The Africa Care Economy Index offers a concrete evaluation of African state performance in the recognition, support and redistribution of caring work. Based on a definition of care economy and related concepts relevant in Africa, the Index uses ten metrics to evaluate the 54 states of the continent. Demonstrating longstanding neglect of the care economy by all states in Africa, including South Africa, recommendations are made around broad policy and in-depth research required to begin supporting and redistributing caring work. Social recognition and state support for caring work are shown to be central to building holistic development that benefits the majority in Africa.