Surveillance of Athletes' Health in Resource-Constrained African Sports Contexts: Why Context Matters and Time To Catch Up.

Athlete health surveillance is fundamental to understanding, preventing, and managing injuries, illnesses, and other health problems in sport. While standardized surveillance systems developed by organizations such as the International Olympic Committee (IOC) have substantially advanced sports medicine globally, their applicability across diverse African sporting environments remains insufficiently examined. Many existing surveillance approaches assume the availability of trained medical personnel, robust health infrastructure, standardized documentation systems, and stable sporting environments-conditions that are not readily accessible across Africa. The continent is not homogeneous; some countries and elite sporting programs have surveillance capacities comparable to international standards, while many others operate under significant resource constraints. This commentary aims to examine the limitations of conventional athlete health surveillance approaches in African settings and to advocate for context-sensitive, African-led surveillance systems capable of generating locally relevant evidence to inform injury prevention, health policy, and athlete welfare. Leveraging collaborations among African researchers, clinicians, universities, sports federations, healthcare organizations, and international partners offers an opportunity to develop sustainable surveillance systems while strengthening research and clinical capacity across the continent.