This chapter examines healthy longevity in Africa: policies, challenges, and opportunities. The research argues that policy frameworks must reconcile biomedical models with entrenched traditional, spiritual, and community practices to be effective and culturally legitimate in Africa. Drawing on continental and national policies influenced by UN and WHO agendas, the analysis highlights an accelerating demographic shift toward older populations in African countries. The major challenge in the region is uneven implementation and underfunding of ageing strategies across many countries. Using a narrative policy review anchored in regional resolutions, national statutes, and scoping studies, the paper synthesizes evidence on core barriers to healthy longevity in Africa which includes fragile primary care systems, workforce shortages and brain drain, poverty and thin social protection, gendered inequities, data gaps, and emergent ageism. Opportunities to improve healthy longevity in Africa include primary health care (PHC) integration, community-based care, digital health, prevention across the life course, and regional partnerships. Findings indicate that pension coverage and geriatric service availability remain far below global baselines, while chronic disease burdens are rising as infectious disease control improves, widening the policy–practice gap for older adults. The research concludes with actionable recommendations: resource and enforce ageing policies, embed geriatric care in PHC, expand non-contributory pensions, invest in data systems, counter ageism, and leverage health-tech and regional collaboration to scale pragmatic, context-fit models of care.