Food: Safe for some, dangerous to others

The United Nations General Assembly, recognising the demonstrable effects of food borne diseases especially for children under five years old and those living in lower-income nations, designated 7 June World Food Safety Day (WFSD). This day is jointly facilitated and observed by the World Health Organisation (WHO) and the United Nations Food and Agriculture Organisation (FAO) to inspire action and preventative measures to detect and manage foodborne risks—for instance, according to the WHO (2020), diarrhoeal diseases affect 220 million children each year leading to 96 000 deaths. Moreover, WFSD focuses on contributing to food security, sustainable development, agriculture, market access, economic growth, and healthy populations (WHO 2021).

This year’s theme is ‘Safe food today for a healthy tomorrow’, which stresses that there are immediate and long-term benefits for the planet, the global economy, and human health driven by the production and consumption of safe food. But what is ‘safe food’? According to the Australian Institute of Food Safety (2019), it encompasses ‘handling, preparing and storing food in a way to best reduce the risk of individuals becoming sick from foodborne illnesses’.

The WHO (2020) details the staggering global burden caused by foodborne illnesses, estimating that 600 million people (or 1 in 10 people in the world) fall ill due to contaminated food, leading to 420 000 deaths each year. In low- and middle-income nations alone, US$110 billion is lost in medical and productivity expenses each year. What is particularly worrying is that there are 200 foodborne diseases—which are usually toxic and infectious—ranging from cancer to diarrhoea (WHO 2020). Africa has the highest burden of foodborne diseases caused by unsafe food, with 135 million infections and 180 000 deaths per annum (Jaffee & Grace 2020). Consequently, Africa’s disability-adjusted life years (DALYs)—a measure of the overall burden of disease, represented as the number of years lost resulting from early death, disability, or ill health—equals 15 million lost (Jaffee et al 2020: 116).

Literature on foodborne diseases notes that low- and middle-income nations bear the brunt of this burden and that this issue is likely to get worse. This is especially true for nations in Southeast Asia, South Asia, and sub-Saharan Africa. In fact, a World Bank (2018) study found that in low- and middle-income nations, the cost of treating illnesses caused by unsafe food equalled US$15 billion, while productivity losses amounted to US$95,2 billion per year. The same report mentions, however, that other costs resulting from unsafe food such as ‘…losses of farm and company sales, foregone trade income, the health repercussions of consumer avoidance of perishable yet nutrient-rich foods, and the environmental burden of food waste’ (World Bank 2018) are harder to quantify. One such issue is that while the prevalence of foodborne risks is well documented in developed nations, developing nations lack regular reporting on these issues, which makes it difficult to monitor these trends (Mbonane & Naicker 2020). In essence, this issue could be far greater than we assume it to be.

Many reasons are offered as to why the African continent bears the brunt of this burden. Generally, the issue is focused on a lack of policy coherence or a general neglect of public health. Jaffee et al. (2020: 115) assert that African diets are dominated by cheap staples such as maize, cereals, rice, and cassava, which is driven by policy intended to ensure the affordability and availability of these foods while lessening the detriment brought by conditions such as malaria, HIV/Aids, and tuberculosis, inter alia. Grace (2019), presenting at the International Forum on Food Safety and Trade, noted that donor investments into initiatives focused on food safety pale in comparison to investments into other sectors of health. Moreover, with the increasing need to address food security on the continent, many African nations are undergoing increased agricultural intensification. However, Grace (2015) argues that this may increase the risk of foodborne diseases due to poor regulation of farming practices and the wider use of pesticides, which increases the risk of food contamination.

Foodborne diseases are likely to become more widespread with increases in the consumption of unsafe food and the expanding nature of value chains (the process of food production, from farm to fork). Bisholo, Ghuman, and Haffejee (2018) argue that this preventable epidemic is a result, inter alia, of consuming uninspected food such as meat, fish, and fresh produce.

But the poignant reality for Africa, according to Jaffee and Grace (2020), is that there is a dire need for increased investment and more adaptive and pragmatic domestic food safety policy. However, this alone will not solve the problem for the continent, and a complete paradigm shift around food safety is required. Food regulatory models adopted from developed nations are held to be ill-suited to an African context. This is because models derived from high-income nations focus on legal enforcement of food practices through regular inspection and product testing, with the imposition of financial and/or legal penalties. However, Jaffee and Grace (2020) explain that food systems in Africa are predominated by informal foodways, micro and macro enterprises, and smallholder farming with limited resources for surveillance and inspection, compounded by weak legalistic frameworks and court procedures.

Bibliography

Australian Institute of Food Safety. 2019. What is food safety? [Online] Available from: https://www.foodsafety.com.au/blog/what-is-food-safety [accessed on 29 May 2021].

Bisholo, KZ; Ghuman, S; & Haffejee, F. 2018. Food-borne disease prevalence in rural villages in the Eastern Cape, South Africa. African Journal of Primary Health Care & Family Medicine, 10(1):1–5.

Grace, D. 2015. Food safety in low and middle income countries. International Journal of Environmental Research and Public Health, 12(9):10490–10507.

Grace, D. 2019. Addressing the economic burden of foodborne diseases. International Forum on Food Safety and Trade. 23–24 April 2019, Geneva, Switzerland.

Jaffee, S & Grace, D. 2020. Flattening the curve on foodborne illness and its costs in Africa. [Online] Available from: https://www.ifpri.org/blog/flattening-curve-foodborne-illness-and-its-costs-africa [accessed on 29 May 2021].

Jaffee, S; Henson, S; Grace, D; Ambrosio, M; & Berthe, F. 2020. Why food safety matters to Africa: Making the case for policy action. IFPRI and AKADEMIYA2063.

Mbonane, TP & Naicker, N. 2020. Knowledge, attitude and practices of environmental health practitioners conducting food-borne disease outbreak investigation at a local municipality in Gauteng province, South Africa. Health SA Gesondheid, 25:1–8.

World Bank. 2018. Food-borne illnesses cost US$ 110 billion per year in low- and middle-income countries. [Online] Available from: https://www.worldbank.org/en/news/press-release/2018/10/23/food-borne-illnesses-cost-us-110-billion-per-year-in-low-and-middle-income-countries [accessed on 29 May 2021].

World Health Organisation. 2020. Food safety. [Online] Available from: https://www.who.int/news-room/fact-sheets/detail/food-safety [accessed on 29 May 2021].

World Health Organisation. 2021. World Food Safety Day 2021. [Online] Available from: https://www.who.int/news-room/campaigns/world-food-safety-day/2021 [accessed on 29 May 2021].