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No food security without food safety: Lessons
from low- and middle-income countries
Delia Grace, Florence Mutua, Johanna Lindahl, Kristina Roesel
and Silvia Alonso
Australian Veterinary Association annual conference
Perth, Australia
5–10 May 2019
I have the following disclosures related to my
presentation:
•Funding Sources: Donors including ACIAR,
BMGF, BMZ, DFID, IDRC, SIDA, USAID
•Financial Interests: None
•Other Interests: None
ILRI Resources
• Staff: 630+
• $ 80-90 million annual budget
• 130 scientists from over 30 countries
• One third of ILRI staff are women
• Large campuses in Kenya and Ethiopia
• Regional or country office in 14 countries
ILRI’s livestock research
Delivering solutions for livestock, zoonotic
and foodborne diseases
Mitigating climate change, enhancing
resilience and increasing livestock
productivity Accelerating Africa’s agricultural
development through biosciences
Efficient livestock production driving
inclusive growth and employment
Taking livestock solutions to scale for
inclusive development
Better nutrition for improved animal
productivity
Improving genetics for better productivity
and profitability
Sustainable Livestock Systems
Impact at Scale
Animal and Human Health
Policies, Institutions &
Livelihoods
Livestock Genetics
BecA-ILRI hub
Feed and Forage Development
ILRI around the world
Animal and Human
Health Program
• AMR – Queensland
• Animal Welfare – Melbourne
• Pork safety – Sydney
• Sustainable livestock – CSIRO
• Village livestock- Kyeema
• GBAD - Murdoch
6
7
Overview
1. Impact of FBD in developing countries
2. Where food comes from in developing countries
3. Where FBD comes from in developing countries
4. Managing FBD
Foodborne disease matters for development
 Developing country consumers show high concern over FBD
 The huge health burden of FBD is borne mainly by developing
countries
 FBD has high economic costs: health, agriculture & economy-wide
 FBD limits access of poor farmers to export markets and threatens
access to domestic markets
 FBD discriminates: the YOMPI are most at risk
10
Havelaar et al., 2015
31 hazards
•600 mio illnesses
•420,000 deaths
•33 million DALYs
USA – 1 in 6
Greece 1 in 3
Africa 1 in 10??
Why food safety matters
The public health and domestic economic costs
of unsafe food may be 20 times the trade-
related costs for developing countries
Cost estimates 2016 (US$ billion)
Productivity loss 95
Illness treatment 15
Trade loss or cost 5 to 7
‘Productivity Loss’ =
Foodborne Disease DALYs x Per Capita GNI
Based on WHO/FERG & WDI Indicators Database
Illness treatment =
US$27 x # of Estimated foodborne illnesses
Trade loss or costs =
2% of developing country high value food exports
12
Milk (cow)
Production: men (x Nairobi)
Processing: women
Marketing: women (x
Abidjan)
Consumed: both
Milk (cow)
Production: men (x Nairobi)
Processing: women
Marketing: women (x
Abidjan)
Consumed: both
Poultry
Production: women
Processing: women
Marketing: women
Consumed: both
Poultry
Production: women
Processing: women
Marketing: women
Consumed: both
Milk (goat)
Production: men (w milk)
Processing: women
Marketing: women
Consumed: both
Milk (goat)
Production: men (w milk)
Processing: women
Marketing: women
Consumed: both
Beef/goat
Production: men (w assist)
Processing: men
Marketing: men (butcher,
pub)
Consumed: both
Beef/goat
Production: men (w assist)
Processing: men
Marketing: men (butcher,
pub)
Consumed: both
Pigs
Production: women
Processing: men
Marketing: men
Consumed: both
Pigs
Production: women
Processing: men
Marketing: men
Consumed: both
Fish, crabs
Fishing: men
Processing: women
Marketing: women)
Consumed: both
Fish, crabs
Fishing: men
Processing: women
Marketing: women)
Consumed: both
Food safety & livelihoods
Food safety & nutrition
 Diarrhoea a risk factor for stunting – perhaps 10-20%?
