A4NH


There is a need for better understanding of how food systems operate in order to effectively address food safety and nutrition in low- and middle-income countries, says a new review paper.

The review published in Frontiers in Sustainable Food Systems (Apr 2021) proposes that countries and international institutions provide an atlas of food system maps for key food commodities. This will help to fill current knowledge gaps in food system mapping and governance.

The review by scientists from the Royal Veterinary College, the University of Greenwich, the University of Liverpool and the International Livestock Research Institute presents the state of knowledge on existing methods of studying food systems towards improving food safety and nutrition.

The review found that food systems analyses vary widely in scope and quality, with most concentrating on specific food commodities as opposed to adopting a whole-diet approach when looking at nutrition or assessing a range of infectious agents when looking at food safety.

In the area of food safety, in-depth assessments of food systems can complement risk analysis to identify risky behaviours, understand institutional settings and improve codes of practice and enforcement. There is a challenge, however, in the area of nutrition, as existing tools on nutrition and food systems science are not yet being merged. 

Addressing food safety and nutrition in low- and middle-income countries will require better understanding of the drivers of the food systems and incorporation of codes of practice and enforcement which ensure access to safe and nutritious food.

It is also important to recognize that food systems are integral to health and thus ensure that food systems policy is aligned with health policy. This calls for interdisciplinary research on food systems encompassing consumption behaviour, value chain analysis, policy analysis, nutrition science and gender research.

Citation

Alarcon, P., Dominguez-Salas, P., Fèvre, E.M. and Rushton J. 2021. The importance of a food systems approach to low and middle income countries and emerging economies: A review of theories and its relevance for disease control and malnutrition. Frontiers in Sustainable Food Systems 5: 642635.

Photo credit: Pulses on sale alongside other food items in a local market in Addis Ababa, Ethiopia (ILRI/Geraldine Klarenberg)

One Health is a concept that recognizes that the health of people is linked to the health of animals and their shared environment. A One Health approach in preventing and controlling diseases therefore involves the collaborative efforts of multiple disciplines and sectors. This approach is especially useful for managing zoonoses, diseases that are transmitted between animals and people.

According to the World Health Organization, at least 61% of all human pathogens are zoonotic and have represented 75% of all emerging pathogens during the past decade. There are more than 200 known zoonotic diseases. The health and economic cost of these diseases falls largely on poorer countries which bear 98% of the global burden of zoonoses.

Additionally, in poorer countries, zoonoses comprise 25% of the human burden of infectious diseases. Just 13 of over 200 zoonotic diseases cause 2.4 billion cases of illness and 2.2 million deaths annually (not including COVID-19).

Most zoonotic diseases are endemic in nature. Apart from emerging zoonoses like severe acute respiratory syndrome, highly pathogenic avian influenza and now COVID-19, many endemic zoonoses such as brucellosis and cysticercosis are not prioritized by national and international health systems and are therefore termed neglected zoonoses.

The impact of neglected zoonoses is most severe on poor households in low-resource settings as most people living in rural areas depend on livestock for food, transport and farm work. People living in urban slums are also affected as the rise in urban livestock agriculture brings people and animals into closer contact.

The ongoing COVID-19 pandemic has brought into sharp focus the interconnectedness of people, animals and the environment, and the need for multi-disciplinary approaches such as One Health to tackle the challenge. Preventing and controlling zoonoses in domestic and wild animal populations is a cost-effective way to ensure such diseases do not spread to human populations.

The International Livestock Research Institute (ILRI) has a wealth of research expertise on zoonoses and One Health. The institute recently launched a set of seven research briefs that highlight the benefits of One Health in sustainable livestock production towards improving the health of people, animals and the environment.

The brief Preventing and controlling human diseases transmitted by animals saves millions of lives and livelihoods gives an overview of the burdens and risks of endemic zoonoses and highlights what can be done to reduce the burden of neglected zoonoses and prevent the spread of emerging zoonotic diseases.

For example, innovative community disease surveillance programs can help health experts to detect disease outbreaks rapidly and identify the specific disease hotspots for more timely and targeted interventions.

A research study on the business case for One Health shows that every one dollar invested in One Health generates five dollars’ worth of benefits. Now is the time for governments, investors and policymakers to increase investment in One Health to prevent and control neglected zoonoses and safeguard the health of millions of people and animals and their shared ecosystem.

