Role of Partnership for Aflatoxin Control in Africa (PACA)

Amare Ayalew (email: Amarea@africa-union.org)PACA Secretariat

Aflatoxin Experts Roundtable MeetingBrussels, 25 January 2016

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

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.

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.

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

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 children4.5 billion people are chronically exposed

Diffi

culty

of d

etec

tion

incr

ease

s

Sym

ptom

s of i

llnes

s

Outbreaks in Kenya: linked to contaminated maize consumption

1981, 2001, 2004, 2005, 2006, 201441.5% case fatality

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

Evidence on association of aflatoxin exposure and child growth

Geography Findings (correlation) ReferenceGhana, 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

Current research on aflatoxin and stunting (funded by BMGF)

Study Expected contribution Lead organization1. 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

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

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

Aflatoxin challenge in

Africa

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:

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

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

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 approachProvide catalytic grants: e.g. testing equipment to enhance gov’t capacity

Aggregate evidence, gather knowledge, and disseminate information

ConvenerWork with RECs and other stakeholders to convene continental, inter-regional, regional, and country forums

Long

-Ter

m R

ole

Shor

t-Te

rm R

ole

• Serve these roles and conduct activities at three levels:– Continental– Regional– Country-level

PACA Secretariat Activities

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

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

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

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

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

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!

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

Main messages for impact1. 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!

Thank You

www.aflatoxinpartnership.org