Traveling in Africa requires more health preparation than most destinations, but don't let that put you off. The key is planning ahead. Book an appointment at a travel health clinic at least four to six weeks before your trip. They will look at your itinerary and tell you exactly what you need. What follows here is a general overview -- your specific needs depend on where you are going and for how long.
Yellow fever is the big one. A yellow fever vaccination is required for entry into many African countries, particularly in West and Central Africa. Countries like Kenya, Ethiopia, Ghana, Senegal, and Tanzania either require proof of vaccination or strongly recommend it. The good news is that the vaccine is considered valid for life -- no more boosters needed. Beyond yellow fever, most travel clinics will recommend hepatitis A and B, typhoid, and making sure your routine vaccinations (tetanus, measles, polio) are up to date. Rabies vaccination is worth considering if you plan to spend time in rural areas or around animals. Meningitis vaccination is important for the "meningitis belt" stretching across the Sahel from Senegal to Ethiopia.
Malaria is present across most of sub-Saharan Africa. The risk is highest in West Africa and around the Great Lakes region, and lower (but still real) in parts of southern Africa and at higher altitudes. South Africa, Namibia, and Botswana have malaria only in certain regions and seasons. Your doctor can prescribe antimalarial prophylactics -- the most common options are atovaquone-proguanil (Malarone), doxycycline, and mefloquine. Take them as directed; skipping doses defeats the purpose. On the ground, use insect repellent with DEET, sleep under a treated mosquito net, and wear long sleeves and trousers after dusk. Malaria is serious but entirely preventable if you take precautions.
Don't drink the tap water in most African countries. Stick to bottled or purified water, and use it for brushing your teeth too. Street food is one of the great pleasures of traveling in Africa, but use your judgment -- eat where the locals eat, choose food that is freshly cooked and served hot, and be cautious with salads and unpeeled fruit. Carrying oral rehydration salts is smart, because a bout of traveler's diarrhea is common and dehydration in hot climates can become serious quickly.
Altitude is something to think about if you are heading to the highlands of Ethiopia, trekking Mount Kilimanjaro in Tanzania, climbing Mount Kenya, or visiting the mountain gorillas in Rwanda or Uganda. Addis Ababa sits at 2,400 meters, so you may feel a bit sluggish on arrival. Kilimanjaro tops out at 5,895 meters, where the air pressure is less than half of what it is at sea level -- more than 75% of climbers experience some form of altitude sickness. The rule is simple: ascend slowly, stay hydrated (three to four liters a day), and do not ignore symptoms. A mild headache is normal. Dizziness, vomiting, or confusion mean you need to descend immediately. If your doctor offers you a prescription for acetazolamide (Diamox), take it along.
Travel insurance is not optional. Get a policy that covers medical evacuation -- in remote areas, the nearest decent hospital may be a flight away, and evacuation costs can run into tens of thousands of dollars. Pack a basic medical kit: rehydration salts, anti-diarrhea medication, painkillers, antiseptic, bandages, sunscreen, and any prescription medications you need (in their original packaging, with a doctor's letter). If you take regular medication, bring more than enough for your trip -- pharmacies in smaller towns may not stock what you need. And one more thing: check whether your destination requires proof of a negative COVID test or specific vaccinations for entry. Requirements change, so verify shortly before you travel.