Citation

ILRI (International Livestock Research Institute). 2021. Preventing and controlling human diseases transmitted by animals saves millions of lives and livelihoods. Livestock pathways to 2030: One Health Brief 2. Nairobi: International Livestock Research Institute.

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ILRI’s expertise on One Health

ILRI’s expertise on zoonoses

One Health Research, Education and Outreach Centre in Africa

Photo credit: Camels drinking at a water pan in Wajir county in Kenya (ILRI/George Wamwere-Njoroge)

Hundreds of trees have been felled along Nairobi’s Uhuru and Waiyaki highways to make space for a new expressway. CELINE CLERY/AFP via Getty Images

Eric Fèvre, University of Liverpool and James Hassell, Yale University

There’s been widespread concern in Kenya over the shrinking of green spaces in Nairobi, the capital city. Most recently, there was uproar over the construction of a raised highway. This resulted in the felling of hundreds of trees, though protests managed to save the life of one 100-year-old fig tree.

It was also proposed that part of the highway run through Uhuru park – one of the city’s few recreational parks. Protests successfully diverted the highway to the park’s outskirts, but development still threatens the city’s few undeveloped spaces.

To give an idea of how much green space has already been lost, between 1976 and 2000, Nairobi’s forest cover went from 14% to 3%. Bushland cover, over the same period, was also reduced from 22% to 13%.

This will have an impact on the city’s wildlife and livestock. Nairobi, like other urban environments in the tropics, has an ecosystem that includes wildlife – such as birds, rodents, primates – and livestock such as cattle, goats, sheep and pigs. As green spaces are lost, native wildlife and bird species can dwindle and non-native species proliferate.

But very few studies explore how development affects wildlife and livestock in tropical cities. Recognising this gap, we explored the impact of a growing and changing urban environment on the wildlife and livestock that live with people in Nairobi from 2013 to 2018.

We found that, as land use in Nairobi transformed, there have been significant changes.

Competition between invasive and endemic species has grown, to the detriment of native biodiversity. Species – many of which play important roles in ecosystems such as fruit bats, primates and pollinators – are lost. And as the ecological landscape becomes less diverse, wildlife species that co-exist with humans – such as rats, scavenging and seed-eating birds (collectively known as synanthropes) – thrive, particularly in the poorer, most densely populated areas of Nairobi.

This is troubling because evidence suggests that synanthropes host more germs and could pass diseases on to people and make them sick. These are called “zoonotic diseases” and range from minor short-term illness to major life-changing illness and even death.

We could not assess the risk posed by zoonoses in Nairobi in our study. What we do know is that the city (and likely most other biodiverse, tropical cities) harbours all the ingredients for zoonotic spillover to occur between animals and people, particularly in the most densely populated areas.

Urban development policymakers must recognise that by shrinking green spaces, they increase the likelihood that people will catch zoonotic diseases. This is because species such as rodents proliferate.

Which species dominate, and where

We studied 99 household compounds – people’s houses and private land – across the city. These were selected to represent the different ways in which people interact with livestock and wildlife across the city. Households were stratified by people’s wealth, the types of livestock they kept and the ecological habitats in which they live.

Our data show that synanthropic species – like rats and insectivorous bats – dominate lower income, densely populated areas of the city. Here the synanthropes live in close quarters with poultry, pigs and small ruminants, such as goats and sheep.

We found that the decline in biodiversity – and subsequent colonisation by synanthropes – was driven by urban development. Trees and other forms of vegetation were replaced by man-made structures, removing the natural resources that most wildlife require to survive. Meanwhile, the resources (such as waste) on which synanthropes thrive increased.

As we argue in our paper, this kind of restructuring has important implications for the emergence of novel diseases at urban interfaces, which is why we used our research results to generate a set of testable hypotheses that explore the influence of urban change on microbial communities.

By testing the hypotheses we provide insights into how rapid urbanisation can generate interfaces for pathogen emergence, which should be targeted for surveillance.

Research done elsewhere shows that synanthropes – which thrive in disturbed environments with lower biodiversity – host more pathogens. And synanthropes seek resources provided by humans and their livestock, such as waste, which brings them into closer contact and increases opportunities for pathogens to cross between them.

For instance, our work in Nairobi shows that, as densities of humans and livestock increase, there is more sharing of antimicrobial resistance with wild birds.

