Africa


Fruit and vegetables on sale alongside other food items in a local market in Addis Ababa, Ethiopia (photo credit: ILRI/Geraldine Klarenberg).

The rapid transformation of food systems is creating unintentional infectious disease risks that will need to be addressed through effective coordination between agricultural and public health sectors, a new review study says.

A food system includes all the aspects of feeding and nourishing people: growing, harvesting, packaging, processing, transporting, marketing and consuming food.

The review, published in Lancet Planetary Health (Sept 2022), explored how intensification of agricultural production and increasing complexity of food supply chains, particularly in low-income and middle-income countries, change the risks and relative burdens of infectious diseases.

The review covered four case studies:

  • vector-borne disease in irrigated agriculture;
  • zoonotic diseases in livestock value chains;
  • food safety; and
  • antimicrobial resistance associated with food systems. 

For each case study, the authors asked three questions:

  1. What aspects of food system transition are creating unintentional infectious disease risks?
  2. What solutions might exist for these problems?
  3. How would they require better coordination of agricultural and public health policy and practice?

Food systems in transition are characterized by intensification and diversification of food production, as an increasingly urban and more wealthy population demands different diets.

The review showed that successfully addressing the challenges of evolving food systems calls for constructive dialogue between agricultural and public health sectors.

Such a cross-sectoral approach recognises the costs and benefits of disease-reducing interventions and seeks win–win solutions that are most likely to attract broad policy support and uptake by food systems.

For areas such as antimicrobial resistance, it is important to identify the potential agricultural and health outcomes of agricultural interventions to reduce health risks.

Citation

Waage, J., Grace, D., Fèvre, E.M., McDermott, J., Lines, J., Wieland, B., Naylor, N.R., Hassell, J.M. and Chan, K. 2022. Changing food systems and infectious disease risks in low-income and middle-income countries. Lancet Planetary Health 6(9): e760–e768.

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

Customers at a milk bar in Ndumbuini in Kabete, Nairobi (photo credit: ILRI/Paul Karaimu).

Informal milk trading in peri-urban Nairobi plays a key role in supporting both livelihoods and nutrition, particularly among poor households. Gender dynamics affect who is involved in milk trading and who benefits from it.

To better understand gendered constraints and opportunities in informal, peri-urban dairy marketing, scientists from the International Livestock Research Institute and the International Food Policy Research Institute conducted a qualitative study in 2017 with 45 men and 50 women milk traders in Dagoretti, a peri-urban area in Nairobi, Kenya. The study is published in Gender, Technology and Development (27 Jun 2022).

The findings show that milk trading is more lucrative for older men than for women and younger men among the respondents. The study delves into the reasons behind the observed differences in the experiences of women and men as informal milk traders. The study also discusses the implications of the findings for interventions aimed at enhancing the sustainability and equity of the dairy sector.

Citation

Galiè, A., Njiru, N., Heckert, J., Myers, E. and Alonso, S. 2022. Gendered barriers and opportunities in Kenya’s informal dairy sector: enhancing gender-equity in urban markets. Gender, Technology and Development 26(2): 214–237.

Photo credit: Customers at a milk bar in Ndumbuini in Kabete, Nairobi (ILRI/Paul Karaimu)

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

Towards enhancing food safety in East Africa, the International Livestock Research Institute (ILRI), the Food and Agriculture Organization of the United Nations (FAO) and the Inter-University Council for East Africa (IUCEA) have been working with food safety experts from universities in the East African Community to develop benchmarks for a Bachelor of Science program in food safety.

As part of this endeavour, a workshop to finalize the curriculum benchmark process was held on 22–24 March 2022 in Kampala, Uganda.

The meeting brought together 21 food safety experts to develop the expected learning outcomes of the curriculum and align the learning outcomes with the main and supportive courses derived from a stakeholder engagement exercise.

The outputs of the group and plenary discussions will be used to draft a benchmark report which will be validated and finalized according to IUCEA processes.

