The World Health Organization estimates that every year, 600 million people become ill and many die because of unsafe food. Up to 38% of those affected are children under five years of age, and 53% were people living in low- and middle-income countries.
On Tuesday 13 December 2022, the EatSafe project will host a webinar to highlight the importance of innovative solutions in food safety, and their applicability to low- and middle-income countries, specifically in traditional markets and along the food value chain.
This webinar is the second part of a series on innovative approaches to food safety. The first webinar, held in January 2022, featured consumer-centred approaches to food safety research.
In this second webinar, speakers will share on the application, implementation and practice of innovative solutions for food safety, including highlights from finalists of the EatSafe Innovation Challenge.
Below are details of the hour-long webinar and how to register.
Date: Tuesday 13 December 2022
Time: 0800 hours EST / 1400 hours CET / 1600 hours EAT
Foodborne disease is a significant global health problem, with low- and middle-income countries disproportionately affected. Given that most fresh animal and vegetable foods in these countries are bought in informal food systems, much of the burden of foodborne disease here is also linked to informal markets.
Developing estimates of the national burden of foodborne disease and attribution to specific food products will inform decision-makers about the size of the problem and motivate action to mitigate risks and prevent illness.
A new research study, published in Frontiers in Sustainable Food Systems (Nov 2022), provides estimates for the burden of foodborne disease caused by selected hazards in Burkina Faso and Ethiopia and attribution to specific foods.
Country-specific estimates of the burden of disease in 2010 for Campylobacter spp., enterotoxigenic Escherichia coli, Shiga-toxin producing E. coli and non-typhoidal Salmonella enterica were obtained from the World Health Organization (WHO) and updated to 2017 using data from the Global Burden of Disease study.
Attribution data obtained from WHO were complemented with a dedicated Structured Expert Judgement study to estimate the burden attributable to specific foods. Monte Carlo simulation methods were used to propagate uncertainty.
The burden of foodborne disease in the two countries in 2010 was largely similar to the burden in the region except for higher mortality and disability-adjusted life years due to Salmonella in Burkina Faso.
In both countries, Campylobacter caused the largest number of cases, while Salmonella caused the largest number of deaths and disability-adjusted life years.
In Burkina Faso, the burden of Campylobacter and enterotoxigenic E. coli increased from 2010 to 2017, while the burden of Salmonella decreased.
In Ethiopia, the burden of all hazards decreased. Mortality decreased relative to incidence in both countries.
In both countries, the burden of poultry meat (in disability-adjusted life years) was larger than the burden of vegetables.
In Ethiopia, the burdens of beef and dairy were similar, and somewhat lower than the burden of vegetables.
The burden of foodborne disease by the selected pathogens and foods in both countries was substantial.
Uncertainty distributions around the estimates spanned several orders of magnitude.
This reflects data limitations, as well as variability in the transmission and burden of foodborne disease associated with the pathogens considered.
The world’s largest publicly-funded agricultural research partnership, CGIAR, is currently developing a series of initiatives to implement its 2030 research and innovation strategy that was launched in early 2021.
The research initiatives are designed to create lasting impact in five key areas:
nutrition, health and food security;
poverty reduction, livelihoods and jobs;
gender equality, youth and social inclusion;
climate adaptation and mitigation; and
environmental health and biodiversity.
One of these research initiatives, Protecting human health through a One Health approach, aims to improve the prevention and control of antimicrobial resistance, foodborne diseases and zoonoses in seven target countries: Bangladesh, Côte d’Ivoire, Ethiopia, India, Kenya, Uganda and Vietnam.
The development of the One Health initiative is being led by a team of scientists from four CGIAR research centres — the International Food Policy Research Institute (IFPRI), the International Livestock Research Institute (ILRI), the International Water Management Institute (IWMI) and WorldFish — in collaboration with external research partners from Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, EcoHealth Alliance and the University of Liverpool.
To ensure alignment of the proposed initiative with national priorities, the team convened a series of online consultative meetings with research collaborators to gain insights on the main One Health priorities, challenges, interventions and partner organizations in the respective countries.
The Ethiopia meeting, hosted by ILRI, took place on Wednesday 11 August 2021, bringing together some 40 participants from government ministries, universities as well as national and international research organizations.
Dieter Schillinger, ILRI’s deputy director general for biosciences research and development, opened the meeting with a word of welcome and an overview of CGIAR’s 2030 research and innovation strategy that will guide the implementation of the 33 new research initiatives, including that on One Health—the focus of the online consultation.
