Food safety concerns leading to foodborne diseases are important because they directly impose health and economic burdens and indirectly affect the development and flourishing of domestic and export food sectors in Africa. Because these impacts are large, it will be difficult to attain the Sustainable Development Goals or meet the commitments of the Malabo Declaration on Accelerated Agricultural Growth and Transformation for Shared Prosperity and Improved Livelihoods unless foodborne diseases in Africa are brought under control. Food safety concerns will become of even greater importance as developments advance towards a free trade zone for the continent and promoting these developmentsbecomes necessary. This background paper was developed for the 9th annual Africa Day for Food and Nutrition Security, commemorated in Dar es Salaam, Tanzania on 4–5 December 2018, and addresses the theme Sustained food safety action for improved nutrition and health of Africans. The paper starts by describing the current status of food safety in Africa, covering the health and economic burden, the most risky foods and the people most at risk. It then briefly summarises current and previous food safety initiatives in Africa. Subsequent sections focus on strengthening the nexus between food quality, nutrition and health and strategic directions for improving food safety policy and regulatory frameworks in Africa.