The workshop was funded by CGIAR donors, FAO (Lloyd’s Register Foundation), the CGIAR One Health Initiative, the ILRI-led Capacitating One Health in Eastern and Southern Africa (COHESA) project and IUCEA.

The workshop report may be accessed via the link below.

Citation

Kang’ethe, E.K., Mutua, F. and Hung Nguyen-Viet. 2022. Benchmarks for food safety curriculum in the East African Community. Nairobi, Kenya: ILRI.

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

Photo credit: Vegetable market in Ethiopia (East African Policy Research Institute/Birhanu Lenjiso)

The rapid evolution of global food safety systems in response to population growth, urbanization, climate change and other socio-economic factors poses many food safety challenges.

Globally, unsafe food causes an estimated 600 million illnesses and 420,000 deaths annually, with Africa disproportionately bearing the highest burden of foodborne diseases.

To effectively tackle the challenge of foodborne diseases in Africa, a team of scientists from the International Livestock Research Institute (ILRI) and Ohio State University has proposed the use of risk-based and One Health approaches.

These approaches to food safety management were put forward in a presentation titled Better food safety solutions in Africa: Understanding the complex social, economic and policy perspectives. The presentation was given at the 37th World Veterinary Association Congress held in Abu Dhabi, United Arab Emirates on 29–31 March 2022.

The main foodborne hazards in the African context were discussed, with local and continental examples of food safety initiatives aimed at reducing the burden of foodborne disease and improving public health. Examples of action research and political decision-making on food safety at the continental level were also described.

In light of the complex nature of global and African food safety systems, food safety interventions to reduce foodborne diseases need to be well designed and coordinated, the researchers say.

Citation

Amenu, K., Alonso, S., Mutua, F., Roesel, K., Lindahl, J., Kowalcyk, B., Knight-Jones, T. and Grace, D. 2022. Better food safety solutions in Africa: Understanding the complex social, economic and policy perspectives. Oral presentation at the 37th World Veterinary Association Congress, 29-31 March 2022, Abu Dhabi, United Arab Emirates. Nairobi, Kenya: ILRI.

Photo credit: Vegetable market in Ethiopia (East African Policy Research Institute/Birhanu Lenjiso)

Milk cans at Ol Kalou Dairy Plant, Kenya (photo credit: ILRI/Paul Karaimu).

Effective communication and constructive dialogue on inclusive ways forward between policy-makers and informal milk vendors can help to bridge the gap between policy and reality in Kenya’s informal milk sector, according to a new research study published in Development Policy Review (May 2022).

Around 80% of milk in Kenya is sold informally, providing livelihoods and contributing to the food security and nutrition of low-income consumers. Government policy, however, is focused on formalization—primarily through licensing and pasteurization—with enforcement via fines, confiscation of milk or closing the premises of informal actors.

The study, which was carried out by researchers from the International Institute for Environment and Development (IIED) and the International Livestock Research Institute (ILRI), sought to better understand if, and why, Kenya’s informal milk sector and regulatory system are disconnected from one another and how the policy–reality gap might be better bridged.

To understand the nature and performance of Kenya’s informal milk markets and their governance, the authors used surveys with informal market players and key informant interviews. Fieldwork was carried out in Nairobi in late 2018.

The study found that milk safety and quality matters to all actors in informal milk value chains. The trust-based system used is effective in moderating behaviour and assessing and prioritizing quality and safety. 

However, government policy was found not to accomplish the stated goal of formalization, with low levels of licensing among informal actors. Pasteurization was not rewarded in the market and there was some evidence of sub-optimal pasteurization processes being undertaken to satisfy regulators. 

These findings point to a gap between the reality of Kenya’s informal milk sector and its policy and regulatory system.

This gap is seen in the form of adversarial relationships between regulators and informal actors, and unnecessary transaction costs, missing opportunities for enhancing livelihoods, food safety, and food security. 

The authors of the study therefore recommend that new approaches build on and consider existing approaches taken by actors in informal food markets to ensure food safety and quality. 

