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Unsafe Food, a Killer in Poor Nations, Needs Government Action

Dried-fish market in Katmandu, Nepal.
A World Bank report on foodborne diseases says food-safety regulations are most deficient in low-income countries in South Asia, Southeast Asia and sub-Saharan Africa, which can result in early deaths, especially among children. A dried-fish market in Kathmandu, Nepal, above.

Poverty’s companions — hunger, malnutrition and recurring sickness — do not have to be the inevitable fate of people in low-income countries, the World Bank said in a recent report. But from national governments to farmers to market stallholders and their customers, making food safer has not been recognized and tackled as a major deterrent to development.

Where regulations do not exist, or are ignored, and effective official institutions to monitor food safety have not been created, foodborne illnesses and early deaths are the result. “Food and nutritional security are realized only when the essential elements of a healthy diet are safe to eat, and when consumers recognize this,” said the report, based on studies by organizations and experts.

“Food safety is linked in direct and indirect ways to achieving many of the Sustainable Development Goals, especially those on ending hunger and poverty, and promoting good health and well-being,” according to the report, “The Safe Food Imperative: Accelerating Progress in Low- and Middle-Income Countries.”

“Although statistically invisible, the domestic economic costs of unsafe food are significant and growing in many low and middle-income countries,” the report, released in October 2018, said. “Most of these countries have weak food safety systems in terms of scientific evidence, necessary infrastructure, trained human resources, food safety culture, and enforceable regulations.”

Consumer organizations, if there are any, may be powerless. And government protections for the population may be weak — a vastly different situation from systems that have evolved over decades in richer countries. “The economic costs of unsafe food, in both absolute and relative terms, vary across countries according to their level of economic development,” the report said.

Experts found the inattention to food safety most pervasive in low-income countries in South Asia, Southeast Asia and sub-Saharan Africa, which make up 41 percent of the global population but are estimated to account for 53 percent of all foodborne illnesses, 75 percent of food-related deaths and 72 percent of disability-adjusted life years.

“A disproportionate share of the burden falls on children under the age of five, who account for 9 percent of the global population but 38 percent of all cases of illness,” the report said. “An estimated 30 percent of premature deaths due to FBD [foodborne diseases] are in children under the age of five. Geographically, children are most likely to die from FBD in Sub-Saharan Africa, followed by South Asia” (which includes Pakistan, India, Nepal and Bangladesh).

In richer countries, efforts are made to prevent foodborne illnesses through public-information campaigns and extensive surveillance and reporting. These actions contrast sharply to the picture in developing countries portrayed in the World Bank report.

Canada has one of the world’s most rigorous food-safety systems. It rests on the commitment that all agencies and medical services collaborate closely and act quickly. Epidemiological investigations are ordered and the federal government provides necessary laboratory assistance and conducts recalls. Public health officials brief the food industry and keep the population informed.

The European Union, acting on the principle that every European citizen has the right to know how the food he eats is produced, processed, packaged, labeled and sold, has established coherent standards for its 28 members (27 if Britain quits the organization) and then monitors them farm-to-table.


 

 

Japan, which imports a large percentage of its food, regulates importers to assure food safety. A Japanese survey found that 70 percent of consumers rated food safety as the most important issue, with only 8 percent seeing price as the major concern when shopping.

In the United States, the Centers for Disease Control and Prevention track outbreaks of  foodborne illness, and the US Department of Agriculture’s food safety and inspection service posts daily bulletins on outbreaks of illness and advisories on foods to be discarded. The service also tracks improperly imported foods, allergens and “extraneous” material in items for human consumption, most recently particles of rubber in chicken nuggets.

The CDC reports that the foods responsible for most illnesses were chicken, pork, seeded vegetables and toxins in fish.

These foods are also widely sold and eaten in low-income countries. Yet, the World Bank report said, “For many developing countries, food safety has, until recently, received very little policy attention and only modest investment in capabilities to manage risks.”

Progress has been hindered by lack of data and institutional factors, namely, “the fragmentation of food value chains and public institutional mandates, and the absence of effective consumer representation in most developing countries.”

“While the safety of food is a ‘public good,’ governments do not and cannot have the primary responsibility for safe food,” the report concluded.

“Rather, food safety needs to become a shared responsibility. Governments need to play effective vision-setting and convening roles; provide reliable information to other stakeholders; and effectively deploy a wide set of policy instruments, both carrots and sticks, to involve, incentivize, and leverage the actions of farmers, food business operators, and consumers.”

 

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