Increasingly, countries are implementing policies to create healthy food environments and sustainable healthy diets, although few in Africa. This chapter presents recent efforts at monitoring food environments, systems for sustainable healthy diets, and diet-related NCDs prevention in Africa. It draws on lessons from Ghana, Kenya, Senegal, and South Africa where assessments of government actions to improve the healthiness of food environments have been conducted. This chapter examines government policy responses to the World Health Organisation’s Best Buys interventions, and discusses the challenges and opportunities to promote sustainable healthy diets and reduce diet-related NCDs in Africa.