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).

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

A new research report (Oct 2020) by scientists from the International Institute for Environment and Development (IIED) and the International Livestock Research Institute (ILRI) reviews the status and policy contexts of informal milk markets in Kenya, Tanzania and Assam (India) to better understand the opportunities for a policy innovation based on training and certification to overcome market access barriers for sellers of informal milk by improving the health and safety practices of informal milk traders, thereby addressing policymakers’ concerns. It is based on an extensive review of available literature and a small number of expert interviews and contributions.

Citation

Blackmore, E., Guarín, A., Alonso, S., Grace, D. and Vorley, B. 2020. Informal milk markets in Kenya, Tanzania and Assam (India): An overview of their status, policy context, and opportunities for policy innovation to improve health and safety. ILRI Project Report. Nairobi, Kenya: ILRI.

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

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

The Alliance for a Green Revolution in Africa launched its 2020 Africa Agriculture Status Report during the African Green Revolution Forum virtual summit hosted in Kigali, Rwanda on 8-11 September 2020.

This year’s report focuses on the challenges of feeding Africa’s cities and the opportunities available to smallholder farmers and agribusinesses to meet the needs of the continent’s fast growing urban food markets.

The report features a chapter on food safety and public health in urban food markets in Africa. Currently, Africa suffers from the highest per capita rate of foodborne illnesses in the world. The riskiest foods from a health perspective are animal-source foods, fruits and fresh vegetables. Consumption of these food products is rising rapidly in African cities.

Improving food safety in Africa’s urban food markets — both the dominant informal markets and the growing formal markets — will go a long way to safeguard the health of consumers and reduce the economic and health burden of foodborne illnesses.

Interventions include improving domestic market infrastructure, training of food handlers and increasing awareness of the shared responsibility of regulators and value chain actors to provide safe food.

Unsafe food directly undermines human health and jeopardises the attainment of national, continental and global development goals. For this reason, African governments urgently need to prioritize food safety and adopt policies and strategies that will ensure the delivery of adequate and safe food to urban markets.

Citation
Kang’ethe, E., Grace, D., Alonso, S., Lindahl, J., Mutua, F. and Haggblade, S. 2020. Food safety and public health implications of growing urban food markets. IN: AGRA, Africa Agriculture Status Report. Feeding Africa’s cities: Opportunities, challenges, and policies for linking African farmers with growing urban food markets. Issue 8. Nairobi, Kenya: Alliance for a Green Revolution in Africa (AGRA). pp. 101–119.

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

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).

The Lancet Countdown tracks progress on health and climate change and provides an independent assessment of the health effects of climate change, the implementation of the Paris Agreement and the health implications of these actions. The research evidence thus generated will help to inform decision-making and drive an accelerated policy response to climate change.

The initiative is a collaboration between 24 academic institutions and intergovernmental organizations based in every continent and with representation from a wide range of disciplines including climate scientists, ecologists, economists, social and political scientists, public health professionals and doctors.

The Lancet Countdown’s 2017 report tracks 40 indicators across five areas, arriving at three key conclusions:

  • The human symptoms of climate change are unequivocal and potentially irreversible.
  • The delayed response to climate change over the past 25 years has jeopardised human life and livelihoods.
  • The past 5 years have seen an accelerated response, and in 2017 momentum is building across several sectors.

Visit the Lancet Countdown website for a thematic breakdown of the report. The full text of the Lancet Countdown 2017 report is available for free via The Lancet website.

Among the report’s co-authors are Delia Grace, veterinary epidemiologist and co-leader of the Animal and Human Health program at the International Livestock Research Institute (ILRI), and Paula Dominguez-Salas, postdoctoral researcher in nutrition at the Royal Veterinary College on joint appointment at ILRI.

Market near Khulungira Village, in central Malawi

Selling agricultural produce at Chimbiya Market, near Dedza in central Malawi (photo credit: ILRI/Mann).

 

On 24 May 2017, the CGIAR Research Program on Agriculture for Nutrition and Health (A4NH) and the London School of Hygiene and Tropical Medicine hosted policymakers, researchers and donors at a workshop in Belgium under the theme Better targeting food safety investments in low- and middle-income countries.