 Ingestion of faecal material on food or in the environment may contribute to
environmental enteropathy
 Associations between aflatoxins and stunting
 Regulations aimed to improve food safety may decrease the availability and
accessibility of foods
 Food scares decrease consumption
Food safety & market access
 Food safety standards often exclude small firms and farms from export markets
– Kenya and Uganda saw major declines (60% and 40%) in small farmers participating in export of fruit and
vegetables to Europe under Global GAP
 Farmers supplying supermarkets are richer, better educated, more likely to be male and
located near cities
 When markets differentiate by quality, substandard food is targeted to the poor
But
 Quality-demanding markets still a small share
 With support smallholders can participate in demanding markets
 Benefits to those who do and (some) evidence of spillover to their own farms
Overview
1. Impact of FBD in developing countries
2. Where food comes from in developing countries
3. Where FBD comes from in developing countries
4. Managing FBD
16
17
18
19
20
21
22
23
24
25
26
27
28
29
Risk misperceptions abound: What you worry about and what
makes you sick and kills you are not the same
•Quantitative microbial risk assessment for
salmonellosis acquired from pork
•Annual incidence rate estimated to be 12.6%
(90% CI: 0.5 – 42.6).
•Driven by cross-contamination in households
followed by prevalence in pork sold in the
central market.
• Pork value chain Vietnam
• 366 kidney, liver and pork samples were pooled into 18 samples analysed for
antibiotic residues, β-agonists, and heavy metals
• ~1% over MRL with minor implications for human health
30
Experts are also wrong
WB,
Informal is not set to fade away
Hanoi
slaughterhouses
Formal not necessarily safe, nor
informal risky
33
More rules may mean worse practice
Average of
17.25 risk
mitigation
strategies
used
Farmers who
believed UA
was legal used
more
strategies
Overview
1. Impact of FBD in developing countries
2. Where food comes from in developing countries
3. Where FBD comes from in developing countries
4. Managing FBD
Causes of FBD
Foods implicated in FBD
Painter et al., 2013, Sudershan et al., 2014, Mangan et al., 2014; Tam et al., 2014;
Sang et al., 2014 ; ILRI, 2016
Foods implicated - FERG
World Health
Organisation, 2017
FBD bucking the trend
2006 to 2016
TB -23%
HIV -44%
Malaria -27%
Models and experience suggest Foodborne will worsen in
LMIC
GDP growth has largest impact on increase in FBD
cases from 2011 to 2030, followed by population
growth
Expected FBD burden in India to rise from 100 up to 170 million in 2030 –
increasing from one out of 12 to one out of 9 people falling sick on average
Increased labour supply but mostly reduced health cost of avoiding FBD amounts
to 0.5% of GDP - equivalent to an annually recurring benefit of up to 28 billion USD
Kristkova et al., 2018
Livestock, blue and produce revolution
Increase in per capita consumption of perishables and pulses in developing
countries with 1963 as index year (FAO, 2009)
%
Overview
1. Impact of FBD in developing countries
2. Where food comes from in developing countries
3. Where FBD comes from in developing countries
4. Managing FBD
Can we regulate our way to food safety?
 100% of milk in Assam doesn’t meet standards
 98% of beef in Ibadan, 52% pork in Ha Noi, unacceptable bacteria counts
 92% of Addis milk and 46% of Nairobi milk had aflatoxins over EU standards
 36% of farmed fish from Kafrelsheikh exceed one or more MPL
 30% of chicken from commercial broilers in Pretoria unacceptable for S.
aureus
 24% of boiled milk in Abidjan unacceptable S. aureus
Can we modernise our way to food safety?
 Supermarketisation is slower than thought.
 Formal sector food is risker than thought.
 Modern business models have often run into problems
– Co-ops, abattoirs, market upgrades
44
Can good practices get us to food safety?