He mentioned that the development of the One Health research initiative is a collaborative process and ILRI is working closely with other CGIAR research centres as well as external partners from research and academia, including those represented at the meeting. He therefore welcomed feedback and suggestions from the participants to ensure the research of the One Health initiative is relevant and impactful.
Hung Nguyen, co-leader of ILRI’s Animal and Human Health program, followed with an overview of the rationale of the One Health initiative, citing the need for a One Health approach to tackle the complexity of the global public health challenges posed by the rising incidence of antimicrobial resistance, foodborne diseases and zoonoses.
He then outlined the three main objectives of the One Health initiative, namely, to generate evidence for decision-making; evaluate impacts of One Health approaches; and scale up innovations into national policies and programs.
He further highlighted the initiative’s Theory of Change, explaining how the research outputs are expected to lead to specific development outcomes and impact by 2030, in line with the United Nations Sustainable Development Goals. The team estimates that between 4 million and 41 million cases of disease will be averted annually through the initiative’s efforts.
The initiative’s research activities will take place through five work packages:
zoonoses;
food safety;
antimicrobial resistance;
environment (water and wildlife interfaces); and
economics, governance and behaviour.
The work package leaders presented briefly on the goals of their respective work packages, giving examples of planned innovations under each.
Bernard Bett, ILRI senior scientist and head of the ILRI-hosted One Health Centre in Africa, outlined the two main objectives of the zoonoses work package: pre-empting the spread of zoonoses at the wildlife–livestock interface and reducing the incidence of zoonotic pathogens associated with poverty. Among other innovations, the work package plans to map the risk of key endemic zoonoses and develop diagnostic kits for surveillance of zoonoses.
Hung Nguyen explained that the food safety work package aims to reduce the burden of foodborne disease in traditional (informal) food value chains, with a focus on animal-source foods and other perishables such as fruits and vegetables. Planned innovations include training and certification of food handlers and traders, promotion of consumer demand for safe food, and behavioural nudges to encourage safe food handling practices.
Arshnee Moodley, who heads the ILRI-hosted CGIAR Antimicrobial Resistance Hub, noted that antimicrobial resistance is a silent pandemic and many low- and middle-income countries do not have effective surveillance programs, resulting in lack of data on the burden of antimicrobial resistance. She however noted that Ethiopia has a national action plan on antimicrobial resistance. The work package on antimicrobial resistance will focus on reducing antimicrobial use in crop, fish and livestock production systems and reducing antimicrobial transmission from animals to people through food. Planned innovations include the generation of evidence on the economic impact of interventions to reduce antimicrobial use and the development of tools to help farmers use antimicrobials more prudently.
In his overview of the environment work package, Javier Mateo-Sagasta, senior researcher at IWMI, noted that water is a key connector between people, livestock and ecosystems and so the focus will be on improving land use and water management to reduce health risks such as antimicrobial residues and zoonotic pathogens. Approaches will include recovery and reuse of animal waste to prevent water pollution and promotion of good practices to ensure the safe use of marginal quality water.
Vivian Hoffmann, senior research fellow at IFPRI, explained that the goal of the economics, governance and behaviour work package is to understand the drivers of people’s behaviour within food systems and the impact of policies and governance approaches on this behaviour. An example of an innovation under this work package is a performance management system for government officials responsible for implementing surveillance and enforcing regulations on antimicrobial use or food safety. Another innovation is a system to ensure inclusion of small-scale farmers, traders, food vendors and vulnerable groups so that they benefit from One Health outcomes.
During parallel group discussions on the zoonoses, food safety and antimicrobial resistance work packages, the participants gave feedback on the main One Health challenges, priority interventions, actions to ensure inclusion and partner institutions in Ethiopia.
With regard to control of zoonoses, some of the key challenges identified were weak surveillance systems, shortages of drugs and vaccines, budgetary constraints and lack of laboratory infrastructure. Priority interventions include generation of data on the burden of zoonoses, strengthening of institutions involved in One Health, and capacity building to improve the prevention and control of zoonoses within the framework of One Health.
Among the main food safety challenges identified were food adulteration, low laboratory capacity, poor law enforcement and weak food safety systems. Priority interventions include strengthening of food safety surveillance systems, development of a national food safety strategy and strengthening of legal frameworks.
Regarding antimicrobial resistance, some of the key challenges identified were inadequate surveillance in livestock production systems, high burden of infectious diseases and irrational use of antimicrobial drugs. To address these challenges, there is a need to develop antimicrobial resistance surveillance plans for human health, animal health and food safety. In addition, public awareness on antimicrobial resistance is needed to ensure prudent use of antimicrobials.
