Realizing the link between food safety and
nutrition security: the case of aflatoxin
control across food systems in AfricaAmare Ayalew
PACA Secretariat
2016 Integrated Nutrition Conference
Nairobi, Kenya, 14-16 November 2016
FAO food security definition expressly
links nutrition and food safety as
integral components:
Food security exists when all people, at all
times, have physical access to sufficient, safe
and nutritious food which meets their dietary
needs and food preferences for an active and
healthy life.
Unfulfilled linkages between food
security, nutrition and food safety
Disproportionate focus on supply, with
emphasis on food production & stock
availability
Over the last decade, the necessity to embed
nutrition into agriculture commands global
attention
Unsafe, contaminated foods still thwart food
security and nutrition
Food safety impacts on nutrition:
Contaminated food could cause disease,
immune suppression and stunting
When contaminated crop is withdrawn from
the supply chain the quantum of food is
directly impacted
Food contamination affects rural incomes and
access to food
Aflatoxins illustrate multi-faceted impact
of food safety across food systems (among most pervasive food safety challenges in Africa)
Public health
Food and nutrition security
Trade and
economy
30% of liver cancer
cases in Africa
40% of commodities in local African markets exceed allowable levels in foods
Africa loses up to
US$670 million
annually from lost export
Summary of Aflatoxin Prevalence in Key Crops
from AfricaAIMS 2015 Surveillance Study
Aflatoxin Prevalence in Foods
(PACA AfricaAIMS, 2015/16)
Occurrence of Aflatoxin M1 in Milk
Location Samples Positive >50 ppt >500
ppt
Max level
detected
Reference
Dar es
Salaam, TZ
37 92% 24% 855 ppt (Urio et al. 2006)
Nairobi,
Kenya
128 100% 63% 2,560 ppt (Kiarie et al. 2016)
Rural Kenya (4
AEZ)
512 40% 10% 0.6% 6,999 ppt (Senerwa et al.
2016)
Libya 49 71% 3,130 ppt (Elgerbi et al. 2004)
Addis Ababa,
Ethiopia
110 100% 92% 26% 4,980 ppt (Gizachew et al.
2016)
Cameroon 63 16% 9.5% 527 ppt (Tchana et al. 2010)
Kenya case study:
1981, 2001, 2004, 2005, 2006, 2014
41.5% case fatality
Country Subject Sample Aflatoxin levels:Incidence (Mean)
Reference
Benin/TogoBenin
Children (n=480)Children (n=200)
BloodBlood
99% (32.8 pg/mg)98-100% (37.4-86.8)
Gong et al. 2003Gong et al. 2004
Cameroon Infants (n=220)Adults (n=175)
Urine n/a (0.33ng/mL)9.1% (0.05µg/L)
Ediage et al. 2013Abia et al. 2013
Egypt Lact. mothers (n=46)Preg. women (n=98)
BloodBloodUrine
37% (50ppm)35% (4.9 pg/mg)48% (19.7 pg/mg)
Shouman et al. 2012Piekkola et al. 2012Piekkola et al. 2012
Nigeria Adults, adolescents & children (n=120)
Urine 14.2% (0.3µg/L) Ezekiel et al. 2014
Senegal Adults (n=168) Blood n/a (45.7 pg/mg) Watson et al. 2015
The Gambia Children (n=472)Preg. womenPreg. womenChildren (n=138)
BloodBloodCord bloodBlood
93% (22.3 pg/mg)100% (40.4 pg/mg)48.5% (10.1 pg/mg)11% (8.7 pg/mg)
Turner et al. 2003Turner et al. 2007Turner et al. 2007Turner et al. 2007
Tanzania Children (n=166)Children (n=166)
BloodBlood
84% (12.9 pg/mg)99% (23.5 pg/mg)
Shirima et al. 2015
Uganda Adults (n=100)Children (n=96)
BloodBlood
100% (11.5 pg/mg)95.8% (9.7 pg/mg)
Asiki et al. 2014
Occurrence of Aflatoxin in Human Body Fluids
Evidence on association of aflatoxin
exposure and child growth
Geography Findings (correlation) Reference
Ghana, The
Gambia
Exposure during
pregnancy and smaller
babies during the first
weeks of life
Barett (2005),
Review
Tanzania Exposure and reduced
weight and height among
breast fed infants under 6
months
Magoha et al.
