What's eating sub-Saharan Africa?

About the Author

Delia Grace

Delia Grace is the program leader for ILRI. She is a veterinary epidemiologist and food safety specialist.

About the Author

Kristina Roesel

Kristina Roesel is co-ordinator of the Safe Food, Fair Food Project at ILRI.

Across the food-challenged regions of sub-Saharan Africa, the sustenance provided by livestock and seafood - milk, meat, eggs, and fish - is far more important than it is in wealthy countries. For most Africans, particularly the poor, there are no alternatives that can supply anywhere near the same level of protein and micronutrients. To get the same amount of vitamin A in just 100g of sardines, you would have to eat 17 bananas.

But along with the high nutritional value of these foods comes high risk. Around the world - but especially in developing countries - meat, milk, eggs and fish are the foods most likely to carry dangerous and all-too-often deadly pathogens like salmonella and E. coli. 

Food safety is starting to get more attention in Africa and elsewhere in the developing world, which should be a good thing. Unfortunately, the attention carries the risk of intensifying both poverty and food problems by pushing governments to adopt high standards that end up damaging markets that are an essential source of food and income for a billion of the world's poorest people. 

The issue is that food safety concerns in the developing world can quickly focus on what appear to be most obvious targets; informal food markets, such as the bustling, unruly "wet markets", where freshly butchered meat and fish is sold in open-air kiosks typically lacking refrigeration, and the urban street vendors, such as the ubiquitous "milk hawkers" plying the morning rush hour in Nairobi with "chupa ya maziwa" - bottles of unpasteurised product.

The burden of disease

A closer look reveals a much more complicated, and often counterintuitive, picture. For example, the carefully shrink-wrapped meat available in the shiny new western-style supermarkets opening up across eastern and southern Africa can be less safe than a piece of beef hanging from a ceiling hook in the rudimentary stalls of wet markets. That finding is among the important insights provided in a new book compiling 25 contemporary studies that focus on food safety in Africa's informal food markets - and which offer lessons relevant for much of the developing world.

An important finding is that informal vendors account for the great majority of meat and dairy purchased in sub-Saharan Africa, where they are often the only source of such foods available.

These informal food vendors will remain predominant for decades to come because even when incomes rise, many consumers still prefer to buy directly from producers who sell fresher, cheaper and more local kinds of food (supermarket prices are frequently double those of informal markets and you need a car to get to them).

These new studies reveal that informal markets are essential to more than food security. In Africa and other developing regions, where most food is produced by the poor, for the poor, informal markets are an important source of income for millions of poor families.

And because Africa's smallholding farmers are rarely sought out to supply supermarkets, selling livestock products - by far and away the most valuable of all farm commodities - in informal markets is often the only thing providing households with a regular cash income.

That said, informal markets - given their prominent role in feeding the developing world - must play a role in reducing food-borne illnesses. Unsurprisingly, analyses of informal sellers show that over-ripe meat and seafood in wet markets, and milk souring on the back of a milk hawker's bicycle, can contain hazardous pathogens such as E coli, brucella and campylobacter. And these pathogens are particularly burdensome in poor countries.

Hazard vs risk

In sub-Saharan Africa, at least one out of every 10 cases of gastrointestinal or diarrhoeal diseases - a leading cause of death in the region - is probably contracted from food. Milk tainted with bacteria such as brucella can also lead to debilitating disease (brucellosis).

Young people, old people, pregnant women and the immunosuppressed are most vulnerable to food-borne disease. In sub-Saharan Africa, the high incidence of HIV/AIDS leaves many especially vulnerable to dying from diseases like tuberculosis that otherwise would be relatively mild or at least survivable.

But the effort to improve food safety in places like sub-Saharan Africa requires a keen eye for how food is consumed. For example, food that appears hazardous in the vendor's stall is not necessarily a risk once it reaches the consumer's plate.

Researchers found that in countries such as the Ivory Coast, Kenya, and Ghana, the vast majority of people boil their milk before consuming it, which kills off many pathogens that can be present in unpasteurised (or "raw") milk. Fermentation also is routinely employed for milk products, a procedure that makes the milk much safer, while for meat and seafood, many consumers understand that thorough cooking is required.

For example, in Kampala, Uganda, the city council tried to shut down informal markets selling pork after a superficial investigation by a government veterinarian who claimed local butchers were not using safe practises. But further investigation revealed the meat posed little risk.

Heavy-handed moves like this ultimately do little to improve food safety but they can do a lot to intensify hunger and poverty in regions where both are already big problems.

Approaches to food security

We have examples of approaches to food security that have worked in Africa. A recent push to improve handling practises among milk hawkers in Kenya reduced food-borne diseases. Training vendors and offering them incentives - rather than punishing them - resulted in lasting benefits worth $28m per year.

Training butchers in Nigeria reduced the number of unsafe meat samples by 18 percent. Every butcher trained, saved $780 in avoided costs for treating diarrhoea caused by unsafe handling practises.

Customers are also receptive to public information. For example, 40 percent of consumers in Vietnam switched to alternative meats when media reported meat safety problems. Researchers also found that poor consumers are willing to pay a 5 to 15 percent premium for products that carry safety assurance.

Just like food itself, food safety is typically viewed through cultural traditions and these need to be acknowledged as well. There are herding communities in Mali that believe boiling milk destroys its life-giving properties. In Ethiopia, where young men consume raw meat as a way to improve their strength and courage, raw meat is common, and commonly viewed as safe. "A man without a tapeworm is not a man," responded one Ethiopian man to a survey by our research team.

Efforts to improve food safety - whether in developed, emerging or developing economies, but particularly in the latter - need to be informed by good understanding of the (very) different ways people produce, purchase, consume and value food in different parts of the world.

With such understanding, we can do much to help reduce the illnesses people suffer from their daily meals without imperilling their food security or livelihoods.

Delia Grace leads the Food Safety and Zoonoses programme at the International Livestock Research Institute (ILRI), based in Nairobi, Kenya

Kristina Roesel coordinates ILRI's Safe Food, Fair Food project, based in Kampala, Uganda