Health


Indicator 2.2, 2018 Lancet Countdown report. 51% of global cities expect climate change to seriously compromise public health infrastructure

The Lancet Countdown: tracking progress on health and climate change is a multidisciplinary, international research collaboration that provides a global overview of the relationship between public health and climate change. Publishing its findings annually in The Lancet, the initiative generates research evidence to inform an accelerated policy response to climate change.

The Lancet Countdown 2018 report presents the work from leading academics and technical experts from 27 partner academic and United Nations institutions around the world, including the International Livestock Research Institute (ILRI), Tehran University of Medical Sciences, University of Sydney and the World Health Organization. The study was funded by the Wellcome Trust.

Among the report’s co-authors are Delia Grace, veterinary epidemiologist and co-leader of the Animal and Human Health program at ILRI, and Paula Dominguez-Salas, assistant professor in nutrition-sensitive agriculture at the London School of Hygiene and Tropical Medicine on joint appointment at ILRI.

The Lancet Countdown initiative brings together climate scientists and geographers, mathematicians and physicists, transport and energy experts, development experts, engineers, economists, social and political scientists, and health professionals, reporting on 41 indicators across five key thematic groups:

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

Below are the four key messages of the Lancet Countdown 2018 report:

  1. Present day changes in heat waves, labour capacity, vector-borne disease and food security provide early warnings of the compounded impacts on public health that are expected if temperatures continue to rise. Trends in climate change impacts, exposures and vulnerabilities show an unacceptably high level of risk for the current and future health of populations across the world.
  2. A lack of progress in reducing emissions and building adaptive capacity threatens human lives and the viability of the national health systems they depend on, with the potential to disrupt core public health infrastructure and overwhelm health services.
  3. A number of sectors have seen the beginning of a low-carbon transition; the nature and scale of the response to climate change will shape the health of nations for centuries to come.
  4. Ensuring a widespread understanding of climate change as a central public health issue will be crucial in delivering an accelerated response, with the health profession beginning to rise to this challenge.

The full text of the Lancet Countdown 2018 report is available for free via The Lancet website (you will need to create a free account with The Lancet).

Johanna Lindahl, senior scientist at the International Livestock Research Institute

Johanna Lindahl, senior scientist at the International Livestock Research Institute (photo credit: ILRI/Dinesh).

We congratulate Johanna Lindahl, a senior veterinary epidemiologist at the International Livestock Research Institute (ILRI), on receiving the 2018 Swedish Institute for Global Health Transformation (SIGHT) Award and SEK 100,000 in recognition of her excellent scientific contribution to global health. The award was presented at a ceremony held in Stockholm on 25 November 2018.

The citation for her award reads: “Johanna Lindahl has, from a holistic perspective and in cooperation with researchers from low- and middle-income countries, developed our knowledge within areas of crucial relevance for the well-being and survival of mankind globally, namely human and animal interaction (One Health) as well as antibiotic resistance.”

The decision on the recipient of the SIGHT Award 2018 was taken by the board of the Royal Swedish Academy of Sciences.

Lindahl is also an associate professor at the Swedish University of Agricultural Sciences and Uppsala University.

Rinsing fresh fish, Accra, Ghana

Rinsing fresh fish in Accra, Ghana (photo credit: ILRI/Kennedy Bomfeh).

A new World Bank study finds that the impact of unsafe food costs low- and middle-income economies about US$ 110 billion in lost productivity and medical expenses each year. Yet a large proportion of these costs could be avoided by adopting preventative measures that improve how food is handled from farm to fork. Better managing the safety of food would also significantly contribute to achieving multiple Sustainable Development Goals, especially those relating to poverty, hunger and well-being.

Foodborne diseases caused an estimated 600 million illnesses and 420,000 premature deaths in 2010 according to the World Health Organization. This global burden of foodborne disease is unequally distributed. Relative to their population, low- and middle-income countries in South Asia, Southeast Asia and sub-Saharan Africa bear a proportionately high burden. They account for 41% of the global population yet 53% of all foodborne illness and 75% of related deaths.

Unsafe food threatens young children the most; although children under five years of age make up only 9% of the world’s population, they account for almost 40% of foodborne disease and 30% of related deaths.

The new study, Safe food imperative: Accelerating progress in low- and middle-income countries, translates these grim statistics into economic terms to focus government attention on the need for greater investment, better regulatory frameworks, and measures that promote behaviour change.

The total productivity loss associated with foodborne disease in low- and middle-income countries is estimated to cost US$ 95.2 billion per year, and the annual cost of treating foodborne illnesses is estimated at US$ 15 billion.

Other costs, though harder to quantify, include losses of farm and company sales, foregone trade income, the health repercussions of consumer avoidance of perishable yet nutrient-rich foods, and the environmental burden of food waste.

