The majority of food consumed in Africa is purchased at informal markets

International donors and domestic governments must do more to tackle high levels of illness and death caused by unsafe food in sub-Saharan Africa.

A new report by the Global Food Safety Partnership, part of the World Bank, says that “relatively little” is being done to reduce the number of food-borne illnesses among people in sub-Saharan Africa, despite the fact more than 100,000 people are killed eating unsafe food every year.

A report by the World Health Organization in 2015 estimated that there are around 137,000 deaths and 91 million cases of illness every year in Africa because of unsafe food. The toll is heaviest on children under the age of five, the report found.

The report warns that the number of cases of food poisoning will only increase as the African food system matures, “supply chains lengthen, and Africans have access to more of the nutritious meat, dairy products, fruits and vegetables that are needed for good health but are more vulnerable to food safety hazards than traditional staples of African diets”.

The importance of food systems to health has been climbing the agenda in recent months. A global coalition of scientists called for a "Great Food Transformation" to fix the world's "faulty food system", which sees one billion people go hungry and two billion eat too much. However, improving the diet of  sub-Saharan Africa have  will be in vain if the food consumed is unsafe. 

The most common food-borne illnesses | The facts

• Salmonella, Campylobacter and Escherichia coli are among the most common food-borne pathogens that affect millions of people annually. Eggs, poultry and other animal products have been linked to outbreaks of salmonella. Campylobacter infections are mainly caused by raw milk, raw or undercooked poultry and drinking water. E. coli is associated with unpasteurized milk, undercooked meat and fresh fruits and vegetables.
• Listeria infection leads to unplanned abortions or death of newborn babies. The bug is found in unpasteurised dairy products and various ready-to-eat foods and can grow at refrigeration temperatures.
• Vibrio cholerae infects people through contaminated water or food. Rice, vegetables, millet and various seafood have been implicated in cholera outbreaks.
• Viruses such as norovirus infections are characterised by nausea, explosive vomiting, watery diarrhoea and abdominal pain. Hepatitis A virus can cause long-lasting liver disease and spreads through raw or undercooked seafood or contaminated raw produce. Infected food handlers are often the source of food contamination.
• Parasites such as tapeworms may infect people through food or direct contact with animals. Other parasites, such as Ascaris, Cryptosporidium, Entamoeba histolytica or Giardia, enter the food chain via water or soil and can contaminate fresh produce.​
• Naturally occurring toxins include mycotoxins, marine biotoxins, cyanogenic glycosides and toxins occurring in poisonous mushrooms. Staple foods like corn or cereals can contain high levels of aflatoxin and ochratoxin, produced by mould. A long-term exposure can affect the immune system and normal development, or cause cancer

Source: World Health Organization

Bacterial and viral hazards such as salmonella are responsible for about 70 per cent of the food-borne disease burden in Africa with salmonella causing 32,000 deaths a year.

Parasites, such as tapeworm, cause 17 per cent of the burden – the pork tapeworm infects millions of Africans, causing severe illnesses such as epileptic seizures.  Another hazard are naturally occurring toxins such as aflatoxin which affects staple crops such as cereals and groundnuts and can lead to liver cancer.

The report, described as a “call to action” on food safety, urges governments and international donors to invest more in food safety for local people – current investments focus on food that is to be exported regionally or overseas, rather than on domestic consumption.

An analysis of more than 500 projects and activities in sub-Saharan Africa since 2010 found most focused on food safety for exports and that food-borne illnesses. 

Less than five per cent of donor investments addressed specific health risks, such as salmonella and E.coli, which can be found in food bought in traditional markets, the report found.

Markets provide the majority of food consumed in Africa – around 85 to 90 per cent – and even though the continent is rapidly urbanising and modernising the traditional, informal markets are expected to supply up to 70 per cent of food by 2040, experts predict.

These markets are vital to the African food system but the report warns that the majority are completely unregulated and lack sanitation facilities and other infrastructure that are vital to food safety, such as cold storage.

The formal food market in Africa is expanding with the growth of medium sized food-processing and agribusinesses. If this is not properly regulated it can lead to large-scale food scares, such as the 2017-18 listeria outbreak in South Africa – dubbed the world's worst ever outbreak which killed 180 people.

The report calls for better regulation, particularly of Africa’s informal food markets, as well as better information to consumers, to empower them to demand safer food.

“The development community is beginning to accept that there will be no food security and achievement of development goals without food safety,” said Louise Scura, chair of the Global Food Safety Partnership governing committee.

“Our hope is that this report will result in greater prioritization of investments in food safety for African consumers, greater alignment of the development community’s support to food safety, and sharper focus on the need to alleviate the public health burden of foodborne disease in sub-Saharan Africa.”

Lystra Antoine, chief executive of the partnership, said that awareness of the importance of food safety was growing among consumers, producers and government. 

She added: "This is not an emergency but a slowly expanding crisis. The current burden is unacceptably high and affects the health of millions of African consumers and undermines development strategies. These illnesses are preventable with the right food safety practices."