Current donor investment in food safety in Sub-Saharan Africa (SSA) largely reflects the concerns of previous decades and as a result is substantially focused on access to regional and overseas export markets, with emphasis on national control systems. Relatively little is being done to reduce foodborne illness among consumers in SSA. More investment in food safety (by African governments, donors, and the private sector) is needed to help ensure that Africans have safe food. New understanding of foodborne disease burden and management, along with rapid and broad change within societies and agri-food systems in SSA, has led to food safety emerging as an important public health and development issue.