PACA aims to support agricultural development, consumer health, and trade in Africa by coordinating efforts to control aflatoxins. Aflatoxins contaminate staple crops and negatively impact three sectors - public health, trade, and food security. They reduce export market share, cause liver cancer and stunting in children. PACA works with over 200 organizations across Africa, providing technical assistance, resources, and knowledge sharing. It implements an evidence-based approach through national plans in six pilot countries and regional activities. PACA's goals are to generate evidence, mainstream plans, pilot approaches, and scale up effective aflatoxin control along agricultural value chains.

1. Role of Partnership for Aflatoxin
Control in Africa (PACA)
Amare Ayalew (email: Amarea@africa-union.org)
PACA Secretariat
Aflatoxin Experts Roundtable Meeting
Brussels, 25 January 2016

2. What are Aflatoxins?
• Invisible poisons that
contaminate many food and
feed produce
• Complex making
targeting interventions
difficult
– Preharvest: increases
with crop stress –
drought, pest
– Postharvest: Increases
further with poor drying
and storage
• Persistent - difficult to
destroy or remove through
normal food processing
Public health
Trade and
economy
Food and
nutrition
security
• Affect three sectors

3. The Trade and Economic Challenge
Picture: after Mbaye(2004)
Example: The Groundnut Subsector of Africa:
• Regulatory limits on aflatoxins impact export trade and income
• In the 1960s (during the days of the Kano ‘groundnut pyramids’
and the barges of groundnut on the River Gambia) Africa had
77% share of world groundnut export market.
• By 2000, Africa's share was just 4%.
• The value of the groundnut market 2000-2007 was about US$1.6
Bn.
• If Africa still had a 77% market share its export value would be
about US$1.2 Bn, instead it gets just 64 million!
• On the other hand, Africa is the only region in the world where the
supply of aflatoxin prone raw materials, such as groundnuts, will
far exceed the internal demand for the years to come.

4. The Trade and Economic Challenge
Picture: after Mbaye(2004)
Quick facts:
• Regulatory limits on aflatoxins impact export trade and income
• In the 1960s (during the days of the Kano ‘groundnut pyramids’ and the
barges of groundnut on the River Gambia) Africa had 77% share of
world groundnut export market.
• By the 2000s, Africa's share was just 4%.
• The Value of the groundnut market 2000-2007 was about US$1.6 Bn.
• If Africa still had a 77% market share its export value would be about
US$1.2 Bn, instead it gets just 64 million!
• About 57% of South African food and feed export rejections to the EU
were due to mycotoxins.
• On the other hand, Africa is the only region in the world where the
supply of aflatoxin prone raw materials, such as groundnuts, will far
exceed the internal demand for the years to come.

5. The Health Challenge
 Acute poisoning: high exposure to aflatoxin, often
fatal
 Liver Cancer: 5-30% of all liver cancer cases
globally are linked to aflatoxin exposures, with the
highest incidence (40%) occurring in Africa
In most vulnerable populations, higher aflatoxin levels
equals:
– Pregnant women
• higher anemia, higher maternal mortality
• lower birthweight babies
– Children
• stunted growth and cognitive development
Kenya case study: linked to
contaminated maize consumption
Outbreaks: 1981, 2001, 2004,
2005, 2006, 2014
41.5% case fatality

6. The Health Challenge
 Acute poisoning – high exposure to aflatoxin,
often fatal
 Liver Cancer – one of the biggest cancer killers
in Africa, from chronic extended exposure
In most vulnerable populations, Higher aflatoxin
levels equals:
–Pregnant women
• higher anemia, higher maternal mortality
• lower birthweight babies
–Children
• stunted growth and cognitive development
Acute
Immune system
suppression
Chronic effects
Liver Cancer
Stunting and underweight in children
4.5 billion people are chronically exposed
Difficultyofdetection
increases
Symptomsofillness
Outbreaks in Kenya: linked to
contaminated maize consumption
1981, 2001, 2004, 2005, 2006, 2014
41.5% case fatality

7. The Food Security Challenge
• Aflatoxin makes nutritious food
harmful for human consumption
– When contaminated crop is
withdrawn from the supply chain
or when unsafe food is consumed
food security is undermined
– Contaminated food is pushed to
the resource-poor
– Children are more susceptible
• Productivity of livestock is
reduced, e.g.:
– Livestock have lower feed
conversion ratios when feed is
contaminated
– Mortality rates up to 29% in the
poultry industry

8. 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

9. Current research on aflatoxin and stunting
(funded by BMGF)
Study Expected contribution Lead organization
1. The relationship
between aflatoxin
exposure and child
stunting in W&S Africa
- Determine mechanism
by which aflatoxin inhibit
early growth
- Validating biomarkers
Queen’s University of
Belfast, UK, led by
Yun-Yun Gong
2. Association of
aflatoxin exposure and
childhood stunting in
Bangladesh
Improve understanding of
how aflatoxin affect the
growth of children under 5
in Bangladesh
ICDDR, Bangladesh
with Univ. Venda, SA;
Univ. Virginia, Univ.
Pittsburgh, USA
3. Mycotoxins as a risk
factor in childhood
growth impairment
worldwide
Integrated information on
the role of dietary
mycotoxins in child growth
impairment
Michigan State
University, USA, led
by Felicia Wu
4. Assessing aflatoxin
exposure and
malnutrition among
children in East Africa
Pathogenesis of toxin-
induced gut dysfunction
and child stunting
Cornell University,
USA

