-quality routine data accessible for at least 80% of essential health indicators. Furthermore, countries have made strides in mortality reporting, with notable improvements observed in Botswana, Mauritius and Namibia, where near-universal death reporting has been achieved.

Additionally, WHO AFRO is developing a Regional Data Hub (RDHub) to counter persistent data fragmentation, providing a central repository of information accessible to all Member States. The minimum viable product (MVP) of the RDHub has been completed, showcasing its core functionalities such as country-specific pages and analytics dashboards. As of 2025, 42 countries have established National Health Observatories (NHOs), reflecting various levels of maturity in data reporting and utilisation.

In supporting health systems assessments, WHO has facilitated evaluations in 748 districts across 18 countries, generating vital data on service availability and functionality. Health facility assessments, supported by WHO, have provided critical insights into how facilities deliver services, allowing countries to identify gaps and implement remedial actions effectively.

WHO’s commitment to strengthening data analytics capabilities has led to capacity-building initiatives in multiple countries. Training sessions on tools like the Health Equity Assessment Toolkit (HEAT) have been instrumental in enabling health ministries to better monitor and address health inequalities. Specialized workshops have also been conducted in six countries, equipping local experts with the skills needed to analyse complex datasets and generate evidence-based recommendations.

Research and knowledge management have been prioritised, with WHO AFRO producing regional analytical products, including GPW13 country profiles that track health indicators across the Region. Insights gained from a comprehensive survey of national research ethics committees (NRECs) aim to enhance ethical review processes and compliance with international research standards. WHO AFRO continues to support the implementation of the World Health Assembly resolution for clinical trials, enhancing the Region’s research capacity and quality.

The overall impact of these initiatives is significant: improved availability and quality of evidence support robust resource allocation and policy-making. Countries are now better positioned to monitor health-related SDGs, address health inequalities and make informed decisions. The ongoing capacity-building efforts further enhance the ability of countries to generate actionable knowledge and design evidence-driven health programmes, ultimately contributing to improved health outcomes across the Region.