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Solution Cluster 1.3.1

Develop Low- and Middle-income Country Capacity to Track Foodborne Disease and Improve Food Safety Performance

designed to help low- and middle-income countries (LMICs) develop capacity to measure and track the burden of foodborne disease and assist governments to adopt programmes to improve their performance. This cluster will build a base of locally relevant knowledge that can help governments build support for food safety improvements with stakeholders both in and outside the government. 

The cluster will provide a diagnostic toolbox on food safety to assist governments with priority setting, especially for LMICs, through tools that help governments measure public health impacts of foodborne disease and monitor national commitment and capabilities. For the private sector,  tools and innovations successfully used in high-income countries and the formal sector will be tailored for use in other sectors and environments.  The tools and activities will be housed in a Global Network for Food Safety Innovation and Capacity Building (aka the Global Food Safety Network). This Network would also help inform governments and the private sector about existing food safety programmes led by relevant international organisations (e.g., WHO, FAO, Codex Alimentarius, OIE, World Bank, regional development banks). 

The World Health Organization’s (WHO) Foodborne Disease Epidemiology Reference Group (FERG) estimates that over 600 million illnesses and 420 thousand deaths annually are linked to unsafe food. This burden falls disproportionately on young and poor consumers, especially in LMICs. The public health burden is comparable to that of malaria, HIV, or tuberculosis. Unsafe food is also linked to malnutrition, equity, livelihoods and food losses. Together, poor nutrition and foodborne disease have serious consequences for the health and wellbeing of all, particularly women,children, the elderly and immunosuppressed.  

While LMICs bearthe greatest burden of foodborne disease, the supply and demand for safe food in these markets is underdeveloped1. The drive to improve food safety is too often focused on food intended for trade, instead of on food intended for domestic consumption, with the consequence that oversight of the domestic food industry is a lower priority and domestic consumers are not adequately protected. It is essential to refocus food safety efforts on domestic food safety systems, benefiting both consumers and food businesses (formal and informal) in LMICs, as this solution aims to do. 

Many LMICs lack basic competencies to regulate food safety, such as the legal and regulatory structures to effectively manage domestic food safety. Capacity-building guidance exists (e.g., through Codex Alimentarius, FAO, and WHO) to assist governments in developing effective management systems, but many governments lack specific knowledge of the human and economic toll of foodborne disease necessary to incentivise the adoption of that guidance. Moreover the incentives that drive adoption of food safety practices in formal and export markets are largely lacking in domestic and informal markets, and must be created. Advocacy may also be required to foster the political support for improving domestic food safety systems, as well as increasing domestic and international investment in food safety. 

To address problems faced by many LMICs, this cluster will support the following activities: Improved disease surveillance tools appropriate for LMICs;  a platform for knowledge sharing and dissemination of surveillance tools and risk assessment methods; an SDG health impact indicator for food safety; indicators for assessing government food safety capacity; and improved burden of disease and costs estimates associated with foodborne illness in LMICs.

1Jaffee, et al., 2019, The Safe Food Imperative: Accelerating Progress in Low- and Middle-Income Countries, Overview Booklet, World Bank

About this Solution Cluster

To advance this work, we propose creating a Global Network for Food Safety Innovation and Capacity Building. This Global Food Safety Network would be an action-oriented, member-driven, collaborative platform for cooperation that will bring together governments, bilateral and multilateral organisations, food businesses, and other stakeholders to achieve the common goal of advancing food safety, in an affordable and equitable manner. Using a centralised knowledge-sharing platform, governments will have the evidence base to support improvements in food safety, leading to more robust and effective food safety management systems in many LMICs. Regional models, like the European Food Safety Authority and Pan American Health Organization, offer evidence that a central repository for public health and risk assessment information can provide value to countries in those regions and that such tools are needed globally.  

Improving surveillance of foodborne diseases, including real-time shared surveillance and food attribution, is also critical to help countries understand the full human and economic costs of foodborne disease.  Such public health knowledge can provide an incentive for governments to act. Developing a health impact indicator for food safety as part of the SDGs could incentivise many countries to improve their food safety systems in advance of 2030. Supporting development of an SDG indicator is important to measure progress in reducing the burden of foodborne disease globally. While 247 indicators are used for tracking progress to achieve the SDGs, no food safety indicator is recognised. Food safety actions are linked to many of these indicators, particularly under SDG 2, 3 or 8, but data segmentation and limitations in measuring and reporting impede progress, camouflaging areas that need more attention and even jeopardising progress towards other SDGs.

To further strengthen national programmes and support a new SDG food safety indicator, indices to measure national food safety capacity can also be developed or adapted. Whether used by government actors, international organisations, or other stakeholders, food safety indices would help prioritise improvements in food safety programmes.  Capacity benchmarking programs used in other areas (e.g., by the Organization of Economic Co-operation and Development or the World Organization for Animal Health) show that such tools can be effective to inspire governments to make improvements.

Development and use of food safety indices can also assist government authorities in prioritising food safety by, for example, providing a baseline, improving resource allocation, and measuring and motivating progress. For example, the African Union has developed the African Food Safety Index as part of its Comprehensive African Agriculture Development Program (CAADP) biennial review, which monitors progress of the 55 AU Member States. Other evidence of the effectiveness of indices comes from areas outside food safety (e.g., the Programme for International Student Assessment (PISA)).

Using the pathway of knowledge, innovation, and mainstreaming, the output of the Global Food Safety Network will improve knowledge on the true impacts of unsafe food for countries and regions, leading to more rapid development and adoption of effective public and private food safety solutions adapted to the conditions in each country and region (see UN FSS Food Safety Solutions Cluster). Some countries have demonstrated the importance of  the engagement of consumer and business stakeholders at all levels of the food system; for example, India developed  a model to engage, empower, and enable consumers and food businesses to create a strong and sustainable food safety culture.

In meetings with WHO, FAO, and Codex Alimentarius, synergies were identified between the work of those organisations and the proposed Global Food Safety Network.  Codex has Regional Coordinating Committees that might collaborate with the Global Network and could be approached to work with or as regional partners to help prioritise regional activities for developing national food safety system capacity and supporting the regional delivery of solutions.

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