Africa’s preventive governance architecture has developed sophisticated mechanisms for diagnosing structural vulnerabilities, yet it remains considerably weaker at translating assessment findings into implemented governance reforms. This paper examines this diagnosis–treatment gap by examining the relationship between the Country Structural Vulnerability and Resilience Assessment (CSVRA) and the African Peer Review Mechanism (APRM). It argues that the problem is not simply weak coordination between the two mechanisms, but the absence of an institutional pathway linking vulnerability diagnosis to reform commitments, national planning, budget allocation, implementation, monitoring and political accountability. While the CSVRA identifies structural vulnerabilities and resilience deficits, the APRM provides participatory, programmatic and peer-review mechanisms through which identified governance challenges can potentially be converted into corrective action. Using a qualitative descriptive-analytical approach based on a desk review of APRM, CSVRA, country reports and other relevant academic literature, the paper draws on Zambia and Ghana as illustrative cases to examine how assessment outcomes are translated into governance reforms and institutional constraints that affect implementation and follow-up. The paper finds that Africa’s preventive governance challenge lies less in identifying structural risks than in converting diagnosis into funded, implemented and monitored reforms. It therefore proposes an AU Preventive Governance Integration Model linking CSVRA diagnosis and mitigation priorities to APRM reviews, National Programmes of Action (NPoAs), National Development Plans, budgeting, monitoring and evaluation, and continental peer review. The model provides a sequenced diagnosis–treatment–follow-up pathway to strengthen preventive governance, institutional accountability and conflict prevention in Africa.