Among the suggested actions to ensure inclusion were stakeholder mapping, group-based community approaches, addressing gender in community conversations, and increased advocacy to engage policymakers.
The identified partner groups to work with included government ministries, national and international research organizations, universities, bureau of standards, farmer groups, women’s groups, consumer associations and the media.
As the meeting ended, Feyesa Regassa, lead researcher at the Ethiopian Public Health Institute and chair of Ethiopia’s National One Health Committee, expressed his appreciation to the initiative design team for their support on One Health, specifically food safety, zoonoses and antimicrobial resistance. He also expressed gratitude to all the participants.
‘This is a valuable opportunity for Ethiopia to collaborate,’ he noted.
In her closing remarks, Siboniso Moyo, the ILRI director general’s representative in Ethiopia, thanked everyone for their participation towards achieving the objective of helping the One Health initiative design team as it formulates key interventions and work packages. She expressed her appreciation to the organizing team, facilitators and all who worked behind the scenes to plan for the meeting. She looked forward to working together in this and other initiatives with partners in Ethiopia towards improved human, animal and environment health.
Once approved, the CGIAR One Health initiative will start in January 2022 and run for an initial three years.
ILRI, IFPRI, IWMI and WorldFish. 2021. Ethiopia stakeholder consultation on a proposed CGIAR One Health initiative. Nairobi, Kenya: ILRI. https://hdl.handle.net/10568/114649
Milk and milk products are essential in the diets of the Borana pastoral community in Ethiopia. However, traditional handling and processing of dairy products using basic equipment and infrastructure coupled with a preference for raw milk consumption pose potential health risks to consumers.
A new research study published in the Journal of Dairy Science (Nov 2020) reports on the testing of a community-based training intervention to improve the knowledge, attitudes and practices of women in the Borana pastoral area of Ethiopia regarding hygienic handling and safe consumption of milk.
The intervention consisted of 16 hours of training on good milk production practices and prevention of milk-borne diseases using locally-tailored content. A total of 120 women who produce and sell milk products were trained and their knowledge, attitudes and practices assessed at three stages: before, immediately after and six months after training.
Overall, training increased the knowledge score of the participants from 75.6% before training to 91.4% immediately after training and 90% six months after training. The attitude score significantly improved from 58.8% before training to 64.7% immediately after training. Likewise, there was an observed increase in the trainees’ understanding of correct milk handling practices from 49.5% before training to 64.7% six months after training.
“Future training interventions should be complemented by locally adaptable technologies, provision of incentives and creation of an enabling environment including improved access to clean water and sanitation facilities,” the study authors recommend, adding that this could include practical sessions at the homesteads or herding places of the pastoralists.
Citation
Amenu, K., Agga, G.E., Kumbe, A., Shibiru, A., Desta, H., Tiki, W., Dego, O.K., Wieland, B., Grace, D. and Alonso, S. 2020. MILK Symposium review: Community-tailored training to improve the knowledge, attitudes, and practices of women regarding hygienic milk production and handling in Borana pastoral area of southern Ethiopia. Journal of Dairy Science 103(11): 9748–9757. https://doi.org/10.3168/jds.2020-18292
Amid the COVID-19 pandemic that has focused global attention on the interconnectedness of people, animals and the environment and how this links to the spread of zoonotic diseases, two postdoctoral scientists affiliated with the International Livestock Research Institute (ILRI) are among five recipients of this year’s Soulsby Fellowships, awarded to support early career researchers in human or veterinary medicine working on One Health projects.
One Health can be defined as the collaborative efforts of multiple disciplines working locally, nationally and globally to attain optimal health for people, animals and the environment.
The two postdoctoral scientists, Lisa Cavalerie from the University of Liverpool and Mark Nanyingi from the University of Liverpool and the University of Nairobi, are collaborators in the One Health Regional Network for the Horn of Africa project, a multidisciplinary international partnership that is working to improve the health and wealth of people in the Horn of Africa through One Health research.
Lisa Cavalerie, a veterinary epidemiologist, will study the benefits and risks of livestock ownership to maternal health in women in Ethiopia. She says: ‘The aim of the study will be to develop sustainable livestock health management to improve both maternal and child health.’
