AGRICULTURE AND FOOD SERIES The Safe Food Imperative Accelerating Progress in Low- and Middle-Income Countries Steven Jaffee, Spencer Henson, Laurian Unnevehr, Delia Grace, and Emilie Cassou THE SAFE FOOD IMPERATIVE ACCELERATING PROGRESS IN LOW- AND MIDDLE- INCOME COUNTRIES AGRICULTURE AND FOOD SERIES A strong food and agriculture system is fundamental to economic growth, poverty reduction, environ- mental sustainability, and human health. The Agriculture and Food Series is intended to prompt public discussion and inform policies that will deliver higher incomes, reduce hunger, improve sustainability, and generate better health and nutrition from the food we grow and eat. It expands on the former Agriculture and Rural Development series by considering issues from farm to fork, in both rural and urban settings. Titles in this series undergo internal and external review under the management of the World Bank’s Agriculture and Food Global Practice. Titles in this series The Safe Food Imperative: Accelerating Progress in Low- and Middle-Income Countries (2019) The Land Governance Assessment Framework: Identifying and Monitoring Good Practice in the Land Sector (2011) Rising Global Interest in Farmland: Can It Yield Sustainable and Equitable Benefits? (2011) Gender and Governance in Rural Services: Insights from India, Ghana, and Ethiopia (2010) Bioenergy Development: Issues and Impacts for Poverty and Natural Resource Management (2009) Building Competitiveness in Africa’s Agriculture: A Guide to Value Chain Concepts and Applications (2009) Agribusiness and Innovation Systems in Africa (2009) Agricultural Land Redistribution: Toward Greater Consensus (2009) Organization and Performance of Cotton Sectors in Africa: Learning from Reform Experience (2009) The Sunken Billions: The Economic Justification for Fisheries Reform (2009) Gender in Agriculture Sourcebook (2008) Sustainable Land Management Sourcebook (2008) Forests Sourcebook: Practical Guidance for Sustaining Forests in Development Cooperation (2008) Changing the Face of the Waters: The Promise and Challenge of Sustainable Aquaculture (2007) Reforming Agricultural Trade for Developing Countries, Volume 2: Quantifying the Impact of Multilateral Trade Reform (2006) Reforming Agricultural Trade for Developing Countries, Volume 1: Key Issues for a Pro-Development Outcome of the Doha Round (2006) Enhancing Agricultural Innovation: How to Go Beyond the Strengthening of Research Systems (2006) Sustainable Land Management: Challenges, Opportunities, and Trade-Offs (2006) Shaping the Future of Water for Agriculture: A Sourcebook for Investment in Agricultural Water Management (2005) Agriculture Investment Sourcebook (2005) Sustaining Forests: A Development Strategy (2004) THE SAFE FOOD IMPERATIVE ACCELERATING PROGRESS IN LOW- AND MIDDLE- INCOME COUNTRIES Steven Jaffee, Spencer Henson, Laurian Unnevehr, Delia Grace, and Emilie Cassou © 2019 International Bank for Reconstruction and Development / Th e World Bank 1818 H Street NW, Washington DC 20433 Telephone: 202-473-1000; Internet: www.worldbank.org Some rights reserved 1 2 3 4 21 20 19 18 Th is work is a product of the staff of Th e World Bank with external contributions. 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All queries on rights and licenses should be addressed to World Bank Publications, Th e World Bank Group, 1818 H Street NW, Washington, DC 20433, USA; e-mail: pubrights@ worldbank.org. I SBN (paper): 978-1-4648-1345-0 ISBN (electronic): 978-1-4648-1346-7 DOI: 10.1596/978-1-4648-1345-0 Cover Illustration: ©JESS3. Used with the permission of JESS3. Further permission required for reuse. Cover design: Critical Stages LLC Library of Congress Cataloging-in-Publication Data has been requested CONTENTS Foreword xi Acknowledgments xiii About the Lead Authors xv About the Contributors xvii Executive Summary xxi Abbreviations xxxvii Introduction 1 The Food Safety Context 1 Aims and Audiences 2 Study Methods 3 Structure of the Report 3 1. Why Safe Food Matters to Economic Development 5 Introduction 5 Food Safety and the Sustainable Development Goals 6 Understanding the Socioeconomic Impacts of Unsafe Food 7 The Food Safety Life Cycle 15 Summary 25 References 25 2. Evidence on the Burden of Unsafe Food in Low- and Middle-Income Countries 27 Introduction 27 The Public Health Burden of Foodborne Diseases 28 v Economic Costs of Foodborne Disease 38 Food Safety Risks in LMIC Domestic Markets 43 Costs of Domestic Food Safety Failures 48 The Costs of Food Safety Failures in Trade 52 Summary 59 References 59 3. The Status of Food Safety Management in Developing Countries 69 Food Safety Capacity 69 Factors That Motivate Food Safety Capacity and Behavioral Change 73 Benchmarking Food Safety Capacity 77 The Public Sector’s Capacities for Managing Domestic Food Safety Risks 80 The Alternatives to Public Regulation 90 Enabling Smallholder Farmers to Be Food Safety Compliant 97 The State of Capacities for Managing Trade-Related Food Safety Risks 99 Moving toward Risk-Based Imported Food Controls 112 Summary 117 References 118 4. Strengthening Food Safety Management Systems 123 Introduction 123 Steps toward a More Effective Food Safety Policy Framework 125 Better Implementation: Moving from Policy to Action 134 References 154 5. The Way Forward 157 Conclusions 157 A Call to Action for Various Stakeholders 158 Priorities Among Countries at Different Stages of the Food Safety Life Cycle 165 Reference 168 Boxes ES.1 Recommendations for Stakeholders in the Food Safety Life Cycle xxxi 1.1 Food Safety and the Sustainable Development Goals 7 1.2 Market Failures Associated with Food Safety 8 1.3 Dietary Changes in Low- and Middle-Income Countries 14 1.4 The Link between Supermarket Penetration and Income per Capita 18 1.5 Consumer Willingness to Pay for Food Safety 21 1.6 Personal and Institutional Trust in Food Safety Systems 23 2.1 Aflatoxins, Staple Crops, and Public Health 32 2.2 The “Good” and “Bad” Food Safety Practices of Consumers 35 2.3 Antimicrobial Resistance and Links to Food 36 vi CONTENTS 2.4 Estimating the Economic Burden of Foodborne Disease 39 2.5 Sudan Red Dye in Chili Powder from India 51 2.6 Brazil’s Tainted Meat Scandal 52 3.1 Food Safety Culture: What Happens When No One Is Looking 72 3.2 Food Handlers, Training, and Behavioral Change 76 3.3 Tackling Risks from Animal-Based Foods in Vietnam 87 3.4 Shifting Paradigms and Responsibilities in Food Safety Regulation 90 3.5 Limitations of Market-Based Incentives: Aflatoxin Controls in Kenya 96 3.6 Investing in Ukraine’s Food Sector to Secure New Markets 109 3.7 Training of Trainers: Bangladesh Aquaculture and India Spices 110 4.1 Food Safety Lead Agencies in Chile and India 126 4.2 Uruguay’s Risk-Based Approach to Strengthening Food Safety Controls 129 4.3 Prioritizing Sanitary and Phytosanitary Investments for Market Access 133 4.4 Professionalizing