“Food safety receives relatively little policy attention and is under-resourced. Action is normally reactive—to major foodborne disease outbreaks or trade interruptions—rather than preventative,” says Juergen Voegele, a senior director at the World Bank. “By focusing on domestic food safety more deliberately, countries can strengthen the competitiveness of their farmers and food industry and develop their human capital. After all, safe food is essential to fuel a healthy, educated, and resilient workforce.”

The report schematically describes the alignment—or lack of alignment—between food safety risks and the capacity to manage them as countries develop economically and food systems and diets transform. The study finds that the gap is the most pronounced “in the middle of the pack,” that is, among lower-middle income countries, and it offers targeted recommendations to address these.

“Governments in low- and middle-income countries not only need to invest more in food safety but also invest more smartly,” says Steven Jaffee, agriculture economist at the World Bank and lead author of the study. “This means investing in foundational knowledge, human resources, and infrastructure; realizing synergies among investments in food safety, human health, and environmental protection; and using public investment to leverage private investment.”

The study was supported by the United States Food and Drug Administration. It is a collaborative effort involving multiple researchers and practitioners and draws on data and insights from the CGIAR Research Program on Agriculture for Nutrition and Health, the Food and Agriculture Organization of the United Nations, the World Bank, the World Health Organization, the World Organisation for Animal Health and other partners.

Among the study’s co-authors is Delia Grace, joint leader of the Animal and Human Health program of the International Livestock Research Institute and leader of the food safety flagship of the CGIAR Research Program on Agriculture for Nutrition and Health.

Panel discussion at the 'Growing with dairy' meeting held at ILRI Nairobi, 9 March 2018

Erastus Kang’ethe (standing) facilitates a panel discussion at the ‘Growing with Dairy’ meeting. The panel members (left to right) are Johanna Lindahl from ILRI, Humphrey Mbugua from the Association of Kenya Feed Manufacturers and Margaret Aleke from the Kenya Bureau of Standards (photo credit: ILRI/Emmanuel Muunda).

Representatives from the dairy sector in Kenya met at the Nairobi campus of the International Livestock Research Institute (ILRI) in March 2018 for a one-day meeting organized to present the research findings and plans of two dairy projects that ILRI is undertaking in collaboration with other partners: Measuring and mitigating the risk of mycotoxins in maize and dairy products for poor consumers in Kenya (MyDairy) and MoreMilk: making the most of milk (MoreMilk).

The meeting, dubbed Growing with Dairy, brought together 33 participants representing different stakeholder groups in Kenya’s dairy sector including industry, government, consumers, academia and development organizations.

Presentations by the principal investigators of the MyDairy and MoreMilk projects discussed various activities and interventions aimed at improving the dairy sector in Kenya and boosting the health and economic benefits that Kenyans derive from the sector.

The meeting also provided an opportunity to disseminate research findings, receive feedback on ongoing and planned activities, and align project objectives with the needs of public and private actors in the dairy sector in Kenya.

The MyDairy project was funded by the Ministry of Foreign Affairs, Finland and implemented between 2012 and 2018 in two phases: an initial four-year phase followed by a second phase of 1.5 years. The project aimed at mitigating the risks of aflatoxins in the dairy value chain in Kenya.

The MoreMilk project is a five-year initiative (2016–2021) funded by the Bill & Melinda Gates Foundation and the United Kingdom government that works to upgrade milk hygiene and quality standards in the informal dairy value chain and maximize economic, health and nutrition benefits, especially for the poorest communities in Nairobi.

Download the Growing with Dairy meeting report

Pipetting in ILRI's biosciences laboratories

Pipetting in ILRI’s biosciences laboratories (photo credit: ILRI/David White).

The scourge of infectious diseases in Africa was the subject of a recent symposium co-hosted by the Academy of Science of South Africa, the Uganda National Academy of Sciences and the German National Academy of Sciences (Leopoldina) in Durban, South Africa on 12–13 April 2018.

The symposium titled Surveillance and response to infectious diseases and co-morbidities: An African and German perspective was attended by about 100 participants from Africa and Germany including senior researchers, policymakers and representatives from the private sector. Presentations and discussions revolved around antimicrobial resistance, One Health, co-morbidities of infectious diseases and the ‘Big Four’ infectious diseases in humans (HIV/AIDS, malaria, tuberculosis and hepatitis C).

Scientists from the human medical field dominated the symposium but in a panel discussion, the few animal health scientists present, including Kristina Roesel from the Animal and Human Health program of the International Livestock Research Institute, drew the audience’s attention to the importance of a One Health perspective on human disease as two thirds of human pathogens are of animal origin. Thomas Mettenleiter, member of the Leopoldina and president of the Friedrich-Loeffler-Institut (German Federal Research Institute for Animal Health), moderated the panel discussion.

The symposium was preceded by a one-day workshop on science advice jointly organized with the International Network for Government Science Advice–Africa and the International Council for Science Regional Office for Africa. Invited junior scientists got practical exposure to science advice including drafting communication strategies and role plays on infectious disease outbreak scenarios.