Mark Nanyingi, an infectious disease epidemiologist, will investigate the presence of Rift Valley fever virus in people, livestock and mosquitoes in Kenya. He aims to develop a human-animal integrated surveillance system which will inform national policy- and decision-making in the event of outbreaks. ‘This study will enhance our understanding of the geographical risk, distribution and genetic diversity of the virus,’ says Nanyingi.
We congratulate them on their awards and wish them all the best as they undertake their research projects.
African food systems are dominated by informal markets, typically open-air markets found at designated sites and street corners, which often have poor hygiene and are subject to limited or poor regulation. Occasionally there are calls for these informal markets to be banned, but most consumers depend on them as they are more accessible and affordable than formal markets.
As we celebrate World Food Safety Day on 7 June 2020, it is crucial that governments recognize the importance of better food safety in informal markets. One way to encourage them to take food safety seriously is by harnessing the power of consumer demand.
Foodborne diseases cause a massive health burden and remain a persistent impediment to socio-economic development. The World Health Organization estimates that close to 600 million people fall ill and 420,000 die every year from foodborne diseases worldwide. Children under five years of age make up 125,000 of those deaths.
Africa bears the largest per capita burden of foodborne diseases. Every year, more than 91 million people fall ill and 137,000 lose their lives, a toll comparable to the continent’s losses from major infectious diseases such as malaria, tuberculosis and HIV/AIDS.
In Ethiopia, as in other developing countries, most consumers buy their food from informal markets, attracted by their low prices, freshness, availability of local products and credit services. However, consumers are concerned about the safety of the food they buy from these markets, and they show this in their purchasing behaviour. Research has found that consumers would pay 5–15% more for safety-assured products.
Furthermore, demand for food safety increases with economic development, rising income, urbanization, increased media coverage and education level. The current COVID-19 pandemic has made consumers more conscious of the safety of the food they buy and eat.
The Government of Ethiopia is working to increase the use of appropriate food safety assurance systems to ensure food quality and safety, but challenges include limited infrastructure and human capacity, such as laboratory facilities and trained personnel. A further challenge is that consumers often cannot detect unsafe food.
In contrast, food products developed for export markets receive considerable attention and are subject to higher standards of food safety. Decision-makers understand that meeting international food quality and safety regulatory requirements is a must for building trust among foreign trading partners.
This success has led to attempts to directly adopt some export food safety approaches for food products marketed in the informal market. However, since the settings are so different these approaches rarely work.
An alternative approach that is showing considerable promise is to harness consumers’ concerns about food safety to create greater demand for safe food. This simple approach requires educating consumers and increasing the awareness and capacity of food retailers and producers.
Urban food markets in Africa: Incentivizing food safety using a pull-push approach is a research project led by the International Livestock Research Institute (ILRI) and funded by the Bill & Melinda Gates Foundation, the United Kingdom Department for International Development and the CGIAR Research Program on Agriculture for Nutrition and Health. It develops and tests a novel but simple and practical approach to improving food safety: building consumer demand for safe food, traders’ ability to deliver it and regulator capacity to support it. It is, in short, a pull-push approach.
For the success of this approach, consumers need to be better informed on safe food including choice, purchase, storage and preparation. In addition, traders and producers need to be supported to develop their capacity to provide safe food and regulators need advice to create an enabling environment.
While regional estimates of the incidence of foodborne diseases are available, less is known at the country level. This project will also provide estimates of the incidence of key foodborne diseases in Ethiopia and provide a better understanding of the cost of foodborne diseases, how these diseases manifest and how they can be controlled.
Food safety is one of the key elements of ILRI’s research portfolio. Our approach to food safety is risk-based, identifying foodborne hazards, generating evidence, developing solutions and building the capacity of policymakers to use risk-based approaches to improve food safety in informal markets.
This feature article for World Food Safety Day was written by Beamlak Tesfaye, a communications officer at ILRI, and Theo Knight-Jones, a senior scientist at ILRI. It was originally published by The Reporter.
The CGIAR Research Program on Agriculture for Nutrition and Health (A4NH) has published its 2017 annual report which highlights the program’s accomplishments and activities during the first year of its second phase.
Detailed in the report are research, events and results from across A4NH’s five research flagships and four focus countries, including:
in-depth analyses of food systems in Bangladesh, Ethiopia, Nigeria and Vietnam, with a recently released report on findings in Ethiopia;
details on the release of 29 new biofortified crop varieties, extending reach to 3.6 million farming households;
the first licence for Aflasafe to be granted to a private company in Africa, for production, sale, and distribution in the Gambia and Senegal to protect crops from aflatoxin;
a special issue of the journal Global Food Security dedicated to stories of change, an innovative initiative building a resource base of experiential knowledge that explores drivers of change in improving nutrition;
research into how rice intensification in Africa can be achieved without increasing the risk of malaria; and
efforts on incorporating equity into A4NH’s research agenda.
