Human health is closely tied to the state of the environment. Risk factors linked to environmental degradation are responsible for 23% of deaths in Africa. Many new environmental issues are also emerging, such as climate change, which will exacerbate these existing impacts and introduce new challenges. In 2008, the Libreville Declaration was adopted by 52 African countries to address these issues of health and environment in Africa. Countries have made significant progress over the last decade in implementing the Declaration and achieving its 11 priority action points. However, there is still much work to be done and countries need to scale up their efforts to be able to achieve the Sustainable Development Goals (SDGs) by 2030. The Third Interministerial Conference and Health and Environment (IMCHE3) in Africa, jointly organized by WHO, the UN Environment Programme and the Government of Gabon, was held from the 6–9 November 2018 in Libreville, Gabon. The general objective of the conference was to catalyze actions by stimulating policies and investments on the joint contributions of the health and environment sectors towards the achievements of the sustainable development goals in Africa. The conference brought together more than 600 participants, from 46 countries. Participants included ministers, development partners, regional economic communities, private sector, NGOs and media. The event was an opportunity for countries to reflect on and share their progress, the challenges encountered, and lessons learnt over the last 10 years.