Citation

Blackmore, E., Guarín, A., Vorley, B., Alonso, S. and Grace, D. 2022. Kenya’s informal milk markets and the regulation-reality gap. Development Policy Review 40(3): e12581.

Photo credit: Milk collection at a dairy plant in Ol Kalou, Kenya (ILRI/Paul Karaimu)

The COVID-19 pandemic has underscored the need to strengthen national surveillance systems to protect a globally connected world.

In low-income and middle-income countries, zoonotic disease surveillance has advanced considerably in the past two decades. However, surveillance efforts often prioritize urban and adjacent rural communities.

Communities in remote rural areas have had far less support despite having routine exposure to zoonotic diseases due to frequent contact with domestic and wild animals, and restricted access to health care. Limited disease surveillance in remote rural areas is a crucial gap in global health security.

Although this point has been made in the past, practical solutions on how to implement surveillance efficiently in these resource-limited and logistically challenging settings have yet to be discussed.

A new paper in Lancet Global Health (Apr 2022) highlights why investing in disease surveillance in remote rural areas of low-income and middle-income countries will benefit the global community and review current approaches.

Using semi-arid regions in Kenya as a case study, the authors’ viewpoint provides a practical approach by which surveillance in remote rural areas can be strengthened and integrated into existing systems.

The viewpoint represents a transition from simply highlighting the need for a more holistic approach to disease surveillance to a solid plan for how this outcome might be achieved.

Citation

Worsley-Tonks, K.E.L., Bender, J.B., Deem, S.L., Ferguson, A.W., Fèvre, E.M., Martins, D.J., Muloi, D.M., Murray, S., Mutinda, M., Ogada, D., Omondi, G.P., Prasad, S., Wild, H., Zimmerman, D.M. and Hassell, J.M. 2022. Strengthening global health security by improving disease surveillance in remote rural areas of low-income and middle-income countries. Lancet Global Health 10(4): e579–e584.

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

The pig production sector in Rwanda is growing rapidly as a result of rising local and regional demand for pork. To better understand how the sector operates, a new study has analysed the country’s pig and pork value chains to map the various actors involved, the governance and sanitary risks and the potential impacts on food safety.

The study, which is published in Frontiers in Veterinary Science (Jan 2022), was carried out by a team of scientists affiliated to the International Livestock Research Institute, the University of Global Health Equity, the University of Leeds, the University of Liverpool and the University of Rwanda.

The researchers held key informant interviews and focus group discussions with farmers, brokers, butchers, abattoir managers and veterinarians to collect data on pig production methods and inputs, the source and destination of live and slaughtered pigs, pork processing infrastructure (abattoirs and factories), the people involved and interactions between them, governance and challenges.

Smallholder farmers dominate pig production in Rwanda, primarily as a source of supplementary income but also for manure. The study also found medium and large pig farms around urban areas. There are few veterinarians attending farms, with most veterinary services provided by less qualified technicians or through self-treatment of pigs by farmers.

Pigs are bought and sold at live pig markets, where brokers play key roles in setting prices, examining pigs for disease and organizing the supply of pigs to abattoirs and for export. The study identified only a few formal pig abattoirs which mainly supply to pork processing factories in Kigali or export to customers.

Although formal abattoirs were attended by a veterinary inspector, a lack of record keeping was noted. Local consumers rely on informal pig slaughtering at farms or restaurant backyards, with irregular veterinary inspection. This observed weakness in pork inspection poses a potential risk to public health.

Generally, the study found that the main sanitary risks were a lack of biosecurity throughout the chain and poor hygiene at slaughter places.

For example, although palpation of the pigs’ tongues was carried out at the markets to check for tapeworm cysts, pigs that tested positive for cysts were not destroyed but were sold at reduced prices in the same market or later informally sold by the owner.

Overall, the pig value chain in Rwanda is characterized by a high degree of informality at all nodes, combined with a rapid growth trajectory in the sector.

