Background: A quarter of a century after its launch, the Integrated Disease Surveillance and Response (IDSR) strategy remains at the heart of Africa’s efforts to build a public health system capable of detecting, analysing and remediating epidemic threats, as well as responding quickly to them. Objective: The objective of this systematic review is to review and document the achievements and challenges regarding the implementation of the integrated epidemiological surveillance system in the WHO African Region and to facilitate the identification of common obstacles to anticipate future health events. Method: In accordance with PRISMA recommendations, we conducted a peer-reviewed literature review that was published over the period from January 2010 to January 2026 on Google Scholar and PubMed verifying the predefined inclusion criteria. The Mendeley software allowed us to eliminate duplicates, while Excel 2021 was helpful for data extraction and analysis. Results: Of the 51 articles that were included, 09 focused on the entire WHO Africa region, while 42 focused on specific countries in the region. About 70% (n = 35) of these were published over the period 2015-2019 and 53% (n = 28) linked several diseases to the implementation of the IDSR strategy. The IDSR has made significant progress in Africa, with improved timeliness and completeness of data, increased efficiency of critical functions, and significant support for polio-related infrastructure to strengthen surveillance of priority diseases. However, the review highlights recurring challenges: insufficient human and financial resources, supply disruptions, low data quality and integration, under-reporting of diseases, lack of training and supervision, as well as coordination and communication problems at all levels of the health system. Conclusion and Perspectives: The IDSR has contributed to strengthening epidemiological surveillance; however, these performances vary by country and remain weakened by persistent structural challenges. Building resilient health systems requires stronger resources, integrated data, digital innovation, and robust governance to sustain gains against emerging and recurrent threats.
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