When Zoonotic Foodborne Disease Keeps Markets Hostage, Consumers May Hold the Key
Authors: Elisabetta Lambertini, Bonnie McClafferty, Florence Mutua, and Delia Grace, Feed the Future EATSafe: Evidence and Action Towards Safe Nutritious Food
It is sometimes said that unsafe food is not truly food. A nutritious diet can turn into poison when contaminated with pathogenic microbes or harmful chemicals. For instance, contaminated food is a major cause of diarrhoeal diseases, which can not only lead to acute illnesses but also long-term sequelae, compounding micronutrient deficiencies, wasting and stunting arising from decreased food intake, malabsorption, and nutrient loss.
Until recently there has been little attention on food safety in developing countries. The health impact of foodborne disease (FBD) in low- and middle-income countries (LMIC) has also only started to be appraised. In 2015, the first WHO global report on FBD highlighted a staggering 600 million illnesses and 420,000 deaths per year, with children below the age of five years bearing 40 eprcent of the burden. Of consequence, the WHO report also confirms that the most nutritious foods, such as animal products and fresh fruits and vegetables, are associated with the highest incidence of foodborne illness.
Most known foodborne diseases are zoonotic, meaning they are transmitted from animals to humans, directly or indirectly via the environment. An estimated 60 percent to 75 percent of all emerging or re-emerging infectious disease events have a zoonotic origin (Jones et al., 2008; Taylor et al., 2001). We also know that several diseases are transmissible at the wildlife-livestock interface. For example, domestic food animals, especially if in contact with wildlife habitat, can transmit Toxoplasma gondii. Worms such as Taenia sodium can be transmitted by pork. In LMICs, zoonotic diseases make up 26 percent of the burden of all infectious diseases, compared to 1 percent in high-income countries (10 and 0.02 percent of total disease burden as DALYs, respectively) (Grace et al., 2012).
The impact of contamination can be amplified by the highly interconnected nature of today’s food production systems. At this time, the viral COVID-19 pandemic, possibly a spill-over from wild animals sold at a wet food market, painfully highlights the risks of zoonotic transmission where human encroachment into wild animal habitat, food trade, wildlife trade, and densely populated human settlements intersect in informal markets.
Markets are a key node where a wide range of foods come together, and informal markets are where most people in LMICs acquire their food, especially fresh food (70 percent in urban Sub-Saharan Africa). They are convenient and easily accessible by the majority of urban populations. They also provide employment to other actors including women and the youth who often sell fresh produce. In wet markets meat, live food animals, wild animals, fresh fruits and vegetables, and dairy may be sold next to each other, often without packaging. These markets are rarely supplied with basic amenities including access to clean water and waste disposal. Clean food can easily become cross-contaminated. This is not to say that informal markets are always dangerous, nor are formal markets always safe. Formal markets too often escape rigorous inspection and have risk factors absent from informal markets, such as reliance on unstable cold chains. In the absence of enforced regulations, guidelines, capacity, and infrastructure to guard against FBD food safety can run unchecked, leaving vendors and consumers to navigate the safety of their food system.
The market environment provides opportunities for consumers to interact with vendors, allowing them to directly exercise not only their purchasing power, but also their ability to demand high-quality food. Consumers demanding safer foods have been known to influence vendors, and vendors in turn have applied pressure on their suppliers. Notable examples in the informal sector include consumer demands for aflatoxin-free milk in Ethiopia, and efforts by dairy vendors in Kenya (GFSP, 2019).
The challenge before us is invisible. Food contamination - just like nutrients - is most often indiscernible, and illness cannot be easily traced back to a specific food or vendor without a strong national surveillance system. Foodborne outbreak scares can change consumers’ behaviour, but usually consumers are unable to verify product claims and are left to rely on their own risk perceptions and trust networks to make food safety decisions. Consumer associations, the whistle blowers on foods, are also limited and weak. What do consumers, vendors, and markets need to ensure safer food? Consumer-driven food safety has great potential, but is still poorly understood. What are consumers’ priorities when choosing which food to buy in informal market settings? What information do they need to recognize what food is safe? Do they feel empowered to make demands to vendors? What are good incentives? And what is the role of market-based associations?
Feed the Future EATSafe: Evidence and Action Towards Safe Nutritious Food is working to answer these questions. The Global Alliance for Improved Nutrition (GAIN), in partnership with USAID, and in collaboration with the International Livestock Research Institute (ILRI) and Pierce Mill Media, is working to empower consumers to recognize good food safety practices and demand safe food from their markets. We also see vendors as key actors with potential to promote food safety and put pressure on the upstream supply chain. EatSafe is a 5-year effort to generate actionable knowledge to improve the safety of nutritious foods sold in informal markets, combining baseline research and testing of potential solutions. The project leverages approaches from behavioural economics, risk analysis, and demand creation programs to understand strategies that consumers can adopt to demand – and obtain- safe food. EatSafe is launching in Nigeria and will expand to other focus countries in the Feed the Future initiative.
On this 2020 World Food Safety Day, we want to renew our commitment to improve food safety, to truly put the “safe” in “safe, nutritious, sustainable food”.