Today, global health is impacted by a triple planetary crisis of climate change, security threats and economic fallbacks, with a particularly heavy burden on most vulnerable countries, many of which are in Africa. Thus, effective funding, access to medicine, vaccines, and diagnostics remain key elements to stabilize African health systems. Against this background, Africa has been successfully investing in its own global health governance capacities. Senegal, for example, ranks among the West African countries with the most resilient health systems. In general, international organizations (WHO, World Health Organization) and supranational players like the African Union (AU) or the European Union (EU) as well as NGOs (e.g. SpeakUpAfrica), Think Tanks, interest groups and philanthropists pursue a horizontal “Health in All Policies (HiAP)” approach. In understanding health as a cross-setional issue, the “Health Day” at the UN Climate Change Conference in Dubai 2023 (COP 28) marked a milestone because it acknowledged the complex interconnections between climate and health policy. Nonetheless, there is a massive unfinished agenda in an increasingly fragile multilateral global health ecosystem.