We expect to be eating peanuts, not extreme amounts of aflatoxins, and chicken but not E. coli. We expect that our salads are washed with clean water, and that the person who prepared the salad first washed their hands. We cannot, however, always assume the expected and thus need to be ready for the unexpected. Unexpected events can take the form of natural disasters, such as earthquakes or floods. They might also come from power cuts or amid sudden political change. Such events can disrupt food availability, accessibility and safety, leaving us exposed to increased levels of unsafe food. Some consequences can be avoided though, by preparing for the unexpected: this year's theme for World Food Safety Day (1).
Every year more than 420,000 people die from unsafe foods, while more than 600 million cases of illness also result. Most of this burden is felt in low- and middle-income countries, which have weaker food safety infrastructure, rules and regulations. People in Africa for example are on average 27 times more likely than those in Europe or North America to encounter foodborne disease (2).
Policies to improve food safety are one way to reduce the awful consequences linked to eating unsafe food – but they must be implemented with adequate support. Strong food safety policy involves different government levels, each playing their role to guarantee citizens consume safe food. When unexpected events strike, a well-functioning food safety policy system, involving multiple actors, can allow for a quick and well-prepared response, reducing harm to minimum levels.
The role of international, national, and sub-national policy
International standards and guidelines for food safety are collaboratively developed by countries through the Codex Alimentarius Commission, often informing national-level policymaking. Originally set up to harmonize standards for international trade, Codex is currently working on guidelines to improve food safety in traditional markets. Traditional markets are as vulnerable to unexpected events as international trade, but applying the same set of standards to both contexts is not realistic (3). Tailoring guidance to traditional markets is a great example of how an international body contributes to preparing for unexpected events in a domestic context.
National-level food safety policy sets the basis for implementation and enforcement. According to data from 2019, 70% of African Union countries had a national food safety policy, act or law that was updated in the ten years prior. Around three in five countries on the African continent have in place either or both of a) safety response systems with standard operational procedures, traceability and recall systems, and b) risk-based, coordinated food safety monitoring and surveillance plans (4). Countries without either are more vulnerable, as there is no agreed-upon response that can be implemented at short notice. In recognition of this challenge, countries are responding by committing to develop national food safety policies.
Sub-national governments, including municipalities and city governments, are usually responsible for implementation and enforcement of national or subnational food safety policies (5). They tend to interact directly with food operators or traditional markets, which are crucially important for many people's food needs. At the same time, such spaces tend to have high food safety risks and are often vulnerable to unexpected events. GAIN and the USAID Feed the Future EatSafe program worked together with local market management committees to restructure markets and improve infrastructure to mitigate food safety risks. Local authority's leadership is crucial in improving resilience to unexpected events.
Pakistan provides an example of recent national and subnational progress towards adopting global best practices. With assistance from partners including GAIN, the government is formulating the National Food Safety Policy 2025-2030. It is also enacting Food Authority Acts and has established regulatory authorities at provincial level. One such sub-national body is the Punjab Food Authority, responsible for the enforcement and monitoring of food safety and quality standards and ensuring food businesses comply with these standards. Additionally, they provide support and awareness-building. Since the authority's establishment in 2011, compliance with standards at inspections has increased, while a larger fraction of food businesses have been licensed (6). This model has been adopted by other provincial governments, where GAIN has provided support to build capacity in areas such as inspection and communication.
Food safety as part of the food system
Just as food safety policy requires coordination across different government levels, it also deserves attention from more than one sector. At any point from farm to mouth, whether in a large food processing plant or in a person’s own kitchen, food safety risks can occur unexpectedly. A recent GAIN Discussion Paper, ‘Nutritious and safe food for all: Improving food safety through food systems actions’ (9), [AV1] sets out why a systems approach is crucial to reduce food safety risks across the board. A joined-up approach, bringing sectors like agriculture, environment, health, technology and trade together, may make the difference between recognizing and adequately responding to unexpected risks, or allowing such risks to build unimpeded, jeopardizing health and safety.
The importance of applying a systems approach to food safety is increasingly recognized. Out of 128 countries that drafted food systems transformation pathways for the 2021 UN Food Systems Summit, 87 included references to food safety and quality (10). This indicates that for many countries food safety is a priority, one which they aim to integrate into their food systems approach. The Ethiopian government included food safety as a priority action under the cluster ‘Ensure availability and accessibility of safe and nutrient dense foods’ as part of its food systems transformation pathway. Action is now underway to strengthen its food safety management and control system to contribute to overall food systems transformation (9).
A final reflection on preparation: risks must be well understood, and responsibilities shared across government administrative levels in a well-coordinated manner. Political will to follow such an approach is growing. At the same time, much remains to be done. A sustained effort to improve food safety – across sectors, and across government levels – is needed to reduce and avoid unexpected (and even expected!) harm from unsafe food.
References
(1) World Health Organization. World Food Safety Day 2024. Accessed on 6 May 2024. World Food Safety Day 2024 (who.int)
(2) Havelaar AH, Kirk MD, Torgerson PR, Gibb HJ, Hald T, Lake RJ, et al. (2015). World Health Organization Global Estimates and Regional Comparisons of the Burden of Foodborne Disease in 2010. PLOS Medicine. 3;12(12):e1001923.
(3) Smith DeWaal, Caroline. (2023, 18 January). Global Focus for Food Safety Turns to Improving Traditional Markets for Food. Global Alliance for Improved Nutrition. https://www.gainhealth.org/media/news/global-focus-food-safety-turns-improving-traditional-markets-food
(4) EatSafe Webinar IV – Food safety oversight and governance [video]. Global Alliance for Improved Nutrition; 2021, March 8. https://www.youtube.com/watch?v=G3hr3EZhpYs&list=PLPx9D5ni2n0gL98BKYjYTzslH-lUUuBvn&index=6
(5) Henson, S., Jaffee, S. and Wang, S. (2023). New directions for tackling food safety risks in the informal sector of developing countries. Nairobi, Kenya: ILRI. https://www.cgiar.org/research/publication/new-directions-for-tackling-food-safety-risks-in-the-informal-sector-of-developing-countries/
(6) Nemer LE, Rasool F, Demmler KM, and Polack S. (2020). The Punjab Food Authority: A model for governance to improve food safety and hygiene. Global Alliance for Improved Nutrition (GAIN). Working Paper #4. Geneva, Switzerland. DOI: https://doi.org/10.36072/wp.4
(7) Impact Story 9: GAIN's Response to Covid-19 – Keeping Food Markets Working. Global Alliance for Improved Nutrition. https://www.gainhealth.org/sites/default/files/publications/documents/GAIN-Response-to-COVID-19-Keeping-Food-Markets-Working_1.pdf
(8) Global Alliance for Improved Nutrition (GAIN). (2021). Policy Options Toolkits. https://www.gainhealth.org/resources/reports-and-publications/policy-options-toolkits
(9) Nordhagen[AV1] , S, T Yalch, R Pluke, G Gebremedhin, W Gonzalez, D Morgan. Nutritious and Safe Food for All: Improving Food Safety Through Food Systems Actions. Global Alliance for Improved Nutrition (GAIN). Discussion Paper 16 Geneva, Switzerland, 2024. DOI: https://doi.org/10.36072/dp.16
(10) United Nations Food Systems Coordination Hub. Pathways Analysis. Accessed on 6 May 2024. https://www.unfoodsystemshub.org/member-state-dialogue/national-pathways-analysis-dashboard/