This document provides an overview of five ‘legacy elements’ that have served the countries of the African Region over the past decade as they responded to an increasingly complex and challenging health landscape. These legacy elements, each unique in their design and approach, have made a significant impact on both the delivery of health services and programmes, and WHO’s ultimate goal of saving lives. The legacy elements highlight the transformative public health initiatives the Regional Office has actioned to ensure a fit-for-purpose Organization that is responsive to the needs of its Member States. Notable in terms of their innovation and impact, sustaining these legacy elements will require more diverse funding models, stronger local partnerships, effective community engagement, and addressing the social and economic determinants of health.

The sustainability of any response to health priorities in the region must build on a commitment to health system strengthening. This requires investments in initiatives such as the legacy elements outlined here, but also in strengthening health systems, extending services in hard-to-reach areas and among people at risk of marginalization, and reducing the wastage of health resources. Combined, these sustained investments will ensure that gains in the health sector will not be lost, and the previous decade of success in the African Region will continue to grow.

Since its inception in 2016, the Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN) has been central to the success story of disease control in Africa. A flagship project for the African Region, ESPEN focusses on the five most common neglected tropical diseases (NTDs) treatable with preventive chemotherapy (PC-NTDs). Through ESPEN, WHO provides targeted technical support to national NTD programmes. As an effective approach to disease control and elimination, ESPEN reflects the transition from vertical health programmes to well-planned, integrated health services that respond to health needs throughout the life course, while ensuring services reach the most vulnerable.

Moving forward, ESPEN’s coordination role will be central in empowering stakeholders with accurate and timely health information, strengthening the capacity for integration of the supply chain for NTD medicines within existing national systems, and enhancing country leadership and ownership to foster multi-sectoral coordination mechanisms, promoting collaboration among NTD partners for joint planning and sustained impact. 

Launched in 2018, WHO’s Pathways to Leadership for Health Transformation Programme provides high level leadership training and strategic support to senior health leaders and WHO staff across the WHO African Region.  Developed in response to the critical need for proficient leadership within the intricate context of health sector reform in Africa, the programme aims to provide high-level leadership and strategic support to senior leaders in the health sector, enabling them to transform health outcomes in their countries.

Since its inception, the programme has empowered over 450 senior WHO staff and officials from various countries in the region. The approach to leadership encompassed by the Leadership Programme will ensure the legacy and impact of the Transformation Agenda and catalyze health sector leadership transformation in Africa – laying a strong foundation for effective health systems that are resilient, agile and equitable.

The Mwele Malecela Mentorship (MMM) Programme for Women in NTDs aims to increase gender equality in representation and leadership by supporting mid-career women to become leaders and champions in NTD elimination. Focused specifically on African women living in African countries, and aligned with the WHO NTD Road map, the programme provides mentorship, training and networking opportunities to at least five women each year from 2023 to 2030.

In line with the commitment to sustained advocacy, strategic initiatives are under way to further position the MMM Programme as a leading advocate for African women in Neglected Tropical Diseases. This includes exploring partnerships, conducting direct outreach to country offices and NTD focal points, and implementing targeted efforts to amplify the programme's impact and influence within the field. The programme is an affirmation of the power of mentorship and the critical role of inclusive leadership in overcoming the challenges posed by NTDs. With an eye to the future, the MMM Programme is set to become a beacon of progress and a driver of transformational change in the global fight against NTDs. 

With over 100 public health events each year, the WHO African Region faces the highest burden of public health emergencies globally. In response, the Regional Office has played a critical and significant role in improving health security and responding to health emergencies. This includes both direct technical assistance and surge support during times of immediate crisis response, to shaping the broader technical and political landscape through, for example, the development of normative guidance and standards, and capacity building and advocacy with local partners.

The inequity in access to vital diagnostics and therapeutics experienced by Africa during the COVID-19 pandemic showed how important it is that the region advances local research and innovation capacity, and development and manufacturing capabilities. Regulatory bodies supported by the WHO Regional Office for Africa will be critical to expanding local capacity to provide the diagnostics and therapeutics that are required, tailored to the local context. WHO in the African Region, has, and will continue to, focus on developing and implementing innovative approaches to ensuring the health of its communities by leveraging the huge progress made in responding to outbreaks and emergencies over the past decade.