From policy to practice: why the WHO’s Africa rehabilitation strategy 2025–2035 risks failure without educational reform

BackgroundIn July 2025, the WHO African Regional Committee adopted an ambitious strategy to address the 63% rehabilitation access gap through a comprehensive five-pillar framework. However, systematic educational exclusion of rehabilitation in African medical curricula may undermine implementation across all strategic pillars.MethodsAnalysis of the WHO AFRO 2025–2035 strategy implementation framework, complemented by systematic curriculum assessment across Central African medical schools and ethnographic observations from Cameroon documenting current access barriers and workforce knowledge gaps.ResultsMedical schools across Central Africa systematically exclude rehabilitation from curricula, with the University of Dschang representing a rare exception (4 h annually). This educational vacuum generates cascading failures: policymakers cannot prioritize services they don’t understand (Pillar 1: Governance), physicians cannot refer to specialists they’ve never encountered (Pillar 2: Workforce), evidence-based interventions are dismissed in favor of pharmaceuticals (Pillar 3: Service Delivery), rehabilitation needs remain invisible in data systems (Pillar 4: Information), and financing mechanisms struggle to support undervalued services (Pillar 5: Resources). Field evidence reveals patients traveling over 1,000 km for rare rehabilitation expertise, reflecting profound system-level educational failures.ConclusionWithout urgent educational reform, the WHO strategy risks replicating historical implementation failures despite comprehensive policy architecture. Educational exclusion represents not a peripheral concern but a foundational threat to strategy success. Medical curriculum integration offers a cost-effective, scalable intervention that amplifies all five strategic pillars. African health leaders must prioritize educational reform as essential infrastructure, not optional enhancement.