The Third Interministerial Conference and Health and Environment (IMCHE3) in Africa, jointly organized by WHO, the UN Environment Programme and the Government of Gabon, was held from the 6–9 November 2018 in Libreville, Gabon. The general objective of the conference was to catalyze actions by stimulating policies and investments on the joint contributions of the health and environment sectors towards the achievements of the sustainable development goals in Africa. The conference brought together more than 600 participants, from 46 countries. Participants included ministers, development partners, regional economic communities, private sector, NGOs and media. The event was an opportunity for countries to reflect on and share their progress, the challenges encountered, and lessons learnt over the last 10 years. This report is a summary of the conference proceedings. It includes the challenges and opportunities discussed in each of the sessions around accelerating and scaling up health and environment interventions in Africa.