 Many actors are well intentioned but ill informed
 Small scale pilots show short term improvements
 Smallholders have been successfully integrated into export chains
 But domestic GAP has limited effect
– In 4 years VietGAP reached 0.06%
– In Thailand GAP farmers have no better
pesticide use than non-GAP
No behaviour change without change
in incentives or choice architecture!
46
Systematic literature review – Food safety
interventions in SS Africa
Along the
value chain
Technologies Training &
information
New processes Organisational
arrangements
Regulation Infrastructure
Farmer +++ +++ + +++ + ++++
Processor
&
transporter
+++ +++ +++ ++ ++ +++
Retailer + ++ + ++ ++ +++
Consumer + +++ + + + +++
Govt +++ ++ ++ +++
Population level:
•Incorporating food safety into other health programs such as mother and child care or HIV treatment
•Medical interventions such as vaccination for cholera or norovirus or binders for aflatoxins
•Dietary diversity to reduce exposure and vulnerability to toxins
•Water treatment
Effective interventions
 Methodological: prioritisation, risk based approaches, HACCP
 Appropriate Technology: milk cans, boilers, disinfectants
 Novel Technology: Aflasafe
 Programmatic: street traders, T&C
 Zoonoses: control in reservoir hosts
 Policies: enabling environment
 Market based solutions - WTP
• Branding & certification of milk vendors in
Kenya & Guwahti, Assam led to improved
milk safety.
• It benefited the national economy by $33
million per year in Kenyan and $6 million in
Assam
• 70% of traders in Assam and 24% in Kenya
are currently registered
• 6 milllion consumers in Kenya and 1.5 million
in Assam are benefiting from safer milk
Towards impact at scale
Technological interventions coupled with training of
value chain actors
savings on firewood / month
= 900,000 UGX (260 US$) + >100 trees
Reach:
50% of all pork butchers and
their 300,000 customers in
Kampala
Gumboots (6US$)
Tippy tap (1US$)
Bar of soap (0.50US$)
250mL bleach (0.70US$)
Laminated poster and certificate (6
US$)
= ca. 15 US$ per kit
Pull
approach
(demand for
safe food)
Push
approach
(supply of
safe food)
ENABLING
ENVIRONM
ENT
Consumers recognize
& demand safer food
VC actors respond to
demand & incentives
Inform, monitor &
legitimize VC actors
Build capacity &
motivation of
regulators
Consumer campaign
for empowered
consumers
Three legged stool
Take home messages
 FBD is important for health and development
 Huge health burden: most is due to microbes & worms in fresh foods sold in wet markets
 Hazards in informal markets are usually high but risks are sometimes low and perception is a poor
guide
 FBD is probably increasing
 Currently no proven approaches for mass markets in LMIC that are scalable and sustainable
 Control & command approaches don’t work but solutions based on working with the informal
sector more promising
a4nh.cgiar.org
ILRI
M.Hasan,c/oPhotoshare

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No food security without food safety: Lessons from low- and middle-income countries

  • 1. No food security without food safety: Lessons from low- and middle-income countries Delia Grace, Florence Mutua, Johanna Lindahl, Kristina Roesel and Silvia Alonso Australian Veterinary Association annual conference Perth, Australia 5–10 May 2019
  • 2. I have the following disclosures related to my presentation: •Funding Sources: Donors including ACIAR, BMGF, BMZ, DFID, IDRC, SIDA, USAID •Financial Interests: None •Other Interests: None
  • 3. ILRI Resources • Staff: 630+ • $ 80-90 million annual budget • 130 scientists from over 30 countries • One third of ILRI staff are women • Large campuses in Kenya and Ethiopia • Regional or country office in 14 countries
