Trends in global health and
food safety
Barbara Szonyi
ILRI@40 Livestock and healthy lives workshop
Addis Ababa, 7 November 2014

Outline
• Trends in leading causes of poor health in
developed and developing countries
• Concerns regarding animal-source foods in
Ethiopia
• ILRI food safety work in Ethiopia
• Questions to consider

Leading causes of poor health in
developed and developing countries
• Measured as disability-adjusted life year
(DALY)
• DALY is a measure of overall disease burden,
expressed as the number of years lost due to
ill-health, disability or early death.

Top causes of DALY in developed countries
Rank 1990 Condition
1 Ischemic heart disease
2 Stroke
3 Low back pain
4 Road injury
5 Lung cancer
6 Major depressive disorder
7 COPD
8 Self-harm
9 Other musculoskeletal
10 Diabetes
Rank 2010 Condition
1 Ischemic heart disease
2 Stroke
3 Low back pain
4 Major depressive disorder
5 Lung cancer
6 COPD
7 Other musculoskeletal
8 Road injury
9 Diabetes
10 Falls
Source: Institute for Health Metrics and Evaluation (IHME)

Developed world
• Over 20 years the leading causes of poor
health remained the same
• Non-infectious diseases
• The leading cause of illness have been cardio-vascular
disease
– Diet and sedentary lifestyle are risk factors

Top causes of DALY in developing countries
1990 Rank Condition
1 Lower respiratory infections
2 Diarrheal diseases
3 Preterm birth complications
4 COPD
5 Malaria
6 Stroke
7 Protein-energy malnutrition
8 Tuberculosis
9 Neonatal encephalopathy
10 Ischemic heart disease
2010 Rank Condition
1 Lower respiratory infections
2 Diarrheal diseases
3 Ischemic heart disease
4 Malaria
5 Stroke
6 HIV/AIDS
7 Preterm birth complications
8 Road injury
9 COPD
10 Low back pain
Source: Institute for Health Metrics and Evaluation (IHME)

Developing world
• Over 20 years the leading cause of poor health
remained the same
• Infectious diseases
• First rank is respiratory infections
– Mostly vaccine-preventable infections
• Second rank is diarrheal diseases
– Poor sanitation and food safety standards
– Zoonotic pathogens
• Cardio-vascular illness is creeping up the list

Food-borne disease in the developing world
Source: D Grace et al. 2002. Mapping of poverty and likely zoonoses hot spots. Report to Department of International Development, UK.

Top causes of death in Ethiopia
Rank 1990 Condition
1 Lower respiratory infections
2 Diarrheal diseases
3 Measles
4 Malaria
5 Tuberculosis
6 War & legal intervention
7 Protein-energy malnutrition
8 Meningitis
9 Preterm birth complications
10 Stroke
2010 Rank Condition
1 Lower respiratory infections
2 Diarrheal diseases
3 Malaria
4 Tuberculosis
5 Protein-energy malnutrition
6 Stroke
7 Preterm birth complications
8 HIV/AIDS
9 Road injury
10 Meningitis
Source: Institute for Health Metrics and Evaluation (IHME)

Concerns regarding animal-source foods in
Ethiopia
• Low level of consumption of animal-source foods
– Contribute to protein-energy malnutrition
• Presence of hazards in animal-source foods
– Biological hazards (food-borne pathogens)
– Chemical hazards (aflatoxins, drug residues)
• Risky practices at all levels along the value chains
Photo credits: Tamsin Dewe, Elias Walelign, the Compass Edge

ILRI food safety work in Ethiopia
• Biological hazard risk assessment targeting
foodborne pathogens in small ruminants
– In slaughterhouses:
• E coli 0157, Salmonella and Campylobacter in meat
• Survey on health status of sheep and goats presented
for slaughter
– Rural smallholder producers:
• Coliforms, E coli 0157 and Listeria monocytogenes in
goat milk and goat milk products

ILRI food safety work in Ethiopia
• Chemical hazard risk assessment targeting
aflatoxins in dairy and poultry food chains

ILRI food safety work in Ethiopia
• Training and intervention
– Hands-on training for meat inspectors on pre-and-post
harvest practices of small ruminants
– Training for rural goat milk producers/processors on
good manufacturing practices

Questions to consider
• Will the current trends in disease burden
continue for the foreseeable future?
• How does agriculture influence these trends?
– Particularly zoonotic agents of diarrheal illness in
the developing world
• What can we as livestock researchers do
about it?

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