Among the presenters were three scientists from the International Livestock Research Institute who presented on why food safety matters in development from an agri-food system perspective, the experience of food safety management in Vietnam, and economic and health outcomes and impacts of food safety interventions.

Over the course of the workshop, several major themes emerged:

  1. Collaboration and knowledge sharing among the different sectors is critical and must be encouraged.
  2. Consumers have to weigh the risks when considering what choices to make, and they need more information in order to make better decisions.
  3. The problem of lack of access to safe foods is particularly acute for small children; not only are they disproportionately affected by foodborne illnesses and deaths, but they have the least control over their own exposure to this risk.

A detailed post about the workshop is available on the A4NH website.

A new international, multidisciplinary research initiative, the Lancet Countdown, was launched yesterday (14 Nov 2016) to track and analyse the impacts of climate change on public health.

The initiative will generate new research evidence to inform decision-making and drive an accelerated policy response to climate change. It will publish its findings annually in The Lancet, the leading global medical journal.

The Lancet Countdown is a collaboration of 48 leading experts from around the world, drawn from 16 academic and research institutions including the International Livestock Research Institute (ILRI), the London School of Hygiene and Tropical Medicine, Tsinghua University (China), University College London and the World Health Organization. It is funded by the Wellcome Trust.

You can download the inaugural report, The Lancet Countdown: Tracking Progress on Health and Climate Change, for free via The Lancet website.

Among the report’s co-authors are Delia Grace, veterinary epidemiologist and leader of ILRI’s Food Safety and Zoonoses program, and Paula Dominguez-Salas, postdoctoral researcher in nutrition at the Royal Veterinary College on joint appointment at ILRI.

Delia Grace presents on zoonotic diseases, UNEP Nairobi, 20 May 2016
ILRI veterinary epidemiologist Delia Grace presenting at the United Nations Environment Programme (UNEP) Science-Policy Forum that preceded the second session of the United Nations Environment Assembly (UNEA-2), on 20 May 2016 (photo credit: ILRI).

The United Nations Environment Programme (UNEP) held its first global Science-Policy Forum in Nairobi, Kenya on 19-20 May 2016 as part of the overall programme of the second session of the United Nations Environment Assembly (UNEA-2) held on 23-27 May 2016.

The forum offered a platform to the science community to engage with policymakers and civil society stakeholders on the science and knowledge needed to support informed decision-making to deliver on the environmental dimension of the 2030 Agenda for Sustainable Development.

Delia Grace, a veterinary epidemiologist at the International Livestock Research Institute (ILRI), took part in the forum as a panellist for the launch of the UNEP Frontiers 2016 report on emerging issues of environmental concern.

Her presentation on zoonotic and emerging infectious diseases focused on the global burden of zoonotic diseases (diseases that can be transmitted between animals and people), the drivers of disease (among them, land use change, environmental degradation and climate change) and how the multidisciplinary One Health approach can be used to support timely response to the threat of zoonotic diseases.

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Zoonotic diseases are also featured in a chapter in the UNEP Frontiers 2016 report, Zoonoses: Blurred lines of emergent disease and ecosystem health by Delia Grace and ILRI colleagues Bernard Bett, Hu Suk Lee and Susan MacMillan.

Typical milk bar in Kenya

A typical milk bar in Kenya. Packaged milk in supermarkets has been found to be no better at meeting food safety standards than raw milk sold from kiosks (photo credit: ILRI/Dave Elsworth).

Kenya’s informal dairy markets are central to the livelihoods, food security and nutrition of the majority of its citizens, particularly the poor, women and children. Kenya’s informal dairy market is significant in size – 86% of Kenya’s milk is sold by unorganized, small-scale businesses in informal markets or consumed directly at home. The sector generates 70% of the 40,000 jobs in dairy marketing and processing.

The International Institute for Environment and Development (IIED) has been working in partnership with the International Livestock Research Institute (ILRI) in Kenya to explore the impacts of efforts to govern Kenya’s dairy sector in a way that works with, rather than against, informal, small-scale milk vendors. We looked at the impact on milk vendors, on food safety and on sustainability, with the findings published in the final briefing in a series on innovations in policy approaches to informality.

Read the rest of the blog post, Lessons in informality from Kenya’s dairy sector, by Emma Blackmore. Originally posted on the IIED website.