Africa has an age old history of production of traditional fermented foods and is perhaps the continent with the richest variety of lactic acid fermented foods. These foods have a large impact on the nutrition, health and socio-economy of the people of the continent, often plagued by war, drought, famine and disease. Sub-Saharan Africa is the world's region with the highest percentage of chronically malnourished people and high child mortality. Further developing of traditional fermented foods with added probiotic health features would be an important contribution towards reaching the UN Millennium Development Goals of eradication of poverty and hunger, reduction in child mortality rates and improvement of maternal health. Specific probiotic strains with documented health benefits are sparsely available in Africa and not affordable to the majority of the population. Furthermore, they are not used in food fermentations. If such probiotic products could be developed especially for household food preparation, such as cereal or milk foods, it could make a profound impact on the health and well-being of adults and children. Suitable strains need to be chosen and efforts are needed to produce strains to make products which will be available for clinical studies. This can gauge the impact of probiotics on consumers' nutrition and health, and increase the number of people who can benefit.