The findings of this study provide useful evidence for policymakers to design interventions to address the weaknesses identified in Rwanda’s pig value chain towards improving food safety and safeguarding the health of consumers.

Citation

Shyaka, A., Quinnell, R.J., Rujeni, N. and Fèvre, E. 2022. Using a value chain approach to map the pig production system in Rwanda, its governance, and sanitary risks. Frontiers in Veterinary Science 8: 720553.

Funding

This study was funded by the UK Medical Research Council Global Challenge Research Fund (Grant number MR/P025471/1). Author Fèvre acknowledges partial support from the CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), led by the International Food Policy Research Institute (IFPRI), and acknowledges the CGIAR Fund Donors (http://www.cgiar.org/funders).

Photo credit: Pig in concrete stable in Mukono District, Uganda (ILRI/Elisabeth Kilian)

Market near Khulungira Village, in central Malawi

The role of food crops as a conduit for transmission of antimicrobial resistance from soil and water to humans has not been widely studied. Contamination of food crops with antimicrobial-resistant pathogens presents an added foodborne risk to human health.

A team of researchers from the London School of Hygiene and Tropical Medicine, the International Livestock Research Institute, the University of Copenhagen, Royal Veterinary College and CABI carried out a systematic literature review to consolidate the current state of knowledge on antimicrobial resistance in food crop value chains globally. The review is published in Frontiers in Sustainable Food Systems (3 Feb 2022).

The review summarized and compared baseline descriptive data on antimicrobial resistance detected in crops and crop inputs globally. This enabled the identification of gaps in understanding of the potential food safety risks to consumers. 

A search of four bibliographic databases using synonyms of antimicrobial resistance in food crop value chains identified 196 studies of interest from 49 countries, mostly in Asia (89 studies) and Africa (38 studies). 

The four most frequently recorded species of interest were Escherichia coli, Salmonella enterica, and Enterococcus faecium or Enterococcus faecalis. Salad crops, vegetables, and culinary herbs were the most sampled crops. 

The review found that acquired antimicrobial resistance in human pathogens is disseminated throughout food crop value chains in multiple regions around the world. 

However, there were variable patterns of distribution of antimicrobial resistance. Chloramphenicol resistance was reported in food value chain samples in low- and middle-income countries in Asia and Africa while vancomycin resistance in enterococci was reported in food crops from high-income countries.

“This review confirms the widespread reporting of resistance to antimicrobials of medical importance in human pathogenic microbes isolated from crops, both in the field and marketplace,” the authors state.

However, it is difficult to conclusively quantify the risks of exposure to consumers because of the low number of longitudinal studies and diverse sampling methods used.

“Firm conclusions cannot be drawn on the prevalence and relative importance of different kinds of resistance and antimicrobial resistance transmission pathways because of the substantial heterogeneity between study methods and conditions,” the authors caution.

“There is a need to include agriculturally-derived antimicrobial resistance in monitoring food safety risks from plant-based foods, and the challenges facing its surveillance,” the authors recommend.

Citation

Brunn, A., Kadri-Alabi, Z., Moodley, A., Guardabassi, L., Taylor, P., Mateus, A. and Waage, J. 2022. Characteristics and global occurrence of human pathogens harboring antimicrobial resistance in food crops: A scoping review. Frontiers in Sustainable Food Systems 6: 824714.

Funding

This scoping review was partially supported by the CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), led by the International Food Policy Research Institute.

Photo credit: Market near Khulungira Village, in central Malawi (ILRI/Stevie Mann)

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

The Tokyo Nutrition for Growth Summit 2021 takes place on 7–8 December 2021. The summit comes at a critical time, midway through the United Nations Decade of Action on Nutrition, with only five years left to achieve the World Health Assembly  targets on maternal, infant and young child nutrition, and 10 years to reach the Sustainable Development Goals.

Ahead of the summit, on 2 December 2021, the International Institute for Environment and Development (IIED) and the International Livestock Research Institute (ILRI) hosted a side event on the role of informal markets within future food systems.

