Global crop production needs to double by 2050 in order to meet demands from rising populations, diet shifts and biofuels. Production must increase through more efficient use of currently available arable land to prevent encroachment on land that otherwise provides vital services to the earth and its people (i.e. through increased biodiversity and reduced carbon emissions). Significant improvements can be realised through enhanced management of critical diseases of crops that are pivotal to food security and income generation. To achieve this, the dynamic and complex interactions between crops and beneficial or antagonistic organisms that characterise the biological environment, must be understood. For Sub-Saharan Africa (SSA) a crop healthcare system is required that encompasses national responsibility and regional cooperation, and which harnesses global excellence in terms of the knowledge and methods that are available for implementation. This system would be able to control crop diseases in a pre-emptive\n and cost efficient manner and avoid the current scenario of belatedly combating largescale epidemics. Components\n would include: risk assessment to predict impacts on food and feed value chains; targeted surveillance; fit-for-purpose diagnostics; control intervention packages; extension mechanisms; and enabling policy environments. Each component would be refined, based on practical feedback and results from research targeted to address knowledge gaps. Specific examples are presented for viruses of cassava, viral and bacterial diseases of banana, stem rust of wheat and a new viral disease complex of maize. Finally, the links among disease control and improved crop quality, consumer health and safe trade are discussed through biological control interventions for aflatoxin in SSA.