A large body of literature has shown that corruption impacts both economic growth and development through multiple channels, such as those related to financial stability, investments in physical and human capital, productivity. Corruption also impacts public trust and the efficiency of government. This book highlights the critical importance of governance and integrity. It suggests that the establishment of sound institutions that guarantee integrity in public affairs may be one of sub-Saharan African's most important milestones in its journey to sustainable development. The book leverages extensive analysis at the cross-country level to provide global evidence and country case studies focusing on the macro-governance links in sub-Saharan Africa. Chapters bring in the COVID-19 pandemic perspective, making this book the first attempt to provide a comprehensive view of the relationships between the quality of institutions and the management of the COVID-19 pandemic. The book argues that the approach to institutional reforms needs to consider the starting position of countries and calls for tailored approaches in fragile countries to consider capacity constraints and societal preferences. It shows how successful reform paths in normal settings become systematically inefficient in fragile environments. This path dependency also applies to the adoption of technological innovations in public affairs. Finally, the book looks at new governance reforms supported by the IMF in sub-Saharan Africa.