The Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa has been hailed for its efforts to promote women’s health and rights.. The Protocol has now been signed and ratified by approximately two-thirds of African Union member states, from the most populous and largest to the smallest countries on the continent. The Protocol envisages major steps to improve the status of women on the continent, from economic opportunities and food security through to marriage and the rights of widows. This article seeks to contribute to the emerging literature on gender, health and rights, by exploring how government commitments to the health mandates of the Women’s Protocol have transpired in practice, one decade after its enactment, with a focus on resource allocations. The article’s scope includes a review of why sexual and reproductive rights matter, intrinsically, as rights, and evidence about their instrumental importance for development. Available evidence about status and trends in women’s health in Africa is presented, highlighting some advances as well as major shortcomings. This is the important empirical background against which to explore the human rights obligations of African states on this front, in particular the right to sexual and reproductive health and the potential contribution of the African Women’s Protocol. New analysis is undertaken of the extent to which governments have responded to the Protocol’s specific mandates with respect to military spending and social development, which suggests some promising trends. The conclusions highlight the finding that resource allocations in favour of health have significantly improved in countries that have ratified the Protocol, while underlining the importance of appropriate indicators and monitoring, and actions to ensure state accountability.