Policy recommendations

Our findings have important implications for the public health and the sustainable planning and management of cities, particularly rapidly developing, biodiverse cities.

The high levels of competent disease carriers near humans is a huge risk to public health. The current response to COVID-19 has shown that the ability to limit the spread of a disease depends upon good public health infrastructure. Developing this infrastructure, while more studies are conducted to assess the risk of zoonotic disease transmission, is crucial.

Mitigating steps can be taken. One would be to maintain areas of forests, grasslands and clean waterways throughout the city. This would preserve and increase the wildlife biodiversity that competes with synanthropes, while also improving biosecurity within households, which could help moderate the presence of synanthropic species in urban centres.

It is, however, worth noting that some synanthropes, like insectivorous bats, help to control mosquito populations and agricultural pests in heavily urbanised environments. Eradicating them would not be advisable. Managing people’s interactions with synanthropes through smart urban planning – for example by removing resources on which synanthropes rely such as manure and rubbish from households – is best.

Our findings also raise important concerns about the social equality of urban development. The benefits of urban biodiversity and risks posed by human exposure to animal-borne diseases are not equally distributed. Currently equitable access to green spaces is restricted in many cities due to socioeconomic barriers, such as land ownership, proximity or lack of transportation. Reconfiguring the distribution of green space from the peri-urban fringe of the city to densely populated areas would build a more equitable society, allowing more city dwellers to have access to recreational space.

David Aronson, Senior Communications Advisor with ILRI, and Timothy Offei-Addo, a Princeton-in-Africa fellow with ILRI, contributed to the writing of this article.

Eric Fèvre, Professor of Veterinary Infectious Diseases, University of Liverpool and International Livestock Research Institute, Kenya, University of Liverpool and James Hassell, Wildlife Veterinarian with Smithsonian’s Global Health Program, and adjunct Assistant Professor, Yale University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Cattle and wildlife at the ILRI Kapiti Research Station (photo credit: ILRI/Paul Karaimu)

Developing risk maps for endemic livestock diseases is important for effective disease prevention and control, particularly in resource-limited countries.

For endemic and easily diagnosed diseases such as anthrax, a useful approach involves analysis and mapping of historical data to identify disease hotspots and define risk factors of its occurrence.

A new paper published in BMC Infectious Diseases (Feb 2021) presents the results of risk mapping of the 666 livestock anthrax events that occurred in Kenya between 1957 and 2017.

The mapping exercise found that there were about 10 anthrax events in Kenya annually, with the number increasing to as many as 50 events annually by 2005.

Mapping also revealed spatial clustering of the disease events in certain sub-counties; 12% of sub-counties were responsible for over 30% of anthrax events while 36% of sub-counties did not report any incidents of anthrax over the 60-year period under study.

Additionally, there was significantly greater risk of anthrax occurring in agro-alpine high- and medium-potential agro-ecological zones than in the arid and semi-arid regions of the country.

Cattle were over 10 times more likely to be infected by Bacillus anthracis (the bacterium that causes anthrax) than sheep, goats or camels.

There was lower risk of anthrax in August and December, months that follow the long and short rain periods, respectively.

By enabling analysis of the trends and patterns of occurrence of livestock anthrax across different regions over the years, the risk maps will be a useful tool for livestock health officials to identify and characterize Kenya’s anthrax hotspots, leading to better targeting of disease management interventions.

Citation
Nderitu, L.M., Gachohi, J., Otieno, F., Mogoa, E.G., Muturi, M., Mwatondo, A., Osoro, E.M., Ngere, I., Munyua, P.M., Oyas, H., Njagi, O., Lofgren, E., Marsh, T., Widdowson, M.-A., Bett, B. and Njenga, M.K. 2021. Spatial clustering of livestock anthrax events associated with agro-ecological zones in Kenya, 1957-2017. BMC Infectious Diseases 21(1): 191.

Photo credit: Cattle and wildlife at the ILRI Kapiti Research Station (ILRI/Paul Karaimu)

Sheep market in Doyogena, Ethiopia

The intensification of livestock production calls for the development of contextually relevant policy frameworks that mitigate potential human health risks such as antimicrobial resistance and zoonotic diseases, a new expert review paper says.

The review by scientists from the University of Liverpool and the International Livestock Research Institute also calls for better data on the burden of antimicrobial resistance and zoonoses arising from intensive livestock production. This would improve evidence-based approaches and resource allocation towards managing these global health challenges.

