Investment, Attention Needed to Improve Food Safety in Low and Middle Income Countries

Meat is prepared for sale in market, Hanoi, Vietnam. Photo: J.Hodur/A4NH

Food safety has skyrocketed up the development agenda. The demand for safe food is growing fast, driven by empowered middle-class consumers, whose numbers are climbing more and more rapidly, from 1 billion in 1985, to 2 billion in 2006, to 3.2 billion in 2016 (Brookings Institution). The food safety concern is supported by a 2015 World Health Organization report, estimating that foodborne disease constitutes a health burden comparable to that of HIV/AIDS, malaria, or tuberculosis.

This report rightly focuses on in low- and middle-income countries (LMICs): LMICs have the greatest share of the burden of foodborne disease, while their food systems are changing the fastest. Fresh foods, such as vegetables, eggs and fish, are key to improved diet diversity and become available as incomes rise and the food supply becomes more complex. These are also the foods that cause the greatest food safety concerns, overwhelmingly from microbes and parasites. Quickly growing rates of urbanization in many countries means consumers are farther from the sources of their food, and have less time to shop for and prepare it. Increasingly, cooked food is bought and consumed outside the household which can stimulate local economies but increase some health risks.

Food systems vary significantly from place to place. With so many factors involved, it is critical to understand the food system context of a particular country – particularly the role of informal domestic markets for perishable foods. These informal markets play an integral but complex role in the food systems of many low- and middle-income countries: food safety is tied up with accessibility of nutritious foods; women’s livelihoods; urban planning; and laws and standards Understanding these roles will be critical to developing and supporting policies and practices to better ensure food safety as the distance between the consumer and the source of the food grows.

Women milk traders. Photo: B.Collis/ILRI

The World Bank’s new report, “The Safe Food Imperative: Accelerating Progress in Low- and Middle-Income Countries,” makes the case for countries to pay attention to and invest in food safety. Investments must be appropriate to the national food system context, which means there is no one-size-fits-all solution, and nuances must be taken into serious consideration. The report also notes that we cannot rely on the export-led supply chains for guidance: there is little spillover here between what stays in the domestic market and what is bound for international markets.

Not only must countries seek solutions appropriate to their own internal contexts, but they must also be prepared to change those solutions. Food systems, markets, and supplies are constantly evolving, and so must our responses.

Despite the fact that there are major gaps, identified in the report, on what to do and how to do it, this is a time for hope and energy, not despair. Food Safety is one of A4NH’s flagship research programs, and in our work, we see many researchers working around the globe with policymakers, private-sector partners, and others to help countries design and assess policies, regulations, and interventions that are appropriate to their particular context. We see progress in the keen interest many countries are paying to improving food safety in their country, from Vietnam’s attention to informal markets to Kenya’s considerations on the milk supply chain. Lessons we learn from one another moving forward will help those working in other areas address their own challenges. While the problem is considerable, there is great optimism for, and momentum towards, tackling these challenges and ensuring a safe food future for all.


John McDermott, Director of the CGIAR Research Program on Agriculture for Nutrition and Health, served as a Peer Reviewer on the World Bank report. Delia Grace, who leads A4NH research on Food Safety, was a Lead Author.