This report summarizes the findings from a consultative and analytical process to document the status of national laboratory directorates across the African continent from the perspective of leadership. Despite myriad contexts and regional differences, common themes are evident and explored in this report – from existential issues related to mandate and structure to more nuanced questions of policy and implementation. While this report identifies many gaps and challenges related to leadership and management capacity, it also highlights promising growth and maturation of the laboratory and diagnostics leadership space both continentally and at a national level over the past fifteen years. This report serves as a standalone document to highlight these findings, and also serves as a foundation for the development of an action plan1 to better support and further improve national laboratory directorates across the continent in the years to come.