The paper, published in the journal Animal (Feb 2021), reviews the drivers of livestock intensification and the negative externalities that may arise from it in terms of antimicrobial resistance and zoonoses.

The authors highlight the need for livestock development plans to incorporate risk mitigation measures, including supportive national policies and development of professional capacity in the veterinary and public health sectors.

Quantifying the burden of animal diseases stemming from livestock intensification, establishing surveillance for antimicrobial resistance and recording the use of antimicrobial products are required to enable governments to appropriately allocate resources to mitigate the twin health risks of antimicrobial resistance and zoonoses, the authors say.

Citation
Gilbert, W., Thomas, L., Coyne, L. and Rushton, J. 2021. Review: Mitigating the risks posed by intensification in livestock production: The examples of antimicrobial resistance and zoonoses. Animal 15(2): 100123.

Photo credit: Sheep market in Doyogena, Ethiopia (ILRI/Zerihun Sewunet)

 A plate served with fried pork and raw relishes (photo credit: ILRI/Martin Heilmann)

A new study published in Frontiers in Veterinary Science (February 2021) has documented the governance structure of the Nairobi pork value chain and the challenges faced by traders and how these impact on food safety.

The pork food system in Nairobi is a growing livestock sub-sector which serves as a source of food and livelihood to the city’s inhabitants. To better understand how this food system works, the study mapped the key pork value chains, assessed their governance and operational challenges and analysed the potential impacts on food safety management.

A mixed-method approach was used to collect both qualitative and quantitative data on animal movements, product flows, stakeholder interactions, perceptions on system governance, operational challenges faced, business operations and market share.

A thematic analysis was also carried out to identify the themes that provide understanding on governance, challenges and food safety practices in the pork system.

The predominant pork value chains identified were the ‘large integrated company’ profile which accounted for 83.6% of marketed pork and the privately owned, small-scale local independent abattoirs accounting for 16.4%.

The study documented a number of challenges associated with governance of the pork value chains including inadequate enforcement of existing regulation, dominance of pig traders and lack of association at all nodes of the system.

The traders themselves were also beset by several challenges that could have a bearing on food safety management; these included inadequate slaughter facilities, lack of capital for upscaling, lack of training on slaughterhouse hygiene and lack of knowledge on how to manage pig diseases.

These findings provide useful insights into the structure of the pork system supplying the city of Nairobi. Policymakers and food safety researchers can use this framework to investigate and further develop the pork industry. The framework can also be used to develop appropriate programs for food safety and control of pig diseases.

The study is an output of a collaborative project on the epidemiology, ecology and socio-economics of disease emergence in Nairobi that was carried out by scientists from the International Livestock Research Institute, the Kenya Directorate of Veterinary Services, Royal College London, the University of Liverpool and the University of Nairobi.

Citation
Murungi, M.K., Muloi, D.M., Muinde, P., Githigia, S.M., Akoko, J., Fèvre, E.M., Rushton, J. and Alarcon, P. 2021. The Nairobi pork value chain: Mapping and assessment of governance, challenges, and food safety issues. Frontiers in Veterinary Science 8: 581376.

Photo credit: A plate served with fried pork and raw relishes (ILRI/Martin Heilmann)

Goats in Mozambique awaiting sale (photo credit: ILRI/Yvane Marblé).

Animal health leaders and researchers from the Global Burden of Animal Diseases (GBADs) program have secured US$ 7 million from the Bill & Melinda Gates Foundation and the UK’s Foreign, Commonwealth and Development Office to roll out a framework on measuring animal health burdens and their impacts on human lives and economies.

The information provided by the GBADs program will guide public policy and private sector strategy, contributing to improve animal health and welfare more effectively. It will also be a basis for further academic research.

Across the world, livestock production and aquaculture are critical to human nutrition and health. These animals play critical roles in society, providing income and food, but also clothing, building materials, fertilizer and draught power. However, the presence of endemic and emerging diseases, as well as other factors, negatively impact them, jeopardizing their contributions.

Every year, hundreds of millions of dollars are invested globally on disease mitigation in order to improve livestock health and productivity. Yet, a systematic way to determine the burden of animal disease on the health and wellbeing of people is not available.

