Foodborne illnesses cost US$110b per year in low- and middle-income countries

Relative to their population, low- and middle-income countries in South Asia, Southeast Asia, and sub-Saharan Africa bear a proportionately high burden

A new World Bank study finds that the impact of unsafe food costs low- and middle-income economies about US$ 110 billion in lost productivity and medical expenses each year. Yet a large proportion of these costs could be avoided by adopting preventative measures that improve how food is handled from farm to fork. Better managing the safety of food would also significantly contribute to achieving multiple Sustainable Development Goals, especially those relating to poverty, hunger, and well-being.

Foodborne diseases caused an estimated 600 million illnesses and 420,000 premature deaths in 2010, according to World Health Organisation. This global burden of foodborne disease is unequally distributed. Relative to their population, low- and middle-income countries in South Asia, Southeast Asia, and sub-Saharan Africa bear a proportionately high burden. They account for 41 percent of the global population yet 53 percent of all foodborne illness and 75% of related deaths. Unsafe food threatens young children the most: although children under 5 make up only 9% of the world’s population, they account for almost 40% of foodborne disease and 30% of related deaths.

The Safe Food Imperative: Accelerating Progress in Low- and Middle-Income Countries translates these grim statistics into economic terms to focus government attention on the need for greater investment, better regulatory frameworks, and measures that promote behavior change. The total productivity loss associated with foodborne disease in low- and middle-income countries is estimated to cost US$ 95.2 billion per year, and the annual cost of treating foodborne illnesses is estimated at US$ 15 billion. Other costs, though harder to quantify, include 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.

“Food safety receives relatively little policy attention and is under-resourced. Action is normally reactive—to major foodborne disease outbreaks or trade interruptions—rather than preventative,” says Juergen Voegele, Senior Director of the Food and Agriculture Global Practice at the World Bank. “By focusing on domestic food safety more deliberately, countries can strengthen the competitiveness of their farmers and food industry and develop their human capital. After all, safe food is essential to fuel a healthy, educated, and resilient workforce.”

For many low- and middle-income countries, rapid demographic and dietary changes among others are contributing to wider exposure of populations to foodborne hazards, stretching if not overwhelming prevailing capacity to manage food safety risks. The Safe Food Imperative: Accelerating Progress in Low- and Middle-Income Countries schematically describes the alignment—or lack of alignment—between food safety risks and the capacity to manage them as countries develop economically and food systems and diets transform. The study finds that the gap is the most pronounced “in the middle of the pack,” that is, among lower-middle income countries, and it offers targeted recommendations to address these.

“Governments in low- and middle-income countries not only need to invest more in food safety but also invest more smartly,” says Steven Jaffee, Lead Agriculture Economist at the World Bank and study co-author. “This means investing in foundational knowledge, human resources, and infrastructure; realizing synergies among investments in food safety, human health, and environmental protection; and using public investment to leverage private investment.”

The study also supports a shift in approaches to food safety regulation. The traditional approach centers on enforcing regulatory compliance through product testing and food facility inspections, and the application of legal and financial penalties for infractions. Greater emphasis is needed on providing information and other resources to motivate and empower food sector operators to comply with food safety regulation.

“The results of regulation should be measured in terms of compliant enterprises, confident consumers, and food safety outcomes rather than the number of fines or business closures,” says Jaffee.

The Safe Food Imperative: Accelerating Progress in Low- and Middle-Income Countries was supported by the US Food and Drug Administration. It is a collaborative effort involving multiple researchers and practitioners and draws on data and insights from the CGIAR Research Program on Agriculture for Nutrition and Health, the Food and Agriculture Organization of the United Nations, the World Bank, the World Health Organisation, the World Organisation for Animal Health (OIE), and other partners.

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