(2014)
Benin, Togo Between higher levels of
aflatoxins and lower
growth rates
Gong et al. (2002)
Togo, Iran, Kenya,
UAE
Exposure and stunting in
children
Barett (2005),
Review
Factors influencing pre- and post-harvest aflatoxin risks in Africa
Aflatoxin challenge in Africa
Conducive climatic
conditions
Complexity –difficulty of
targeting interventions
Heavy reliance on
dietary staples
Low awareness
levels
Traditional agronomic practices
Weak institutional
capacity
Groundnut shelling, Senegal 2015,
improvements needed
Photo: PACA
PACA’s vision and mission
• Vision: an Africa free from the harmful effects of aflatoxins
• Mission: to support agricultural development, safeguard consumer health & facilitate markets & trade by catalyzing, coordinating & increasing effective aflatoxin control along agricultural value chains in Africa
Endorsed by the AU Joint Conference of Ministers of Agriculture and Ministers of Trade in 2012
PACA Secretariat’s Strategic Direction:directly support governments to have wide sphere of influence for
systemic change in aflatoxin control, while forging strong
partnerships with private sector and other players
PACA Secretariat’s systemic change approach -
How?
1. Strong knowledge base through:
– Searchable database with credible data and information;
– Sharing knowledge through meetings/conferences.
2. Implementation sustainability through inclusion of aflatoxin mitigation in:
– national development strategies; e.g. CAADP
– national quality and standards programs;
– national agricultural extension, community health and
education curricula;
– Market incentives (‘carrot’) and regulatory enforcement
(‘stick’)
PACA Secretariat’s systemic change approach –
How?
3. Scaling and replicability through:
– Awareness and behavior change interventions;
– Massive training and program shadowing;
– Technologies and practices appropriate for
multiple agro-ecological zones of countries;
– Enabling policies for technology adoption
4. Financial sustainability through:– Government support and allocation of resources
to activities;
– Private sector and development partnersinvestment in aflatoxin prevention and control;
– Monitoring and evaluation of program implementation
PACA Secretariat focus on six pilot countries with
a plan to scale
Maps are illustrative
Gambia, Malawi, Nigeria, Senegal, Tanzania, Uganda
National Action Plans for Aflatoxin
Control: some componentsThe Gambia
Malawi Nigeria Senegal Tanzania Uganda
Period 2016 – 2026 2013-2018 To be
developed
To be
validated
2016-2018 2015-2025
Key
components
Create broad
awareness
Mainstream
GAP
Enhance
awareness
Enable VC
actors to comply
with regulations
Strengthen
capacity in GAP
and PH handling
Develop
national
implementatio
n capacity
Develop
capacity for
diagnostic
Build
capacity for
risk
assessment
Risk
assessment
institutional
framework
Enhance
capacity of VC
actors
Create
conducive
policy
environment
Provide a
supportive
regulatory
policy
framework
Popularize
mitigation
measures
Improve
regulatory
system
Increase
awareness VC
actors
Enhance
coordination,
monitoring
Create broad
awareness
Strengthen
national
food control
Enhance
research
Improve
compliance
Improve
regulatory
and legal
framework
Enhance
awareness
M&E
Private sector priorities for aflatoxin control:
(from CTA-PACA Private Sector Roundtable)
• Creating demand for safe food
• Make the latest technology available to the private sector players
• Find matching funding for cost of mitigation technologies and aflatoxin testing
• Understand the level of the aflatoxin problem at country level
• Detoxification/alternative uses of contaminated produce
• Supply chain approach to make the system work
Main messages
• Food safety, nutrition, food security and public health are linked
• Embed food safety in agriculture and nutrition policies and strategies
• Global attention to food safety for impact at all levels
• Partnership, multi-sectoral and integrated approaches
• Create incentives for safe food to enhance private sector actions toward aflatoxin mitigation (food safety)
Thank You
www.aflatoxinpartnership.org
