Africa stands at a decisive moment in which urgent action is essential to safeguard its brain health and economic stability. While Africa's population remains predominantly young, it is expanding and aging rapidly. This demographic shift is projected to drive a sharp rise in neurodegenerative diseases, including Alzheimer's, with profound health and economic costs-but brain health research, policy, funding and care across the continent remain critically underdeveloped. In this Perspective, we examine key trends in aging and brain health across Africa and introduce the 6 × 5 Plan-a 5-year strategic framework developed through collective multi-stakeholder insights-to address this pressing challenge. The plan targets six high-impact priorities: strengthening advocacy and health literacy, positioning brain health as a socioeconomic driver, breaking down silos of people and data, repurposing local resources, investing in artificial intelligence and digital health, and boosting research funding. To ensure effective implementation and long-term sustainability, the plan will be executed through a pan-African, multisectoral task force. This initiative seeks to accelerate Africa's response to the needs of a changing population and position the continent as a global leader in brain health innovation.