Bi-regional Advocacy Meeting:
Risk Mitigation in Traditional Food Markets in the Asia Pacific Region
1-2 September 2021
Overview of traditional food
markets in Asia Pacific
Hung Nguyen-Viet1, Johanna Lindahl1,2, Fred Unger1, Delia Grace1,3
1 International Livestock Research Institute
2 Swedish University of Agricultural Sciences and Uppsala University
3 Natural Resources Institute, University of Greenwich

Bi-regional Advocacy Meeting on Risk Mitigation in Traditional Food Markets in the Asia Pacific Region
1-2 September 2021
What are traditional food markets?
• Traditional, wet, informal markets: selling dry, fresh
(and sometimes live) food all over the world.
• Wet markets: selling mainly fresh foods such as
meat, fish and vegetables, mostly used in Asia.
• Often poor infrastructure, inadequate health and
safety regulation, sell traditional products,
traditional processing, not licensed, no tax paid,
often some form of compliance with regulation

Bi-regional Advocacy Meeting on Risk Mitigation in Traditional Food Markets in the Asia Pacific Region
1-2 September 2021
Why are traditional markets popular in LMICs?
• 80% food (animal-source foods, vegetables) in LMICs is produced by
smallholders and sold in informal markets
• This provides many benefits to farmers, value chain actors and consumers
but is threatened by concern over health (diseases and food safety)
% production by smallholder livestock farms
Beef Chicken
(meat)
Small ruminant
(meat)
Milk Pork Eggs
East Africa 80 60-90
Bangladesh 65 77 78 65 77
India (< 2ha land) 75 92 92 69 71
Thailand 43 37
Vietnam 80

Bi-regional Advocacy Meeting on Risk Mitigation in Traditional Food Markets in the Asia Pacific Region
1-2 September 2021
Future of traditional markets and research evidence
• Many consumers prefer: cheaper, local products, flexible quantities,
services like credit
• Many consumers lack cars, fridges, storage space that makes
infrequent shopping at supermarkets attractive
• Traditional markets for fresh foods predominate and will persist
• Wet market food often no less safe than formal markets
• Control and command regulation doesn’t work and may lead to worse
practices (forcing underground)
• Solutions based on working with and legitimizing the informal sector
are effective and feasible

5
Foodborne disease: A new priority – much or most
probably from animal-source food
0
2,000,000
4,000,000
6,000,000
8,000,000
10,000,000
12,000,000
14,000,000
16,000,000
18,000,000
20,000,000
Other toxins
Aflatoxins
Helminths
Microbial
Havelaar et al., 2015
31 hazards
• 600 million illnesses
• 420,000 deaths
• 33 million DALYs
zoonoses
non zoonoses
Burden LMIC Cost estimates for 2016 : > US$ 115 billion
Productivity loss 95
Illness treatment 15
Trade loss or cost 5 to 7
Domestic costs may be 20 times trade costs
Food safety
Millions DALYs lost per year (global)

Bi-regional Advocacy Meeting on Risk Mitigation in Traditional Food Markets in the Asia Pacific Region
1-2 September 2021
Safe Food, Fair Food for Cambodia (2018-2021)
A nationwide multi-hazard survey in
markets in Cambodia found the % of
meat (pork and chicken) samples
positive for Salmonella was 43% and of
Staphylococcus was 31%.
The cost of illness of foodborne diarrhoea
was USD 63 per case.
Sample type
N.
Specimen
N.positiveboth
Salmonella andS.aureus
Salmonella
positive
S. aureus
positive
Chicken 186 38 (20.4%) 84 (45.2%) 78 (41.9%)
Cuttingboard chicken 62 6 (9.7%) 26 (41.9%) 12 (19.4%)
Cuttingboard pork 62 1 (1.6%) 19 (30.6%) 7 (11.3%)
Pork 186 33 (17.7%) 85 (45.7%) 58 (31.2%)
Grand Total 496 78 (15.7%) 214 (43.1%) 155 (31.3%)
Cost National
Hospital
(n=44)
Referral
Hospital
(n=60)
Regional
Hosp.
(n=100)
Communi
ty Clinic
(n=62)
Overall
(n=266)
Direct medical cost $ 126 9 28 4.19 34.38
Direct non-medical
cost $
41 8 26 0.3 19
Indirect cost 21 7 11 3 10
Total cost [usd] 186 24 65 8 63
Chea Rortana et al. (2021) Pathogens

Bi-regional Advocacy Meeting on Risk Mitigation in Traditional Food Markets in the Asia Pacific Region
1-2 September 2021
Food safety assessment along key pig value chains
(modern, traditional, food service retail)
SafePORK project: 2018-2022, sampling: 9/2018-4/2019
Hoang Hai et al, 2021, IJFM

Bi-regional Advocacy Meeting on Risk Mitigation in Traditional Food Markets in the Asia Pacific Region
1-2 September 2021
PigRISK – QMRA for salmonellosis from Vietnam
Age and gender groups
Estimated annual salmonellosis
incidence rate (Mean (90% CI)) (%)
Children (under 5 years old) 11.18 (0 – 45.05)
Adult female (6-60 years old) 16.41 (0.01 – 53.86)
Adult male (6-60 years old) 19.29 (0.04 – 59.06)
Elder (over 60 years old) 20.41 (0.09 – 60.76)
Overall 17.7 (0.89 – 45.96)
Dang Xuan Sinh et al. (2016) IJPH
• 94 million people
• Cases of foodborne diseases by
Salmonella in pork at 17%: 16
million get sick
• Cost $ 107 to treat a case: $ 1,709
million (0.8% GDP)

