Efforts and initiatives to combat hunger and malnutrition in Africa are gaining momentum at all levels—local, national, continental, and international. To design and implement effective strategies for action, it is vital that we have a clear understanding of the problems and options. In this 2020 discussion paper, Todd Benson reviews the extent of food and nutrition insecurity across Africa. He assesses recent patterns and trends, exploring where significant progress has occurred, or not, and why. The differences between food and nutrition security, and how they are linked, are clarified. Benson examines the key direct and indirect determinants and consequences of food and nutrition insecurity in the African context and offers a menu of actions and strategies. Lack of access to and availability of food—the key factors behind food insecurity—remain central concerns in Africa. When food insecurity interacts with health and care problems it translates into nutrition insecurity. HIV/AIDS is an important issue in that context. This comprehensive paper gives prominent attention to the oft-neglected issue of nutrition security. Reflecting emerging Africa-wide initiatives, the paper takes a continental perspective, which should be helpful for strategic consideration by the New Partnership for Africa’s Development (NEPAD) and the African Union. This paper was commissioned for the IFPRI 2020 Africa Conference on “Assuring Food and Nutrition Security in Africa by 2020: Prioritizing Actions, Strengthening Actors, and Facilitating Partnerships,” held in Kampala, Uganda on April 1–3, 2004. There, it served to illuminate the discussions on why Africa has not yet achieved food and nutrition security and what needs to be done. I am sure this paper can influence the dialogues and indeed actions being undertaken to end hunger and malnutrition in Africa.