The purpose of the side event was to derive a set of principles to help national policymakers develop risk-based policies that reward positive food safety as opposed to criminalization and marginalization. Such policies will improve the governance, operations and future of informal markets to ensure their continued contribution to livelihoods, health and nutrition.

A panel discussion featured the following speakers:

  • Delia Grace, professor of food safety systems, Natural Resources Institute, University of Greenwich and joint appointed scientist, ILRI
  • Jane Battersby, senior lecturer, Department of Environmental and Geographical Science, University of Cape Town
  • Vivian Maduekeh, managing principal, Food Health Systems Advisory
  • Emma Blackmore, research associate, IIED
  • Stella Nordhagen, senior technical specialist, Global Alliance for Improved Nutrition
  • Utpal Kumar Sharma, director, Dairy Development Department, Government of Assam, India

View the recording below.

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

Locally made beef stew sold in Bagnon market at Yopougon, Abidjan, Côte d’Ivoire (photo credit: ILRI/Valentin Bognan Koné).

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 Côte d’Ivoire meeting, hosted by ILRI, took place on Thursday 12 August 2021, bringing together some 35 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 zoonoses work package aims to pre-empt the spread of zoonoses at the wildlife–livestock interface and reduce the incidence of zoonotic pathogens associated with poverty. Innovations include risk mapping of key endemic zoonoses and developing diagnostic kits for surveillance of zoonoses.

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. 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.

The antimicrobial resistance work package will focus on reducing the burden of antimicrobial resistance by promoting the prudent use of antimicrobials in crop, fish and livestock production systems. Innovations include surveillance of antimicrobial resistance and communication of evidence on the costs and benefits of rational use of antimicrobials

The environment work package will focus 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.

The economics, governance and behaviour work package aims 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 work packages, the participants gave feedback on the main One Health challenges, priority interventions, actions to ensure inclusion and partner institutions in Côte d’Ivoire.

Among the main food safety challenges identified were the informal food sector (street foods) and low awareness on food safety. Priority interventions include risk analysis, consumer education and strengthening of capacity to assess risks.

With regard to control of zoonoses, some of the key challenges identified were non-compliance with disease control measures and non-adaptation of laws to current challenges. Priority interventions include improved communication among actors involved in control of zoonoses and an effective monitoring network.

Regarding antimicrobial resistance, some of the key challenges identified were environmental contamination through hospital and slaughterhouse waste, misuse of antimicrobials in livestock and aquaculture production systems and lack of surveillance of antimicrobial use. Priority interventions include strengthening of regulation and control of antimicrobial use and increasing awareness on rational use of antimicrobials and the dangers of self-medication with antibiotics.

To ensure inclusion, all important actors in the value chain need to be identified and invited for meetings where they can participate in exchange of information. In this regard, stakeholder mapping and the use of gender-focused approaches will be important.

The identified partner groups to work with included government ministries, universities, hospitals, public health institutes, pastoralists, the private sector, pharmaceutical companies and food manufacturers.

As the meeting ended, Vessaly Kallo, deputy director of animal health at the Directorate of Veterinary Services, lauded the proposed CGIAR One Health initiative. He noted that the initiative’s activities would support the implementation of a One Health multisectoral platform in Côte d’Ivoire.

Once approved, the CGIAR One Health initiative will start in January 2022 and run for an initial three years.

For more information, please contact Hung Nguyen (h.nguyen@cgiar.org) or Vivian Hoffmann (v.hoffmann@cgiar.org).

Access the meeting notes and presentation slides

Citation

ILRI, IFPRI, IWMI and WorldFish. 2021. Côte d’Ivoire stakeholder consultation on a proposed CGIAR One Health initiative. Nairobi, Kenya: ILRI. https://hdl.handle.net/10568/114915

Photo credit: Locally made beef stew sold in Bagnon market at Yopougon, Abidjan, Côte d’Ivoire (ILRI/Valentin Bognan Koné)

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