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In many low-income and middle-income countries, access to specialised surgical care is limited by infrastructure gaps, workforce shortages and weak financing, leading to unmet needs and cross-border inequities. The African Network of Medical Excellence (ANME) was created as a public–non-government organisation partnership to strengthen national health systems through specialised centres of excellence providing free, high-quality care. This paper outlines the design, implementation and outcomes of the ANME Regional Programme (RP), a coordinated cross-border referral system.The RP operates through formal agreements with Ministries of Health, structured referral pathways, specialist outreach missions, and full coverage of patient travel, accommodation, surgery, follow-up and essential medicines. Two ANME hospitals—the Salam Centre for Cardiac Surgery in Sudan and the Children’s Surgical Hospital in Uganda—serve as regional hubs. By December 2024, 190 screening and follow-up missions had reached over 16 000 patients across 28 countries, with 2024 receiving specialised surgical care.Outcomes confirm the feasibility and safety of this model. At the Salam Centre, early postoperative mortality among RP-referred patients was lower than that of host-country patients (1.8% vs 2.9%), reflecting effective case selection and continuity of care. At the Children’s Surgical Hospital in Uganda, early implementation of the paediatric RP addressed major unmet needs for complex congenital conditions, with no postoperative deaths reported.The ANME regional programme demonstrates how a not-for-profit, government-supported referral system can expand equitable access to specialised care, strengthen local capacity and support sustainable, rights-based health system development. Its approach offers transferable lessons for regional collaboration in other resource-limited settings.