Findings from the cost effectiveness analysis Clare Narrod, on behalf of the teamInternational Food Policy Research Institute Uniformed Services University of the Health SciencesInternational Center for the Improvement of Maize ACDI/VOCA/Kenya Maize Development Programand Wheat Kenya Agricultural Research InstituteInternational Crops Research Institute for the Semi- Institut d’Economie RuraleArid Tropics The Eastern Africa Grain CouncilUniversity of Pittsburgh
• CEA evaluates the cost effectiveness of possible control decisions (options) on risk and health impacts • Interested the least costly way to reduce aflatoxin risk C % Risk Reduction B . A D Cost per unit
We estimate probability of aflatoxin contamination at each stage effectiveness of each technology cost of each technology When budgets are limited, keeping everything else equal, technologies that abate the greatest risks: are more effective should be adopted first
Procedure Interventions Purpose/status/applicationPre-harvest Timing: planting and harvest Avoid insect infestation which Drought and pest resistant varietiescan serve as vectors for mould Good agricultural practices invasion; avoid plant stresses such as drought and other growth stressHarvesting & Post Hand sorting-sun drying; storing Reduce moisture levels andharvest: drying and bags on wooden pallets or elevated exposure to toxigenic mouldsstorage off ground; insecticides; rodent controlPost-Harvest: food Physical separation of damaged, Effective in reducing aflatoxinpreparation immature and mould-infested levels in final product; kernels, nuts, seeds etc
Effectiveness of these measures in practice under developing country conditions is not well understood. In 2009 we implemented a 2-stage Delphi expert elicitation via email with a panel of experts to provide guidance on the effectiveness of selected aflatoxin control measures for maize and groundnut producers in the study countries. Augmented information on effectiveness from literature.
Technique Duration of Effectiveness effectiveness of Capacity (# of (%) method (years) Price** 90 kg bags)Drying 50 1 4.5 0.28Tarpaulin 50 5 6,2000 4000Postharvest intervention *69 2 *61 5.00Plastic Silos S 60 10 4,600 3.00Plastic containers M 60 10 11,132 12.00Plastic containers L 60 10 17,020 20.00Metal Silos Small 60 20 8667 3.00Metal Silos Medium 60 20 17833 12.00Metal Silo Large 60 20 24883 20.00 * from Turner et al, rest from expert elicitation, ** from CIMMYT survey/ ACDI/VOCA
Present value of reduction in Cost per unit of aflatoxin Cost per bag of reduction in risk prevalence maize (Ksh/90 kg) (Cost-effectiveness)Drying 50.00 16.07 0.32Tarpaulin 226.22 155.00 0.69Postharvestintervention 134.55 12.20 0.09Plastic Silos S 481.52 1533.33 3.18Plastic containers M 481.52 927.67 1.93Plastic containers L 481.52 851.00 1.77Metal Silos Small 769.82 2889.00 3.75Metal Silos Medium 769.82 1486.08 1.93Metal Silo Large 769.82 1244.15 1.62Biocontrols 60.00 369.34 6.16
D 900 Present value of reduction in aflatoxin 800 Metal silos 700 600 Plastic Silos prevalence 500 400 300 Tarp 200 Post harvest 100 Drying Biocontrols 0 0 500 1000 1500 2000 2500 3000 3500 Cost per bag of maize (Ksh/90 kg)
Technologies with similar costs and effectiveness Keeping everything else equal, technologies that abate the greatest risks should be adopted first. Technologies with similar costs and contamination risks Keeping everything else equal, more effective technologies should be adopted first. Technologies with similar effectiveness and contamination risks Keeping everything else equal, cheaper technologies should be adopted first. Technologies with differing levels of effectiveness and exhibit economies of scale properties Education efforts need to be directed at getting small holders to adopt those measures most cost-effective for them; subsidies may be needed.
Governments may chose to intervene when the conditions required to achieve market efficient disease control outcomes through the use of subsidies. From a public policy point of view, the key challenge is to identify the optimal subsidy or varying subsidies to achieve the greatest net social gain, which should be driven by and understanding of the cost effectiveness associated with a singular or combination of risk reduction activities. WTP analysis suggest which technologies need subsidies;.
Difficult to identify the level of effectiveness in real world situation; relying on the experts; Levels of effectiveness assume correct application of methods; Estimates for cost of risk reduction technologies still in development highly uncertain; Cross-contamination and further growth can occur further up the value chain; need to evaluate the cost/effectiveness of applicable interventions
Aflatoxin risk at Input transportation Aflatoxin providers risk at Distributors/ Traders transport ConsumersExtension Producers ation Small local services Local Markets Small-scale informal farmers (< 3 tradersInternational acres ) Urban markets NGOs COLLECTORS Large- Schools, hospitals, Agro- scale & other input farmers Large buyers institutions shop (> 3 acres) at market Export Large scale (Sudan, Town traders (incl Somalia) market NCPB) Supermar kets Aflatoxin Industrial risk at storage processors Aflatoxin Aflatoxin risk at risk at storage storage
Application point ProcedureTrader/WH/Processor Awareness buildingTrader/WH/Processor Monitor mycotoxin levels in stores, remove damage corn, promote the dry corn to optimal moisture content before storageWH/storage Frequent cleaning of feed delivery systems and short-term storage areas; drying techniques to achieve adequate storage moisture and store product on dry clean surface, promote appropriate storage structures for different size producers, and monitor for pest, moisture levelsWH/storage/ Processor Separation of damaged and mould-infested kernels, (can be done by one or a combination of several methods (farmer selection, belt separator, gravity table, colour sorting, use of BGYF light)Processor Enterosorption – based on the approach of adding a binding agent to prevent the absorption of the toxin while the food is in the digestive tract; Chemical inactivation by ammonization, Nixtamalization with addition of hydrogen peroxide and sodium bicarbonate, Thermal processing