Article by Kristina Roesel

Wet Markets of Hanoi

Pork on sale in a local wet market in Hanoi, Vietnam (photo credit: ILRI/Andrew Nguyen).

“Is my food safe?” This question voices a fundamental consumer concern – regardless of where they live, what their income level is, or where they purchase their food. The demand for information on food safety, meanwhile, grows louder particularly among consumers in low- and middle-income countries as they move towards cities and away from farms, growing more conscious of the quality of food they eat. But that information is rarely readily available, particularly in those countries.

Recognizing the universal nature of this question, the Agriculture, Nutrition and Health (ANH) Academy created a working group to consider current research on food safety, including metrics, tools, and definitions; identify areas of opportunity or need for additional research in this area; and suggest ways to make research on food safety in low- and middle-income countries more robust and replicable.

The results of this effort are reported in a new working paper and related technical brief by the ANH Academy Food Safety Working Group, which we have co-authored with our colleagues. The conceptual framework we developed in the course of undertaking this work identifies three main areas of focus:

  • foodborne hazards and risks that consider private, public, and export standards;
  • food safety system performance, which considers how well the food system delivers safe food; and
  • foodborne disease outcomes, which look at the impact that the safety of foods has in public health and the economy, among others.

With such a wide scope and so many actors, it naturally follows that there is no one measure to comprehensively cover this issue, however, we also recognize the need for stakeholders to be able to measure and report on it to identify areas and means of improvement. An important component of the report offers principles to guide those designing and selecting appropriate food safety measures and metrics.

We recommend, among other things:

  • those undertaking this process begin with a strategic plan that includes food safety goals and steps towards achieving them;
  • the plan looks beyond processes to also consider outcomes and impact;
  • the plan includes multiple measures, accurately reflecting the complex nature of this issue;
  • what is being measured is understood and accepted by all stakeholders; and
  • the benefits of measure-based food safety systems should outweigh the costs of their implementation.

As the working group conducted stakeholder workshops and situational analyses throughout Africa and Asia, we homed in on three key considerations for those looking to delve into the issue of understanding and managing food safety risks. Decision-makers need to understand:

  • the scope of the problem, and its impacts;
  • where concern exists, what it is rooted in, how it affects behaviour and what will allay it; and
  • what is being done in management of the issue, who is and should be involved and what can make it more effective.

To be sure, the report makes clear the intimidating size and scope of the food safety issue in low- and middle-income countries. However, it also lays out a roadmap to tackling this important challenge, one in which researchers and policymakers and the private sector and others can each contribute valuable pieces to the larger pool of knowledge. This collaboration, accompanied by thoughtful planning, can create an environment where people everywhere can rest assured about the safety of the food they eat.

Article by Delia Grace and Silvia Alonso, scientists at the International Livestock Research Institute (ILRI)

Originally posted on the ANH Academy website

Citations:
Grace, D., Dominguez-Salas, P., Alonso, S., Fahrion, A., Haesler, B., Heilmann, M., Hoffmann, V., Kang’ethe, E., Roesel, K. and Lore, T. 2018. Food safety metrics relevant to low and middle income countries: Working paper. Agriculture, Nutrition and Health Academy, Food Safety Working Group. London, UK: Innovative Methods and Metrics for Agriculture and Nutrition Actions programme.

Grace, D., Dominguez-Salas, P., Alonso, S., Fahrion, A., Haesler, B., Heilmann, M., Hoffmann, V., Kang’ethe, E., Roesel, K. and Lore, T. 2018. Food safety metrics relevant to low and middle income countries: Technical brief. Agriculture, Nutrition and Health Academy Food Safety Working Group. London, UK: Innovative Methods and Metrics for Agriculture and Nutrition Actions Programme.

Fish market in Kota Kinabalu, Malaysia, photo by Jamie Oliver, 2007

Fish market in Kota Kinabalu, Malaysia (photo credit: WorldFish/Jamie Oliver).

Agrilinks is an online community for food security and agricultural development practitioners. During the month of March 2018, Agrilinks shines the spotlight on the topic of food safety, with a series of feature articles and resources by food safety experts on how households and farmers can ensure the safety of their crops and animal-sourced foods and prevent post-harvest losses.

In her article, Delia Grace, joint program leader for Animal and Human Health at the International Livestock Research Institute (ILRI), gives an overview of the food safety research activities of the CGIAR Research Program on Agriculture for Nutrition and Health (A4NH). Grace also leads the A4NH flagship program on food safety.

She calls for collaborative approaches to knowledge-sharing towards improved food safety, nutrition and health of people throughout the world.

“Collaboration and knowledge-sharing will be key in addressing food safety challenges, and this collaboration must include the formal and informal markets, policymakers, researchers, and public and private sectors,” she says.

Read the article, Food safety: March spotlight needs year-round attention

Next Page »