It is sometimes believed that the large-scale and rapid extension of social security coverage in low-income
Africa is impossible. The evidence over the last years has turned this idea on its head: in Rwanda, for instance, universal health insurance coverage is becoming a reality. The Rwandan case, amongst others, draws attention to wider positive developments observed in African social security, country developments that are focused firmly on addressing the needs of vulnerable populations, investing in forward-looking and earlier interventions, and enhancing all aspects of the performance of social security administrations and programmes. As this Highlight concludes, while the challenges for social security remain great, the positive impacts of recent developments and trends in Africa give ground for optimism.