It is still unknown how the burden is apportioned between smallholders and the commercial sector, or across regions and gender. Consequently, decision-makers lack the information to accurately assess whether their investments target the animal health issues that have the most significant impact on human wellbeing.

The GBADs program, led by the University of Liverpool, the World Organisation for Animal Health (OIE) and a partnership of international institutions, will enable the examination of animal health and the disease burden from a different perspective.

By assessing the global burden in economic terms, the program will help identify the individuals and communities which are the most impacted, demonstrating how animal health is intrinsically linked to agricultural productivity, smallholder household income, the empowerment of women and the equitable provision of a safe, affordable, nutritious diet.

Professor Dame Janet Beer, Vice Chancellor, University of Liverpool, said: ‘The GBADs program is a key part of our commitment to deploying our research capacity towards the welfare of humankind. The GBADs program is crucial in building a world with zero hunger, good health and equality for all, an urgent mission in which we are proud to play our part. We are grateful for the support of the Bill & Melinda Gates Foundation and the UK’s Foreign, Commonwealth and Development Office, who are supporting this work in partnership with the OIE. Together, we will realise a brighter future for animal and human well-being.’

Dr Monique Eloit, OIE Director General, said: ‘It is more evident now for everyone that animal health and public health are interconnected and play an essential role in building a sustainable and healthy planet, especially if we succeed in incorporating the environmental and socioeconomic components.’

The international institutions partnering with the University of Liverpool and OIE in the GBADs program are the Commonwealth Scientific and Industrial Research Organisation; the University of Guelph; the Institute for Health Metrics and Evaluation at the University of Washington; the International Livestock Research Institute; Murdoch University; Sciensano; Washington State University; the University of Zurich; and the Food and Agriculture Organization of the United Nations. The program has also received funding from the Brooke Foundation and the Australian Centre for International Agricultural Research.

The International Livestock Research Institute will play a key role in investigating and applying approaches to improve our understanding of the burden of animal disease in farming systems in Ethiopia. This work will act as a case study, providing insights relevant to other settings and methods that can be used elsewhere. Understanding the scale and nature of how animal disease impacts livelihoods and economies is key, but this information then needs to be used to better advise governments and other investors in livestock and disease control. Therefore, tools and approaches will be developed to ensure that animal health policies are rational and informed by evidence.

The new partnership will support the implementation of the GBADs program. In a world where 1.25 billion people work in agriculture, the program will have a positive impact on the Sustainable Development Goals contributing to Zero Hunger; Good Health and Well-being; Gender Equality; Decent Work and Economic Growth; and Responsible Consumption and Production.

Photo credit: Goats in Mozambique awaiting sale (ILRI/Yvane Marblé)

Landscape in Hoa Binh province, northwest of Vietnam

The World Health Organization has declared that antimicrobial resistance is one of the top 10 global public health threats facing humanity. It requires urgent multisectoral action in order to achieve the Sustainable Development Goals.

Improving evidence for action is crucial to tackle this global challenge. The number of interventions for antimicrobial resistance is increasing but current research has major limitations in terms of efforts, methods, scope, quality and reporting.

Moving the agenda forward requires an improved understanding of the diversity and feasibility of interventions, the factors that influence their effectiveness, and the ways in which individual interventions might interact to affect actions against antimicrobial resistance in different contexts.

As part of efforts to strengthen the global governance of antimicrobial resistance, a group of international research experts is advocating for an evidence-based approach to the challenge through the creation of an international One Health platform for online learning that will synthesize the evidence for actions on antimicrobial resistance into a fully accessible database.

The researchers discuss this One Health learning approach to antimicrobial resistance in an article published in Lancet Infectious Diseases (1 Dec 2020), noting that there are currently significant limitations in terms of availability of context-specific evidence on appropriate actions to tackle antimicrobial resistance.

The proposed platform will also offer new scientific insights into the design, implementation, evaluation and reporting of the range of interventions relevant to addressing antimicrobial resistance.

“Fundamental gaps in knowledge hinder action against antimicrobial resistance, but the limitations of research into interventions for antimicrobial resistance serve as even bigger obstacles,” the authors say.

The range of interventions to tackle antimicrobial resistance is wide: from simple actions to complex ones, from regulatory to behavioural approaches, and from those focusing on prevention of infection to those focusing on responsible use of antimicrobials. Therefore, it is crucial to consolidate an evidence-based approach to the challenge.