  • 4. ILRI’s livestock research Delivering solutions for livestock, zoonotic and foodborne diseases Mitigating climate change, enhancing resilience and increasing livestock productivity Accelerating Africa’s agricultural development through biosciences Efficient livestock production driving inclusive growth and employment Taking livestock solutions to scale for inclusive development Better nutrition for improved animal productivity Improving genetics for better productivity and profitability Sustainable Livestock Systems Impact at Scale Animal and Human Health Policies, Institutions & Livelihoods Livestock Genetics BecA-ILRI hub Feed and Forage Development
  • 5. ILRI around the world Animal and Human Health Program • AMR – Queensland • Animal Welfare – Melbourne • Pork safety – Sydney • Sustainable livestock – CSIRO • Village livestock- Kyeema • GBAD - Murdoch
  • 6. 6
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  • 8. Overview 1. Impact of FBD in developing countries 2. Where food comes from in developing countries 3. Where FBD comes from in developing countries 4. Managing FBD
  • 9. Foodborne disease matters for development  Developing country consumers show high concern over FBD  The huge health burden of FBD is borne mainly by developing countries  FBD has high economic costs: health, agriculture & economy-wide  FBD limits access of poor farmers to export markets and threatens access to domestic markets  FBD discriminates: the YOMPI are most at risk
  • 10. 10 Havelaar et al., 2015 31 hazards •600 mio illnesses •420,000 deaths •33 million DALYs USA – 1 in 6 Greece 1 in 3 Africa 1 in 10?? Why food safety matters
  • 11. The public health and domestic economic costs of unsafe food may be 20 times the trade- related costs for developing countries Cost estimates 2016 (US$ billion) Productivity loss 95 Illness treatment 15 Trade loss or cost 5 to 7 ‘Productivity Loss’ = Foodborne Disease DALYs x Per Capita GNI Based on WHO/FERG & WDI Indicators Database Illness treatment = US$27 x # of Estimated foodborne illnesses Trade loss or costs = 2% of developing country high value food exports
  • 12. 12 Milk (cow) Production: men (x Nairobi) Processing: women Marketing: women (x Abidjan) Consumed: both Milk (cow) Production: men (x Nairobi) Processing: women Marketing: women (x Abidjan) Consumed: both Poultry Production: women Processing: women Marketing: women Consumed: both Poultry Production: women Processing: women Marketing: women Consumed: both Milk (goat) Production: men (w milk) Processing: women Marketing: women Consumed: both Milk (goat) Production: men (w milk) Processing: women Marketing: women Consumed: both Beef/goat Production: men (w assist) Processing: men Marketing: men (butcher, pub) Consumed: both Beef/goat Production: men (w assist) Processing: men Marketing: men (butcher, pub) Consumed: both Pigs Production: women Processing: men Marketing: men Consumed: both Pigs Production: women Processing: men Marketing: men Consumed: both Fish, crabs Fishing: men Processing: women Marketing: women) Consumed: both Fish, crabs Fishing: men Processing: women Marketing: women) Consumed: both Food safety & livelihoods
  • 13. Food safety & nutrition  Diarrhoea a risk factor for stunting – perhaps 10-20%?  Ingestion of faecal material on food or in the environment may contribute to environmental enteropathy  Associations between aflatoxins and stunting  Regulations aimed to improve food safety may decrease the availability and accessibility of foods  Food scares decrease consumption
  • 14. Food safety & market access  Food safety standards often exclude small firms and farms from export markets – Kenya and Uganda saw major declines (60% and 40%) in small farmers participating in export of fruit and vegetables to Europe under Global GAP  Farmers supplying supermarkets are richer, better educated, more likely to be male and located near cities  When markets differentiate by quality, substandard food is targeted to the poor But  Quality-demanding markets still a small share  With support smallholders can participate in demanding markets  Benefits to those who do and (some) evidence of spillover to their own farms
