Research programs point the way forward for food safety in Ethiopia

New research has revealed the health and economic impacts of foodborne diseases in Ethiopia, as well as the challenges and opportunities for improving food safety in the country. The research was conducted by six food safety research projects and presented at a conference organized by the International Livestock Research Institute (ILRI) in Addis Ababa on 26–27 October 2023.  

Examining the dairy, meat and vegetable value chains, the studies assessed the prevalence and impact of major foodborne pathogens in Ethiopia. The results suggest that the evidence can be used to inform policy and intervention design to enhance food safety and nutrition, reducing disease burden and improving health. 

The research identified some of the critical knowledge gaps and research priorities for food safety. These included the need for more investment from both public and private sectors, the key role of consumer demand and awareness in driving improvements in food quality, and the need to use innovative tools and approaches to enhance food safety. 

‘The collaborative, multi-stakeholder approach used in these studies has been crucial in identifying critical control points across food chains. By prioritizing these points, we can significantly reduce the incidence of foodborne illnesses and deaths, making our food systems safer and more resilient,’ said Theo Knight-Jones, principal scientist and team leader of herd health at ILRI. 

‘Multi-stakeholder approaches along the food safety value chain ensured that we involved regulators, producers, processors, traders, consumers, and researchers in addressing food safety issues,’ he added.

Many studies found high levels of bacterial pathogen contamination in different food items.  Twelve foodborne pathogens were ranked as the most significant public health concerns based on burden-of-disease estimates. Stakeholders then prioritized critical control points in four food chains—dairy, beef and small ruminant meat, poultry meat and eggs, and vegetables—that would contribute most to preventing illnesses, especially fatal ones.

‘Our findings reveal the staggering economic cost of foodborne diseases in Ethiopia, estimated at USD $723 million annually. This figure only accounts for three major pathogens, suggesting the total economic burden is much higher. Addressing food safety is not just a public health priority but also an economic imperative for the country,’ Knight-Jones explained.

Two key bacteria, Campylobacter and non-typhoidal Salmonella, are reported to cause illness in an estimated 400,000 people and the death of 190 in Ethiopia every year from eating contaminated beef. Dairy products are estimated to cause 500,000 cases of illness and 200 deaths, and an even greater burden is attributed to their presence in chicken: 1.8 million reports of illness and 850 deaths. Likewise, vegetables are linked to 300,000 cases of illness and 320 deaths per year from non-typhoidal Salmonella and enterotoxigenic E. coli.

During the conference, the Ethiopian National Steering Committee for One Health launched the One Health National Food Safety Technical Working Group. This specialized group aims to serve as a platform to exchange information on food safety in the country and discuss the evidence that informs decisions to improve food safety. It is supported by the ILRI through the CGIAR initiatives on One Health and Resilient Cities.

The research was led by ILRI, Ohio State University, University of Florida, Addis Ababa University, and the Technical University of Denmark. It received funding from the Bill & Melinda Gates Foundation and the UK Government Foreign, Commonwealth and Development Office (FCDO). 

The six projects are:

• Pull-push: This project incentivized food safety in urban food markets in Africa by creating demand for safe food and strengthening the capacity of value chain actors to supply it. Running from 2018 to 2022, it was implemented in urban informal markets in Burkina Faso and Ethiopia. Lead institution: ILRI.
• TARTARE (The assessment and management risk from non-typhoidal Salmonella, diarrheagenic Escherichia coli, and Campylobacter in raw beef and dairy in Ethiopia): This project focused on three major food safety pathogens found in raw beef and dairy products (also frequently consumed raw in Ethiopia): non-typhoidal Salmonella enterica, shiga-toxin producing Escherichia coli, and Campylobacter species. It assessed the risk factors, transmission routes, and health outcomes of these pathogens along the value chain. Lead institution: Ohio State University.
• ENSURE (Ensuring the safety and quality of milk and dairy products across the dairy value chain in Ethiopia): This program focuses on improving the safety and quality of dairy foods in Ethiopia by building the capacity of Ethiopian academic, government, and industry institutions for monitoring the prevalence of foodborne microbiological hazards through food safety training. 
• FOCAL (Foodborne disease epidemiology, surveillance, and control in African low- and middle-income countries, LMIC): This project aimed to estimate the burden of foodborne diseases in four African LMICs by combining different microbiological and epidemiological methods. It also evaluated the cost-effectiveness of interventions to reduce the burden of foodborne diseases. Lead institution: Technical University of Denmark.
• CAGED (Campylobacter genomics and enteric disease in Ethiopia): This research sought to understand the livestock reservoirs for Campylobacter infection, which is a leading cause of diarrheal disease in humans. This project used genomic tools to characterize the diversity, evolution, and transmission dynamics of Campylobacter strains in livestock and humans. Lead institution: University of Florida.
• EXCAM (Exposure to enteric pathogens in rural northwest Ethiopia): This project aimed to measure child exposure to enteric infection in rural northwest Ethiopia by collecting and analyzing fecal samples from children under five years old and their household animals. It also explored the associations between enteric infection, environmental factors, and child growth. Lead institution: The University of Florida