The authors also note that the open access One Health learning platform will be useful to health-care professionals, public health practitioners, policymakers, industries and consumer groups.

“Ultimately, this will contribute to building societal resilience to this central challenge of the 21st century.”

Citation

Wernli, D., Jørgensen, P.S., Parmley, E.J., Troell, M., Majowicz, S., Harbarth, S., Léger, A., Lambraki, I., Graells, T., Henriksson, P.J.G., Carson, C., Cousins, M., Ståhlgren, G.S., Mohan, C.V., Simpson, A.J.H., Wieland, B., Pedersen, K., Schneider, A., Chandy, S.J., Wijayathilaka, T.P., Delamare-Deboutteville, J., Vila, J., Lundborg, C.S. and Pittet, D. 2020. Evidence for action: A One Health learning platform on interventions to tackle antimicrobial resistance. Lancet Infectious Diseases 20(12): e307–e311.

Photo credit: Landscape in Hoa Binh province, northwest of Vietnam (photo credit: ILRI/Vu Ngoc Dung).

The COVID-19 pandemic and climate change represent converging challenges to which no continent, country or community is immune. Aligning the global recovery from COVID-19 with our response to climate change offers a triple win: protect public health, promote a sustainable economy and preserve our planet.

This is according to a new report by the Lancet Countdown initiative, an international, multi-disciplinary research collaboration that tracks the evolving public health impacts of climate change and publishes its findings annually in The Lancet medical journal ahead of the United Nations climate change negotiations.

The Lancet Countdown 2020 report, launched on 3 December 2020, tracks the links between health and climate change across 43 indicators in five domains:

  • climate change impacts, exposures and vulnerabilities;
  • adaptation, planning and resilience for health;
  • mitigation actions and health co-benefits;
  • economics and finance; and
  • public and political engagement.

The report represents the findings and consensus of the 35 leading academic institutions and United Nations agencies that make up the Lancet Countdown initiative, and draws on the expertise of climate scientists, geographers, engineers, experts in energy, food and transport, economists, social and political scientists, data scientists, public health professionals and doctors.

Among the report’s co-authors is Delia Grace, professor of food safety systems at the Natural Resources Institute, University of Greenwich and contributing scientist at the International Livestock Research Institute.

Visit the Lancet Countdown 2020 website to read thematic summaries and key findings of the report. The full text of the report is available for free via The Lancet (you will need to create a free account with The Lancet).

Photo credit: A Maasai pastoralist taking livestock to drink from the Olkitikiti Dam in Olkitikiti village, Kiteto, Tanzania (ILRI/Fiona Flintan)

Market place in Kenya (photo credit: World Bank/Sambrian Mbaabu).

Food safety has never featured prominently on Africa’s development agenda. When it is an issue, typically the focus has been on high-value food items produced for export, while food safety in domestic markets has been largely neglected, both by governments and development partners. This must change. Recent research has shown that the health and economic consequences of foodborne diseases in Africa are significant and growing, as urbanization and income growth prompt dietary changes that increasingly expose consumers to food safety hazards.

The coming decade is critical. A ‘business as usual’ approach to food safety, involving a combination of post-outbreak firefighting and fragmented regulatory and ad hoc interventions, will do little to check the threats posed by unsafe food in many African countries. The good news is that many of these problems can be controlled and their costs reduced. A combination of incremental and systematic measures, well within the capacity of most governments, can flatten the curve of foodborne illness.

Until recently, research on foodborne diseases was mostly limited to high-income countries. Research and public health interventions in poorer countries largely focused on the so-called big three—tuberculosis, HIV/AIDS and malaria—and on maternal and child mortality. Yet, recent epidemiological research from the World Health Organization shows the costs of neglecting foodborne diseases in developing countries. Worldwide, the global health burden of foodborne diseases is on par with the big three. The young, old, malnourished and poor are disproportionately impacted and children under five years of age are especially vulnerable.

Globally, Africa south of the Sahara and emerging Asia have the highest incidence of and death rates from foodborne diseases. Yet while the incidence rates of the two regions are comparable, Africa’s estimated death rate is nearly four times higher. The reasons for that difference are not fully understood, but the prevalence of endemic ailments and poor diagnostic and treatment options probably account for much of it. Drawing on data from the World Health Organization and other recent sources, we estimate that Africa experiences around 135 million cases of foodborne diseases and 180,000 foodborne disease-related deaths per year. Microbial pathogens—especially Salmonella spp., toxigenic Escherichia coli, norovirus and Campylobacter spp.—account for about 80% of Africa’s foodborne disease burden.