  • 15. Overview 1. Impact of FBD in developing countries 2. Where food comes from in developing countries 3. Where FBD comes from in developing countries 4. Managing FBD
  • 16. 16
  • 17. 17
  • 18. 18
  • 19. 19
  • 20. 20
  • 21. 21
  • 22. 22
  • 23. 23
  • 24. 24
  • 25. 25
  • 26. 26
  • 27. 27
  • 28. 28
  • 29. 29 Risk misperceptions abound: What you worry about and what makes you sick and kills you are not the same •Quantitative microbial risk assessment for salmonellosis acquired from pork •Annual incidence rate estimated to be 12.6% (90% CI: 0.5 – 42.6). •Driven by cross-contamination in households followed by prevalence in pork sold in the central market. • Pork value chain Vietnam • 366 kidney, liver and pork samples were pooled into 18 samples analysed for antibiotic residues, β-agonists, and heavy metals • ~1% over MRL with minor implications for human health
  • 30. 30 Experts are also wrong WB,
  • 31. Informal is not set to fade away Hanoi slaughterhouses
  • 32. Formal not necessarily safe, nor informal risky
  • 33. 33 More rules may mean worse practice Average of 17.25 risk mitigation strategies used Farmers who believed UA was legal used more strategies
  • 34. Overview 1. Impact of FBD in developing countries 2. Where food comes from in developing countries 3. Where FBD comes from in developing countries 4. Managing FBD
  • 36. Foods implicated in FBD Painter et al., 2013, Sudershan et al., 2014, Mangan et al., 2014; Tam et al., 2014; Sang et al., 2014 ; ILRI, 2016
  • 37. Foods implicated - FERG World Health Organisation, 2017
  • 38. FBD bucking the trend 2006 to 2016 TB -23% HIV -44% Malaria -27%
  • 39. Models and experience suggest Foodborne will worsen in LMIC GDP growth has largest impact on increase in FBD cases from 2011 to 2030, followed by population growth Expected FBD burden in India to rise from 100 up to 170 million in 2030 – increasing from one out of 12 to one out of 9 people falling sick on average Increased labour supply but mostly reduced health cost of avoiding FBD amounts to 0.5% of GDP - equivalent to an annually recurring benefit of up to 28 billion USD Kristkova et al., 2018
  • 40. Livestock, blue and produce revolution Increase in per capita consumption of perishables and pulses in developing countries with 1963 as index year (FAO, 2009) %
  • 41. Overview 1. Impact of FBD in developing countries 2. Where food comes from in developing countries 3. Where FBD comes from in developing countries 4. Managing FBD
  • 42. Can we regulate our way to food safety?  100% of milk in Assam doesn’t meet standards  98% of beef in Ibadan, 52% pork in Ha Noi, unacceptable bacteria counts  92% of Addis milk and 46% of Nairobi milk had aflatoxins over EU standards  36% of farmed fish from Kafrelsheikh exceed one or more MPL  30% of chicken from commercial broilers in Pretoria unacceptable for S. aureus  24% of boiled milk in Abidjan unacceptable S. aureus
  • 43. Can we modernise our way to food safety?  Supermarketisation is slower than thought.  Formal sector food is risker than thought.  Modern business models have often run into problems – Co-ops, abattoirs, market upgrades
  • 44. 44
  • 45. Can good practices get us to food safety?  Many actors are well intentioned but ill informed  Small scale pilots show short term improvements  Smallholders have been successfully integrated into export chains  But domestic GAP has limited effect – In 4 years VietGAP reached 0.06% – In Thailand GAP farmers have no better pesticide use than non-GAP No behaviour change without change in incentives or choice architecture!