Aflatoxins are highly toxic fungal by-products produced by certain strains of Aspergillus fungi in more than 40 susceptible crops including maize and groundnuts. Aflatoxins can be separated into aflatoxins B1, B2, G1 and G2.
When ingested, aflatoxin B1 is metabolized to aflatoxin M1 which is secreted into milk. Aflatoxin B1 is particularly important because it has been found in most foods and animal feeds and is highly carcinogenic.
Aflatoxins cause around 90,000 cases of liver cancer each year and are strongly associated with stunting and immune suppression in children. Aflatoxins in contaminated animal feed can lead to reduced animal productivity. They can end up in products like milk, meat and eggs, thus presenting a health risk to humans, with children being particularly susceptible.
In Ethiopia, previous studies have investigated aflatoxin contamination in staple cereals, red chili pepper and ground peas. Now, a new research study published in the journal Food Control (6 July 2015) has, for the first time, documented aflatoxin contamination in milk and dairy feeds in Ethiopia and the results show that milk and dairy feeds in the Greater Addis Ababa milk shed are highly contaminated with aflatoxins.
The cross-sectional study by scientists from the International Livestock Research Institute (ILRI) was carried out in the Greater Addis Ababa milk shed between September 2014 and February 2015 in order to detect and quantify the levels of aflatoxin M1 in samples of raw cow’s milk and aflatoxin B1 in samples of dairy feed.
The Greater Addis Ababa milk shed was selected because it is a rapidly intensifying system where aflatoxins are likely to be an increasing problem. A value chain approach was used, whereby production, processing and marketing of dairy feeds and milk were examined, as well as milk sold to consumers in Addis Ababa.
A total of 110 milk samples (100 from dairy farmers and 10 from milk traders) and 156 dairy feed samples (114 from farmers and 42 from feed producers, processors and traders) were collected and analysed by enzyme-linked immunosorbent assay (ELISA).
The study analysed all the commonly used dairy feeds such as mixed concentrate feed, brewery by-products, maize grain, pea hulls and silage. The most common ingredients in concentrate feeds were wheat bran, noug cake, pea hulls and maize grain.
All the milk samples were found to be contaminated with aflatoxin M1. Over 90% of the milk samples contained aflatoxin M1 levels that exceeded the European Union limit of 0.05 micrograms per litre. Out of a total of 110 milk samples, only nine contained aflatoxin M1 levels below 0.05 micrograms per litre.
Similarly, all the feed samples were contaminated with aflatoxin B1, with levels ranging from 7 to 419 micrograms per kilogram. Along the value chain from farmers to feed manufacturers and traders, the levels of aflatoxin contamination were fairly similar.
Out of a total of 156 dairy feed samples, only 16 contained aflatoxin B1 at a level less than or equal to 10 micrograms per kilogram. At the same time, 41 feed samples contained aflatoxin B1 at levels exceeding 100 micrograms per kilogram.
There was a significant association between aflatoxin B1 contamination in concentrate feeds and the presence of noug cake in the feed.
Noug (Guizotia abyssinica or Niger seed) is an oilseed crop that is indigenous to Ethiopia. Noug seed is pressed to produce noug oil while the remaining noug cake is sold as animal feed to feed processors and dairy farmers. Noug cake is becoming increasingly popular among dairy farmers in Ethiopia because its high nutrient content increases animal productivity.
Noug cakes were found to be highly contaminated with aflatoxin B1 (290–397 micrograms per kilogram) while the other feed components (wheat bran, maize grain and Brewer’s dry yeast) had relatively low levels of aflatoxin.
For this reason, the authors of the study recommend that further research on aflatoxin risk mitigation should focus on noug cake so as to effectively reduce the risk of aflatoxin contamination in peri-urban and urban dairy value chains in Ethiopia. Risk assessment of aflatoxins in noug seed and its by-products in other food chains should also be carried out.
In addition, there is an overall need to increase awareness of aflatoxins and to support risk mitigation practices along the entire dairy value chain.
“Policymakers and development organization need to support the dissemination of information about good agricultural and storage practices and other simple risk-reduction measures,” the authors conclude.
In addition to organizations recognized for specific projects and outputs, we thank all donors which globally supported the work of ILRI and its partners through their contributions to the CGIAR system
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