The economic consequences of foodborne diseases in Africa are correspondingly severe. A recent World Bank study estimated the productivity losses alone attributed to unsafe food within Africa at $20 billion in 2016 and the cost of treating these illnesses at an additional $3.5 billion. These costs are heaviest in larger, middle-income countries such as South Africa, Nigeria and Egypt, yet are also significant elsewhere. Overall, the relative economic burden of foodborne diseases is higher for African countries than for developing countries elsewhere.

Both the health and economic consequences of foodborne diseases in Africa are likely to grow as the continent develops. In low-income countries, food is typically produced close to the point of consumption and undergoes limited transformation. Starchy staples such as cassava, maize and rice predominate. Traditional processing techniques dominate and are often fairly effective at reducing risk. As they develop and urbanize, countries experience rapid shifts in diet and towards more intensified agriculture. Such transitions typically lead to increased consumption of fresh produce and animal-sourced foods and a lengthening of food supply chains. Yet much of this perishable food continues to be handled and distributed through informal channels, creating potentially multiple points for food hazards to develop. In these transitioning food systems, the official regulatory apparatus is often overwhelmed by the breadth and depth of emerging challenges.

Until very recently, domestic food safety programs in Africa have been few and poorly funded. By contrast, literally hundreds of projects supported by trade partners or development agencies have sought to address international trade-related food safety problems. These have been beneficial and have helped to push Africa’s trade in safety-sensitive foods such as fish, fresh fruit and vegetables from $3.8 billion in 2001 to $16.1 billion in 2017. But overall, the available evidence suggests that the trade-related costs associated with unsafe food in African countries are small compared to the domestic public health costs and productivity losses. In fact, we estimate the ratio between domestic and trade-related costs is likely to be on the order of 40 to 1, suggesting that the predominant attention of policymakers on the trade impacts of food safety has been deeply misguided.

African countries must implement better domestic food safety policies and support them with needed investment. But this, in itself, will not be enough to give them the upper hand against foodborne diseases. What they need is nothing less than a food safety paradigm shift. The traditional regulatory model, imported from high-income countries, centres on enforcement through regular inspection of food facilities and product testing, with set legal and financial penalties. This model is ill-suited to food systems in Africa, where smallholder farmers, micro- and small enterprises and informal food channels predominate, surveillance and inspection mechanisms can be weak and court procedures challenging and slow. It introduces an antagonistic and often unproductive relationship between government and the private sector as regulator versus regulated.

A better approach is to think of food safety as a shared responsibility between food business operators, consumers and the government. In this model, governments set forth a vision, convene stakeholders and offer a diverse set of policy instruments to involve, incentivize and leverage the actions of key value chain actors. Instead of being the ‘official food control’ authority, governments should act as facilitators encouraging investments and behaviour change. Experimentation and flexibility will be critical.

There are no quick fixes to Africa’s food safety challenges. They require a comprehensive approach that focuses on improving food safety awareness, practices and governance. Foundational investments will be needed in people, infrastructure and institutions. Addressing these issues will require sustained attention from technical agencies and government ministries as well as donors. It will require broader interventions to improve access to quality public health services, clean water and sanitation and improved agricultural productivity. It will require, in short, a commitment commensurate to the scale of the problem. It is also likely, as in other parts of the world, that improvements will ultimately be driven by better-aware consumers demanding food safety and eliciting responses from public sector and food suppliers. Recognizing that is a good place to start.

This article by Steven Jaffee and Delia Grace was originally posted on the International Food Policy Research Institute website. It is based on a chapter they and others co-authored in the 2020 Annual Trends and Outlook Report: ‘Why Food Safety Matters to Africa: Making the Case for Policy Action’ by Steven Jaffee, Spencer Henson, Delia Grace, Mateo Ambrosio and Franck Berthe.

Steven Jaffee is a lecturer at the University of Maryland. Delia Grace is a professor of food safety systems at the Natural Resources Institute, University of Greenwich and a contributing scientist at the International Livestock Research Institute.

Photo credit: Market place in Kenya (World Bank/Sambrian Mbaabu).

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