In June 2013, on the occasion of its 10th anniversary, DNDi and founding partner KEMRI brought together key African decision makers and public health actors to explore the challenges for research and development in Africa at a 2-day meeting entitled “A Decade of R&D for Neglected Diseases in Africa”. The first day focused on regulatory harmonization with a view to accelerating access to essential medicines and vaccines in Africa. Representatives from 20 African countries together with 15 others from Europe, Asia and the United States, including over 360 African regulators, ministers of health, WHO representatives and public health experts, investigators, national control programme representatives, clinical trial and data managers, research and training institutes, and others were present. This resulting document examines the progress made to date, in anticipation of further discussions.