Foodborne disease is a significant threat to global health, and food safety is a growing concern among consumers in low- and middle-income countries as these countries develop and incomes increase. Ensuring access to safe food, however, is complicated by the fact that our food systems are increasingly complex, with foods traveling longer distances and passing through more stages between where it is grown and where it is eaten.

Food safety is both a health issue and an economic one: Foodborne disease carries a global health burden comparable to that of malaria or tuberculosis, and affects everyone who eats food—meaning all of us. At the same time, the food system is a major source of employment worldwide, including people who grow, transport, package, sell, and prepare foods. Taking a hard line on food safety can mean excluding some of these people, whose small scale makes the adoption of recommended practices, or testing for hazards, impossible.

How, then, can we address the need to ensure food safety in the context of these changing food systems, while also ensuring broad-based, inclusive growth? In a new paper, “Food safety in low and middle-income countries: The evidence through an economic lens,” published in World Development, we took a look at food safety issues and research done at each stage of the value chain, to identify the economic questions, practical challenges, and knowledge gaps along the way. While there are many variations among value chains and geographic locations, there are lessons that can be drawn from some areas and applied to others. Further, by identifying gaps that exist, we can better inform the conversation on where additional information is needed, and why.

Consumers: Our consideration begins with the consumer; after all, it is their needs and preferences that ultimately drive the food system, while their handling of food constitutes a major source of foodborne illness. Among this very large and diverse group, a few themes emerge:

• What do consumers know about how to keep their food safe, and where do they get that information? Education campaigns can play a major role in ensuring consumers are able to protect themselves and their families from foodborne illness.
• While information on how to safely store and handle food is critical, it may not be enough to change consumer behavior. Moreover, a consumer’s ability to follow some of these guidelines, such as refrigeration or using safe water to wash and prepare, will vary greatly from place to place.
• We need to rely on estimates of consumers’ willingness to pay for safe food that are based on observed behavior and not shaped by what the consumer thinks the right answer is.
• The need for safe food transcends economic standing. We need to be cautious of approaches that rely on premium prices to deliver food safely, so that safe food reaches poor consumers as well as those more affluent.
• Often, consumer responses to food safety concerns are driven by misunderstanding of risks, or scares that disproportionately impact decisions. Consumers need reliable sources of information on food safety.

Food providers and retailers: Working back from the consumer, the next step in the value chain is often the person selling food to the consumers, whether it involves preparation, such as from a restaurant or street vendor, or not, as in a supermarket or wet market.

• Providers: particularly as more people are moving to cities and finding themselves with less time to prepare their own food, restaurants and street vendors are growing in prominence. Yet these agents often have no more knowledge about safe food storage and preparation than consumers. Would approaches taken in developed countries, like issuing letter grades to food vendors for safety and hygiene, be transferrable to low- and middle-income countries?
• Enforcing food safety standards across retailers must take into account the variety of retailers operating and recognizing their differences, to ensure the needs of consumers are met. Supermarkets and wet markets serve different demographics and needs, but both need support in developing and implementing food safety standards that are responsive to their differences in operation.

Aggregators, processors, and manufacturers: A lot can happen between when food leaves the farm and when it gets to the market or restaurant—transport, milling, canning, bottling, and other activities all expose food to potential safety problems.

• Many food producers in developing countries operate on smaller scales, requiring these activities be done by third parties.
• Attention must be given to preventing fraud, ensuring accurate standards for certification are established, and efficient testing systems are put into place. These steps can help protect not only producers and consumers, but also the economic interests of all parties involved between them.

Producers: Finally, we have worked back to the origin of the food itself, another key area where food safety risks can be introduced. Producers vary in size, capacity, and knowledge, but working to create a system that works for and supports all will help ensure, in turn, that all consumers have greater access to food that is safe.

• As with consumers, ensuring farmers have access to knowledge on how to handle animals, waste, water, and other food safety practices is critical, as is maintaining those standards regardless of where food is heading—the domestic market as well as for international export.
• Standards and regulatory approaches must take smallholder farmers into account, and be supportive, not punitive. This does not mean they should be lenient, but that they should include support and capacity-building to enable farmers to achieve compliance. Otherwise, farmers may simply sell food that doesn’t comply with standards into informal markets where those standards are not enforced, putting vulnerable populations at greater risk of consuming unsafe food.

Answering these questions and meeting these needs will take time. Indeed, one lesson that can be drawn from both developed and developing countries with regard to food standards is that there is no one-size-fits-all approach, and policymakers will need to consider the specific of the circumstances when working to make improvements along the value chain. Alongside these efforts, researchers can help fill evidence and knowledge gaps on a variety of questions that remain outstanding, including those related to how information is shared and received, the value consumers put on certification, how testing can be feasible, the impacts of price, how trade-offs are weighed, and more.

The silver lining of this complex and serious situation is that there is much attention to it, and much work being done to test different approaches, interventions, and policies. This creates a wealth of resources to be drawn from, and a host of opportunities to improve the system. Bit by bit, we can ensure everyone has access to food that is safe.

Vivian Hoffmann is a Research Fellow with IFPRI’s Markets, Trade, and Institutions Division. She conducts research under the CGIAR Research Program on Agriculture for Nutrition and Health (A4NH)’s Food Safety flagship. This post also appears on the A4NH blog.