This book examines the landscape of sustained investment in research and innovation in Africa, which are critical for development. This cutting-edge analysis is based on empirical evidence and the author experience in managing health and related innovations on the continent and globally. It concludes, for the first time, that African innovation is largely driven by the principles of Social, rather than Technological innovation. The significance of this finding and the need to optimize, scale and sustain this dominant innovation is addressed in various chapters that analyze the status, challenges and opportunities. Particularly, the financing, collaboration and coordination patterns for these activities on the continent show a fragmented ecosystem that is largely dependent on external donors and aid. The importance of supportive policies, leadership and venture mechanisms that incentivizes public and private entities to innovate is further exemplified by the lessons of the COVID-19 pandemic. The book proposes mechanism to address identified challenges.