Bi-regional Advocacy Meeting on Risk Mitigation in Traditional Food Markets in the Asia Pacific Region
1-2 September 2021
Research approach: what do we do to understand and improve food safety?
• Situational analyses of food safety
• Capacity building on risk-based approaches
• Proof of concept: participatory risk assessment
• Pilot testing interventions
• Scaling assessments
• Policy support
Solutions to traditional markets

Bi-regional Advocacy Meeting on Risk Mitigation in Traditional Food Markets in the Asia Pacific Region
1-2 September 2021
From evidence generation to ECM (enabling, capacitating,
motivating) interventions to improve food safety in wet markets
Key content:
-Easy to clean surface
-Frequent washing (and
disinfection)
-Separation (fresh/cooked)
-Training
-Hygienic cutting board
-Branding

Bi-regional Advocacy Meeting on Risk Mitigation in Traditional Food Markets in the Asia Pacific Region
1-2 September 2021
Policy impact: translational research for
interventions in modernizing food system
• CGIAR/ILRI niche: Risk assessment and
policy/regulatory analysis for fresh foods in domestic
markets
• World Bank convenes overall support to government:
ILRI led technical works
• Project development based on World Bank report we
led will improve food safety for 20 million people in
major cities of Vietnam

Bi-regional Advocacy Meeting on Risk Mitigation in Traditional Food Markets in the Asia Pacific Region
1-2 September 2021
Transmission of emerging diseases

Bi-regional Advocacy Meeting on Risk Mitigation in Traditional Food Markets in the Asia Pacific Region
1-2 September 2021
Scavengers
and wildlife
Retailers and
customers
Wild and domestic
animals for sale
Animal-source
foods
Transmission of
pathogens
within markets
contribute to
viral emergence
Naguib et al. (2021) Trends in Microbiology

Bi-regional Advocacy Meeting on Risk Mitigation in Traditional Food Markets in the Asia Pacific Region
1-2 September 2021
Overview of zoonotic
pathogens with high
potential for spread
through live animal and
wet markets
Naguib et al. (2021) Trends in Microbiology

Huanan market, Wuhan, China
https://www.who.int/health-
topics/coronavirus/origins-of-the-virus

Bi-regional Advocacy Meeting on Risk Mitigation in Traditional Food Markets in the Asia Pacific Region
1-2 September 2021

Bi-regional Advocacy Meeting on Risk Mitigation in Traditional Food Markets in the Asia Pacific Region
1-2 September 2021
Responses to Covid-19
• China closed Huanan wet market on 1 January 2020
after the outbreak of COVID-19 in late 2019 in Wuhan
• China banned all the trade and consumption of wildlife
for food on 26 January 2020
• Vietnam banned wildlife imports and ordered the
closure of illegal wildlife markets to protect human
health and ecological balance in July 2020
• WHO, OIE, UNEP Guidance on sale of live wild
mammals seeks to reduce public health risk, April 2021
• ---
• Does this work?

Bi-regional Advocacy Meeting on Risk Mitigation in Traditional Food Markets in the Asia Pacific Region
1-2 September 2021
How to de-risk traditional markets?
• Regulation
• Infrastructure investment
• Trainings
 not affordable or sustainable in many countries
We have piloted new interventions to improve food safety in traditional markets
Interventions: to improve not prohibit
Enabling (regulatory) environment – stroke of the pen reforms
Risk based – not hazard based command/control, co-create solutions to improve
Enhance the benefits of fresh food markets
Training and simple technology – many of the shelf solutions available
Regular, short, simple, innovative, gender-sensitive training
Simple, effective solutions (cutting boards, disinfectant, safe containers)
Incentives – most difficult
Consumers recognize and will pay more for safer food; peer pressure or norms; guard against
harassment; change choice architecture (‘nudges’)
 without incentives, short term or no impact
 not feasible or effective in many countries

Bi-regional Advocacy Meeting on Risk Mitigation in Traditional Food Markets in the Asia Pacific Region
1-2 September 2021
Key messages
1. Traditional markets in LMICs are important and will continue to be so
2. Hazards are common
• But risks can be low when especially if subsequent food processing involves
reliable control steps
• The informal sector is not always dangerous, and the formal sector is not
always safe
3. Live animals in traditional markets are linked to zoonoses transmission
and spill-over of new diseases and animal welfare issues
• But many consumers have strong preference for live animals
• Live animals can be safer than dead animals
4. Most promising solutions combine enabling (regulatory) environment,
training and simple technology, and motivation for behaviour change
• Promising when food is unsafe, high concern over food safety, clear benefits
for behaviour change, traditional markets a critical control point

Bi-regional Advocacy Meeting on Risk Mitigation in Traditional Food Markets in the Asia Pacific Region
1-2 September 2021
Acknowledgements
• ILRI team: Kristina Roesel, Silvia Alonso, PigRISK and SafePORK team
• Melissa Young and Safe Food, Fair Food for Cambodia team
• BMZ project team
• Funding: Australian Centre for International Agricultural Research; CGIAR Research Program on
Agriculture for Nutrition and Health; Federal Ministry of Economic Cooperation and
Development, Germany; United States Agency for International Development through the Feed
the Future Innovation Lab for Livestock Systems; World Bank

THANK YOU