The Thirteenth General Program of Work (GPW 13) defines WHO’s strategy for the five-year period 2019–2023, a resolution of the World Health Assembly validated its extension until 2025. It focuses on triple billion targets to achieve measurable impacts on people's health at the country level. The triple billion targets are to ensure by 2023:

• One billion more people are benefiting from universal health coverage.
• One billion more people are better protected from health emergencies.
• One billion more people are enjoying better health and well-being.

Measurable impact is at the heart of WHO's mission to transform the future of public health.

2.1 Universal health coverage

Making quality health services available for all, ensuring people are not pushed into poverty by health care costs are the main objectives of Universal Health Coverage (UHC). UHC represents a practical expression of the right to health care for all. In the African Region, even though great efforts have been made, the service coverage index, one of the key indicators for UHC monitoring, remains at 46%.

The need for family planning satisfied with modern contraceptive methods in women aged 15–49 is an indicator that reflects inequalities in reproductive health service coverage shows that 56.3% of women living in a couple or married use family planning in 2020 compared to an average of more than 75% in the rest of the world. For antenatal care and childbirth, families in urban and rural areas are not always accompanied by qualified health personnel, thus compromising the well-being and future of the child. Protecting the health of both newborns and adults includes immunization, the coverage of which is declining worldwide, as well as in Africa. This substantial decline has been accentuated by the COVID–19 pandemic, pushing back the targets to be reached and forcing states to redouble their efforts to catch up on immunization everywhere, with few resources available to countries. On the other hand, since 2014, the TB treatment coverage curve shows an increase. But, despite free access to drugs, many countries are still lagging. Treatment barely covers 1 out of 2 affected patients (57%). The global response to HIV/AIDS has produced noticeable effects in the African Region. By the end of 2017, a total of 15.3 million people living with HIV in the African Region had access to lifesaving antiretroviral drugs. In addition, Malaria continues to strike mainly pregnant women and children, particularly in Africa. Significant progress has been made in universal access to basic water supply, sanitation and hygiene services, but considerable gaps remain in the quality of the services provided. The African Region remains the Region with the lowest coverage with only 23% (2 out of 10 people) of the population having access to at least basic sanitation. Tobacco is the leading preventable cause of death worldwide, And Africa could become a playground for tobacco companies.

By 2021, the reports point out a deterioration in household financial protection, particularly because of falling incomes, as well as rising poverty and inequality, moving away from UHC. Almost 7.8% population in the Region are spending more than 10% of income on health expenditure. In fact, Africa and Asia represent 97% of the world’s population impoverished by direct health expenditure. The acceleration of implementation of the “Abuja Declaration” for the mobilization of more resources from public for the health sector in African countries is more than ever necessary.

2.2 Health emergencies protection

The COVID–19 health crisis has demonstrated that more needs to prepare for the next pandemic and coming public health emergencies. Indeed, The COVID–19 pandemic has revealed global differences in response. Previous disparities in detecting, assessing, reporting and responding to international health emergencies led to the signing of the International Health Regulations in 2005 (IHR 2005). The frequency and pervasiveness of epidemics, disasters and other public health emergencies in Africa requires substantial investments in preparedness capacity in all countries. While investing in preparedness should be guided by global frameworks such as the IHR, it is the responsibility of each government to fund needs.

Preparedness and response require collaboration between countries and regional economic communities, but also financial, material and effective human resources, multi-disciplinarity and intersectorality; and certainly real leadership. Before the emergence of COVID–19, the top five causes of epidemics were cholera, measles, yellow fever, meningococcal meningitis, and influenza most of which are preventable by strengthening routine immunization. Large-scale protracted outbreaks can be prevented through early detection, notification, and rapid control. The median time from detection to containment reduced from 418 days in 2016 to 51 days in 2018.

2.3 Healthier populations

Pursuing the goal of a healthier population in the Region, prevalence of stunting among children under five years of age is dropping slowly in the African Region from 43.6% in 2000 to 31.7% in 2020. Almost 80% of the countries in the Region has a high or very high prevalence of stunting among children under five. Undernutrition is responsible of about 45% of deaths of children under five in low-and-middle-income countries. Regional figures show a decline of overweight from 6.04% to around 4.54% from 2000 to 2021. That clearly shows that the aim of reducing the prevalence of overweight by 50% by 2025 might not be reached if nothing is done.

Suicide remains one of the leading causes of death worldwide. The decline over the past 5 years (2015–2019) from 7.32% to 6.9% in the African Region. However, the situation seems to be alarming in Southern Africa. While the link between suicide and mental disorders is well established, many suicides occur in a time of crisis and lack of ability to cope with life stresses. Africa has missed the SDG 3.6.1 target of halving the number of global deaths and injuries from road traffic accidents by 2020. Death rates are declining in other Regions of the world between 2015 and 2019, except in North America and Africa, where they are increasing. The increase is greater in Eastern and Southern Africa (3.0%) than in Sub-Saharan Africa (2.2%) and West and Central Africa.

The global ambition of achieving net zero greenhouse gas emissions by 2050 sets a new direction for the energy sector. African countries are particularly well placed to take advantage from the technological benefits of these changes and attract increasing flows of green finance. WHO reports that Uganda and Namibia had the lead with an average of 11.8 liters of alcohol per year. The most abstinent AFRO countries are Mauritania and the Comoros with 0.2 liters of pure alcohol. Moreover, 80% of the 1.1 billion smokers in the world live in low- and middle-income countries. However, the smoking rate in the WHO African Region is the lowest of all WHO Regions. In addition, a multi-country WHO study shows that, 13–61% of women surveyed said they had experienced physical violence by a partner; and 6–59% said they had experienced sexual violence by a partner at some point in their lives.