Abstract The African continent continuously experiences extreme aerosol load conditions, during which the World Health Organization clean air standard of 10 μg/m3 of PM2.5 mass is systematically exceeded. Africa holds the world largest source of desert dust emissions, undergoes strong industrial growth, and produces approximately a third of the Earth's biomass burning aerosol particles. Sub-Saharan biomass burning is driven by agricultural practices, such as burning fields and bushes in the postharvest season for fertilization, land management, and pest control. Thus, these emissions are predominantly anthropogenic. Here we use global atmospheric composition, climate, and health models to simulate the chemical composition of the atmosphere and calculate the mortality rates for Africa by distinguishing between purely natural, industrial/domestic, and biomass burning emissions. Air quality-related deaths in Africa rank within the top leading causes of death in Africa. Our results of  780,000 premature deaths annually point to the extensive health impacts of natural emissions, high mortality rate caused by industrialization in Nigeria and South Africa, and a smaller extent by fire emissions in Central and West Africa. In Africa, 43,000 premature deaths are linked to biomass burning mainly driven by agriculture. Our results also show that natural sources, in particular windblown dust emissions, have large impacts on air quality and human health in Africa.