  • 46. 46 Systematic literature review – Food safety interventions in SS Africa Along the value chain Technologies Training & information New processes Organisational arrangements Regulation Infrastructure Farmer +++ +++ + +++ + ++++ Processor & transporter +++ +++ +++ ++ ++ +++ Retailer + ++ + ++ ++ +++ Consumer + +++ + + + +++ Govt +++ ++ ++ +++ Population level: •Incorporating food safety into other health programs such as mother and child care or HIV treatment •Medical interventions such as vaccination for cholera or norovirus or binders for aflatoxins •Dietary diversity to reduce exposure and vulnerability to toxins •Water treatment
  • 47. Effective interventions  Methodological: prioritisation, risk based approaches, HACCP  Appropriate Technology: milk cans, boilers, disinfectants  Novel Technology: Aflasafe  Programmatic: street traders, T&C  Zoonoses: control in reservoir hosts  Policies: enabling environment  Market based solutions - WTP
  • 48. • Branding & certification of milk vendors in Kenya & Guwahti, Assam led to improved milk safety. • It benefited the national economy by $33 million per year in Kenyan and $6 million in Assam • 70% of traders in Assam and 24% in Kenya are currently registered • 6 milllion consumers in Kenya and 1.5 million in Assam are benefiting from safer milk Towards impact at scale
  • 49. Technological interventions coupled with training of value chain actors savings on firewood / month = 900,000 UGX (260 US$) + >100 trees Reach: 50% of all pork butchers and their 300,000 customers in Kampala
  • 50. Gumboots (6US$) Tippy tap (1US$) Bar of soap (0.50US$) 250mL bleach (0.70US$) Laminated poster and certificate (6 US$) = ca. 15 US$ per kit
  • 51. Pull approach (demand for safe food) Push approach (supply of safe food) ENABLING ENVIRONM ENT Consumers recognize & demand safer food VC actors respond to demand & incentives Inform, monitor & legitimize VC actors Build capacity & motivation of regulators Consumer campaign for empowered consumers Three legged stool
  • 52. Take home messages  FBD is important for health and development  Huge health burden: most is due to microbes & worms in fresh foods sold in wet markets  Hazards in informal markets are usually high but risks are sometimes low and perception is a poor guide  FBD is probably increasing  Currently no proven approaches for mass markets in LMIC that are scalable and sustainable  Control & command approaches don’t work but solutions based on working with the informal sector more promising

Hinweis der Redaktion

  1. OPT 1
  2. Findings from SFFF on gender and value chains: shows which gender dominates
  3. Pathogens in pig meat in Vietnam – similar findings for milk in India, milk in Kenya, meat in Nigeria, meat in Gambia
  4. Pathogens in pig meat in Vietnam – similar findings for milk in India, milk in Kenya, meat in Nigeria, meat in Gambia
  5. Kampala dairies: we looked at good practices (risk mitigation). High numbers of good practices and those who were harassed had worse practices
  6. Two-thirds of human pathogens are zoonotic – many of these transmitted via animal source food (salmonellosis, EHEC, cryptosporidium) Animal source food single most important cause of food-borne disease Many food-borne diseases cause few symptoms in animal host (chicken and S. enteritidis, calf and E. coli O157:H7, oysters and V. vulnificus) Many zoonotic diseases controlled most effectively in animal host/reservoir Recent studies shown pre- ‘harvest’ stage most important for controlling food-borne pathogens
  7. Two-thirds of human pathogens are zoonotic – many of these transmitted via animal source food (salmonellosis, EHEC, cryptosporidium) Animal source food single most important cause of food-borne disease Many food-borne diseases cause few symptoms in animal host (chicken and S. enteritidis, calf and E. coli O157:H7, oysters and V. vulnificus) Many zoonotic diseases controlled most effectively in animal host/reservoir Recent studies shown pre- ‘harvest’ stage most important for controlling food-borne pathogens
  8. Two-thirds of human pathogens are zoonotic – many of these transmitted via animal source food (salmonellosis, EHEC, cryptosporidium) Animal source food single most important cause of food-borne disease Many food-borne diseases cause few symptoms in animal host (chicken and S. enteritidis, calf and E. coli O157:H7, oysters and V. vulnificus) Many zoonotic diseases controlled most effectively in animal host/reservoir Recent studies shown pre- ‘harvest’ stage most important for controlling food-borne pathogens
  9. Pathogens in pig meat in Vietnam – similar findings for milk in India, milk in Kenya, meat in Nigeria, meat in Gambia
  10. s/h participation in markets Risk rather than regulatory
  11. OPT 1