Living in an increasingly interconnected world, epidemics and pandemics are increasingly likely to be a vista for the future. This, coupled with the likely devastating effects of climate change, means that humanitarian crises are likely to increase. Now, more than ever before, is the time to scale up investment in prevention and preparedness strategies, and to review our current approaches to delivering health services, including those that address neglected tropical diseases. The Ascend West and Central Africa programme has illustrated the importance of innovation, multisector partnerships, resilience and the opportunity for change.