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The Reset the Table essay series is published weekly, describing today’s challenges to global food security and proposing U.S. government responses.
Unsafe food and malnutrition can be twin threats to consumer health and create hurdles to achieving food security for consumers. Yet addressing these twin threats is vital to meet the United Nations’ Sustainable Development Goal 2, a bold call to end hunger and all forms of malnutrition by 2030. Achieving this goal will take aggressive action by all countries, especially as pre-pandemic global food security challenges are further exacerbated by Covid-19.
Though access to safe food is essential for food security, many international development experts and donors are unaware of this connection. Food contaminated with pathogens, or chemical or physical adulterants, can interfere with the uptake of nutrients, worsening malnutrition and affecting developmental outcomes in children. Malnutrition can increase an individual’s susceptibility to infections, including diarrhea. There is a strong relationship between gastrointestinal illness and growth impairment in children, including links to stunting. In fact, diarrhea was identified as the greatest single cause of stunting, and even mild diarrheal disease can have long-term effects on child development and adult health.
In 2015, the World Health Organization (WHO) estimated that unsafe food causes 1 in every 10 people to fall ill each year, leading to 600 million cases of foodborne-related illness and 420,000 deaths a year worldwide. Children under five are uniquely vulnerable, and consumers in sub-Saharan Africa face the greatest disease burden. Almost one-third (30 percent) of all deaths from foodborne diseases are in children under the age of 5 years, estimated at 125,000 per year.
The economic consequences of foodborne disease for countries are also significant; the World Bank estimates approximately $110 billion is lost in productivity and medical expenses each year. For consumers, this can mean an inability to provide and care for oneself and one’s family, perpetuating cycles of poverty and hunger. These costs also impact national economies, trade, tourism, and ultimately sustainable development.
Foodborne disease is frequently linked to highly nutritious foods, like fresh vegetables or animal products high in protein, because such food items are susceptible to contamination. Animals harbor pathogens, including strains of E. coli or Salmonella, that can be transferred to food during slaughter or harvesting. These risks are especially severe in countries where regulation of food production and food handling are less restrictive, and where consumers and food handlers have less access to clean water sources and adequate food storage. Limited cold chain infrastructure and longer supply chains can increase the likelihood of survival and growth of pathogens in food. Amid the Covid-19 pandemic, some food supply chains have been disrupted, and market surveys in several countries by EatSafe find that fresh fruits and vegetables are most impacted. Ensuring that traditional markets for safe nutritious food are supported during the pandemic is central to ensuring food security for low-income consumers globally.
In promoting World Food Safety Day, the Food and Agriculture Organization of the United Nations has said, “if it isn’t safe, it isn’t food.” The United States has included food safety issues within the framework of its food security and nutrition work in recent years, and those efforts should continue. The Global Alliance for Improved Nutrition (GAIN) is partnering with the Feed the Future Initiative and U.S. Agency for International Development (USAID) on a new project, EatSafe, to help safeguard consumer access to safe and nutritious food in informal markets. Although GAIN has traditionally focused on fighting malnutrition globally, EatSafe is one of GAIN’s first projects focused exclusively on food safety.
A recent report by the World Bank emphasized the need to focus efforts to address food safety in sub-Saharan Africa at the level of the traditional markets where many consumers buy their food. These informal markets are generally subject to minimal regulation or oversight. They also frequently lack essential infrastructure, like clean water, safe storage, a cold chain, sanitary facilities, effective processing equipment, and adequate food service facilities. Informal markets are often located in urban and peri-urban areas, where they are a critical source of food for nearby residents. Incentivizing informal markets and their vendors to improve food safety practices may be the key to improve food safety. As one example, training programs for vendors could improve food handling to increase food safety, and publicizing market training programs might drive consumers to purchase from markets and vendors with the food safety training programs.
The lowest-income consumers, those most vulnerable to food insecurity, frequently shop at informal markets. Therefore, it is essential to look at how both food vendors and consumers conceptualize food safety, what incentives improve food safety practices, and how demand can drive the supply of safe food. As food safety practices vary from country to country, understanding consumer and food vendors interactions is important to develop effective, targeted interventions to improve food safety. Central to the approach of EatSafe is the concept, tested through research, that the interaction between consumers and vendors in traditional markets offers a food safety leverage point by empowering consumers to demand safe food, and vendors to deliver it. We are examining whether improving consumer demand can significantly improve food safety in lower-income countries using market-based approaches.
Prevention is key. Assisting food suppliers and vendors to develop effective food safety practices can protect livelihoods and consumer health while also preventing food safety problems before food reaches the marketplace. Promoting a cadre of well-informed consumers who shop and prepare food is important to creating consumer demand for safe, nutritious food. Identifying key consumers and finding the opportunities to share information in a manner where those consumers are likely to see and learn food safety information is critical.
In the first-ever World Risk Poll, the Lloyd’s Register Foundation and Gallup recently surveyed 150,000 consumers in 142 countries and reported on the public perceptions of food-related risks and government food safety performance. The poll found that one in six consumers said they or someone they know had experienced serious harm from eating unsafe food in the last two years, showing the burden of foodborne disease remains high. Governments suffered from gaps in trust on food safety response in many regions.
Prevention of foodborne illness is a shared responsibility across the food chain, including consumers, producers, processors, vendors, and even transporters and farmers. At the local level, improving the food safety practices of stakeholders (such as farmers, vendors, and consumers) can help reduce the burden of foodborne disease in those communities, thus making them healthier and more economically sustainable.
Providing incentives for governments to enhance their food safety systems over time will also be a welcome improvement, especially if those systems are refocused on the needs of their domestic consumers, rather than those of their trading partners. As it works to make nutritious diets accessible to the world’s malnourished, USAID through its Feed the Future Initiative is also exploring how to ensure the safety of those foods—because if it isn’t safe, it isn’t food.
Caroline Smith DeWaal is the deputy director of Feed the Future’s EatSafe, a new food safety program led by the Global Alliance for Improved Nutrition (GAIN). Lawrence Haddad is the executive director of GAIN and a 2018 World Food Prize laureate for his work in fighting malnutrition.
Commentary is produced by the Center for Strategic and International Studies (CSIS), a private, tax-exempt institution focusing on international public policy issues. Its research is nonpartisan and nonproprietary. CSIS does not take specific policy positions. Accordingly, all views, positions, and conclusions expressed in this publication should be understood to be solely those of the author(s).
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