The World Health Organisation (WHO) says regardless of promises of better healthcare by governments and donor countries, millions of mothers, newborn babies and children continue to die each year in Africa from preventable diseases.
The WHO has found that some of the continent's biggest problems are getting worse and the rates of death during childbirth and among young children are increasing.
Although Africa has 11% of the global population it has 60% of the world's HIV/AIDS cases and 90% of world malaria cases, mainly in children under 5.
The African Regional Health Report, the first study to look at health trends among 738 million Africans, said more investment was needed to cut disease and tackle poverty and because of AIDS and armed conflicts, the health situation in many African countries has not improved in recent years and in some cases has worsened.
The WHO says a "silent epidemic" in African countries accounts for 19 of the 20 countries with the highest rates of maternal mortality worldwide and the highest death rate worldwide for babies up to a month old.
The WHO says in Africa it stands at 43 per 1,000 live births or four times the rate in Europe.
Although the report was not all negative and successes, such as Uganda's AIDS programme, Mali's community health centres, and the greater availability of anti-retroviral drugs used to treat people with HIV/AIDS were highlighted, it does reveal the difficult health challenges facing African countries.
While diseases such as polio, measles and leprosy have almost been eradicated, the report acknowledges the growth of "lifestyle" medical conditions such as heart disease, diabetes and stroke.
Louis Gomes Sambo, WHO's regional director for Africa, says they know what the challenges are, and how to address them, but Africa's fragile health systems represent an enormous barrier.
He says African governments and their partners must make a major commitment and invest more funds, because African countries will not develop economically and socially without substantial improvements in the health of their people.
According to the report only 58 percent of the people living in sub-Saharan Africa have access to safe drinking water.
The WHO says however that river blindness has been all but eliminated and 33 of the 42 countries most affected by malaria have adopted the artemisinin-based combination therapy, which is the most effective.