Food safety in developing countries

I've written a couple of recent articles about street food in developing nations (Brazil and Nigeria, specifically), and the evidence was pretty overwhelming that there's a lack of formal food safety training in these countries, which leads to mediocre food handling practices and increases food safety concerns. A study in Critical Reviews in Microbiology took a broader look at food safety practices in developing countries by performing a thorough literature search, and highlighted some of the concerns with the current system.

One of the first things they pointed out is that food safety is "well recognized" as a primary indicator of economic growth in the developing world. In other words, it's not only important to ensure a safe food supply for health reasons, but also for economic reasons. The cost of health care treatment, missed employment, and lowered production are all financial reasons for improved food safety systems. While countries like the U.S.A. and Canada closely track the economic impacts of food-related outbreaks, and can identify specific numbers of specific illnesses, the researchers found no such data for developing nations. Besides the fact that the majority of food-borne illnesses go unreported (everywhere, not just in developed countries), there's also a lack of formalized surveillance programs in developed countries that could identify these cases and outbreaks. The lack of information is actually representative of a problem unto itself: you can't manage what you can't measure. Without the surveillance systems in place, knowing where to start a food safety program in a developed country would be guess-work, at best.

The authors estimate that 1.8 million children die from diarrheal diseases in developing countries every year. The lack of potable water, adequate medications, and inappropriate hygiene all contribute to an inability to adequately prevent diarrhea from becoming deadly. The lack of post-exposure solutions highlights the importance of preventative systems to ensure diarrhea is not contracted in the first place. Unfortunately, while "improved hygiene, sanitation, and awareness" would lead to reduced illness, death, and economic burdens in developing nations, the fact remains that "poor food supply systems and microbiological contamination" are rampant. Specifically, the authors highlight that "microbiological contamination ... has been identified as a potential cause of food-borne illness in Latin American countries", and that "Argentina has the highest incidence of HUS (hemolytic uremic syndrome) in the world".  They also referenced a study in which Brazilian chickens were analyzed for Salmonella contamination, which found antibiotic resistant strains of S. enteritidis and S. infantis. So, not only does the microbial contamination exist, it exists in a form that would be nearly impossible to quickly and properly treat in developed countries.

Tying in with the street food studies that I've recently written about, Akhtar, Sarker, & Hossain point out that "street vending of foods is believed to be a potential cause of illness and thus needs to be precisely focused". This echoes what the other studies have suggested as well: street food brings about some unique challenges to safe food handling, and hazard management needs to be able to mitigate these specific dangers. When considering the economic benefits of street food that were identified in Nigeria & Brazil, this paper's commentary on the detriments of food-borne illnesses to developing nation's economies makes even more sense. In these nations where street food is considered a great way for females to make money and provide for their families, lack of controls and food safety programs could derail the entire system.

So, while it's clear what needs to be done, why hasn't it happened yet? Akhtar et al indicate an "absence of political commitment, intervention of international agencies, awareness, and strict legislation". Political commitment is clearly one of the most important first steps that needs to occur, however. Agencies like the UN and WHO are unable to provide anything more than information and basic guidance unless the leaders of these developing nations are willing and able to commit to specific food safety programs. Education, legislation, and funding for enforcement all need to be in place before change can occur. It may be a difficult sell to convince poor nations to provide funding to preventative measures, but with further research into the true economic cost of food-borne illnesses in developed countries, a strong case could be made that prevention is the best medicine.

Source: Akhtar, S., Sarker, M.R., & Hossain, A. (2014). Microbiological food safety: a dilemma of developing societies. Critical Reviews in Microbiology, 40(4), 348-359.