10. Economic Impact Estimates: Case
Studies (PACA, 2012; 2015)
Country DALYs lost Monetized burden
Nigeria 100,965 between USD112 and 942 million
The Gambia 93,638 USD 94.4 million
Senegal 98,304 between USD 78 and 138 million
Tanzania 546,000 between USD 92 and 757 million
• Costs based on monetization of the DALYs is economic loss due to mortality and morbidity.
• Estimates capture only the amount of money that would be saved from DALYs, if efforts to
reduce aflatoxin exposures were exercised.
• Estimates do not take into account potential impact on national and international trade.
• Senegal estimated cost of action to achieve 20 ppb standard: USD 35 million

11. Aflatoxin is a complex developmental
challenge for Africa
• Multi-ministerial – challenges
governments
• Multi-sectoral – challenges
development partners
• Multi-country – challenges
standards and regulations
• Continent-wide – undermines
achievement of Malabo
Declaration Commitments,
especially in trade growth and
rural poverty reduction
Public health
Trade and
economy
Food and
nutrition
security

12. Aflatoxin
challenge
in Africa
Conducive
climatic
conditions
Complexity –
difficulty of
targeting
interventions
Heavy
reliance on
dietary
staples
Low
awareness
levels
Traditional
crop
production
practices
Weak
institutional
capacity

13. Interactive map on the PACA
website:
Disclaimer: The Database only
includes activities that have been
submitted to the Secretariat
There is growing attention to aflatoxin
control, yet inadequate and not well
coordinated:

14. Partnership for Aflatoxin
Control in Africa is a
flagship program of AU
Commission
Mission:
To support agricultural
development, safeguard
consumer health and facilitate
trade by catalyzing, coordinating
and increasing effective aflatoxin
control along agricultural value
chains in Africa

15. About PACA
• Innovative partnership that unites over 200
organizations from 54 countries in Africa
• Comprised of public, private sector & non-state
actors
• Coordinated by a Secretariat at African Union
Commission
• Governed by a multi-sector Steering Committee
• Focused on producing results at country-level,
with continental and regional coordination

16. Technical
Assistance
Financial
Resources
Knowledge
manager
PACA Secretariat roles:
Provide TA in the short-term (3 years)
Mobilize resources and support
projects aligned with country plan
approach
Provide catalytic grants: e.g. testing
equipment to enhance gov’t capacity
Aggregate evidence, gather
knowledge, and disseminate
information
Convener
Work with RECs and other
stakeholders to convene continental,
inter-regional, regional, and country
forums
Long-TermRole
Short-
Term
Role

17. • Serve these roles and conduct
activities at three levels:
– Continental
– Regional
– Country-level
PACA Secretariat Activities

18. The PACA Model at country level:
• Directly support member state governments
while forging strong partnerships with private
sector and other stakeholders
• Generate evidence to inform policies and
interventions for aflatoxin control, feeding into
national plans (six pilot countries completed this)
• Mainstream aflatoxin control plans into
existing strategies and frameworks (e.g.
Tanzania and Uganda)
• Pilot the national plan approach in selected
countries and scale

19. PACA pilots evidence based model in 6 countries
and will be further scaling
Maps are illustrative
Phase 1 Pilot Countries: Gambia, Malawi, Nigeria, Senegal,
Tanzania, Uganda

20. Generation and use of locally relevant
evidence is key for impact in Africa

21. Continental and Regional Support
• A wealth of information and experience sharing
• Example 1: Africa Aflatoxin Information Management
System (AfricaAIMS):
– One-stop information portal for all aspects of aflatoxins
– Pilot countries received equipment, training and technical
backstopping for data generation and submission
– To be developed into searchable database
• Example 2: Experience sharing and peer-to-peer
learning:
– PACA PPM (Oct 2014): identified action areas at different
levels
– Regional Workshop on groundnut VCs (Sept 2015)
formulated signature projects to revive the subsector

22. Additional research needs from
PACA Perspective
1. Conclusive evidence: Mechanism for stunting
beyond correlation; additional studies on human
health, including effect of aflatoxins on immune
modulation
2. Control: Innovations to develop options for
aflatoxin control
3. Testing: Harness innovations to develop rapid,
low-cost, adoptable aflatoxin testing methods
4. Alternative uses: Detect-Decide-Decontaminate
(3D for aflatoxin control); overcome challenge of
alternative uses where food control systems are
weak

23. Notions of Evidence
(From J. Lomas et al., 2005 cited by Philip Davies (2015)
Policy Makers:
• Colloquial
(Narrative)
• Anything that seems
reasonable
• Policy relevant
• Timely
• Clear Message
Researchers:
• ‘Scientific’
(Generalizable)
• Proven
empirically
• Theoretically driven
• As long as it takes
• Caveats and
qualifications
Knowledge Transfer
PACA is a unique organization in the area of aflatoxin
control that is driving policy uptake of research results!

24. Where do policy makers go to look for
evidence? (from Philip Davies, 2015)
Academic/Evaluation Research?
PACA:
• Provides policy
guidance in
aflatoxin control
and food safety
• Leverages on
continental
convening power
and political clout
in policy
dialogues and
delivery

25. Main messages for impact
1. Knowledge and information: less well documented health
and nutritional impacts of aflatoxin; further research
2. Evidence-based and coherent policy development:
Avoiding parallel structures and developing AfricaAIMS as a
one-stop shop for data on aflatoxins in Africa
3. Support innovation: revive worst affected crop value
chains and other subsectors and increase market for
smallholders and promote agribusiness
4. Strong commitment to serve Africa (smallholders and
business)
5. Embedding aflatoxin control in nutrition and value chain
development projects involving susceptible
commodities, for better impact!

26. Thank You
www.aflatoxinpartnership.org