Foodborne diseases and public health governance: comparing food safety, consumer preferences and governance in the supply of meat to urban markets

Lead Research Organisation: Royal Veterinary College
Department Name: Pathobiology and Population Sciences


We will study the safety of chicken meat and beef, how poor people access these meats and how can their safety be improved to increase people's nutrition and health in Peru.
We have chosen to study meat because 1) meat is an excellent source of high-quality protein and nutrients (especially important for children and adolescents), but 2) consumption of meat is often associated with foodborne illness, in particular in low- and middle-income countries such as Peru. The synergistic interactions of diarrhoea and undernutrition are well recognized and young children are particularly vulnerable. In Peru, diarrhoea is one of the most common illness for children, causing long-lasting malnutrition, and problems in infants' and children's health. For adults, these diseases lead to illness and at times death. Therefore, it is important to understand how safe meat products are in Peru, from whom poor people buy meats, and how the quality of meats poor people consume can be improved.
We will study three kinds of meat vendors: supermarkets, wet markets, and street vendors. Peruvian people buy much of their everyday food from wet markets and street vendors. However, supermarkets are becoming important as well. Even though research to date assumes that supermarkets sell better quality and safer meat, this has not been proven. Policy makers across the world have suggested moving from traditional wet markets to supermarkets in order to improve food safety. We need research to first test whether food safety differs across the types of vendors and identify the best ways to improve meat safety for all citizens, including poor consumers and farmers who supply traditional markets. We will conduct research in three medium-sized cities in Peru. We selected these cities because they receive chicken and beef from different parts of Peru and outside of Peru. We will conduct our research with people who are involved with production and consumption of chicken and beef. More specifically, we want to answer the following questions:
1. What are the food safety risks of locally supplied meat by small-scale farmers compared with imported meat or meat produced by large-scale farmers?
2. How are food safety risks perceived and addressed by farmers, traders, processors, food vendors and poor urban consumers? How do consumers perceive the link to their/their children's nutritional health?
3. What food hygiene measures can improve safety of meat sourced from different supply chains?
4. What governance models can improve food safety and public health without disrupting local food production?
We will first study what laws exist in Peru that ensure food safety in supermarkets, wet markets and street vendors. Then, we will ask vendors how they obtain their meats, from whom, what they think about meat safety, and how they ensure food safety when selling meats. We will evaluate what vendor practices can increase food safety risks, and biologically test if certain pathogens that cause human illness exist in meats. We will use one type of bacteria meat safety indicator: E.coli and the enterotoxigenic strain E.coli 0157:H7 is one of the major meat-borne pathogen causing colitis and haemolytic-uremic syndrome in children, it shares exposure routes with other common foodborne gastrointestinal pathogens and its presence (of E.coli itself, not necessarily enterotoxigenic) can be used as hygiene indicator along the food chain.
We will use simulation models to test the impact of potential controls and will ask consumers and other actors how they think about food safety and what they do to improve it. At the end of the project, we will communicate our findings at an event where we invite Peruvian policy makers, farmers, traders, slaughterers, vendors, consumers and Peruvian researchers. This event will ensure that our research is used by people who are affected and are in the position to improve food safety outcomes in Peru that are important for nutrition and health

Technical Summary

Foodborne diseases are a major cause of morbidity, mortality and undernutrition including micronutrient deficiencies, with animal-derived food posing the highest risk for consumers in low and middle-income countries such as Peru. Traditional food markets are still the dominant distribution channel for locally produced food in developing countries and the main food source for most poor urban households. The research will explore the safety of meat supplied through traditional food markets that serve poor urban consumers. Our proposal is framed around three main questions:
1.What are the food safety risks of local smallholder-supplied meat compared with industrially processed meat on offer in food markets?
2.How are food safety risks experienced, perceived and addressed by farmers, traders, processors, food vendors and poor urban consumers? How do consumers perceive the link to their/their children's nutritional health?
3.What food hygiene measures can improve the safety of meat sourced from different supply chains?
4.What are public policies that facilitate the emergence of food safety governance models that address public health and food safety while facilitating local food production?
We will adopt an interdisciplinary approach combining value chain analysis, policy analysis, qualitative nutrition studies and probabilistic modelling of the fate of foodborne pathogens along the supply chains. Based on an assessment of the microbiological safety of meat products from a heterogeneous purposively selected sample of market outlets, and the identification of critical control points along six supply chains, we identify entrance points for national policies and local governance arrangements that support the safety of meat supplied by local small-scale producers in urban food markets. By combining quantitative modelling of pathogens with value chain and policy analysis, we intend to propose strategies that incorporate the perspectives of actors along the food chains.

Planned Impact

In this project, we tackle foodborne disease, which is a major cause of morbidity, mortality and undernutrition including micronutrient deficiencies in Peru and other LMICs. We will specifically focus on the safety of meat supplied through traditional food markets, which are still the dominant distribution channel for locally produced food in developing countries and the main food source for the majority of poor urban households. By targeting the local informal smallholder supply of meat where food safety management poses a greater challenge, the project will benefit those most vulnerable to disruptions due to foodborne disease and the consequences. Our multidisciplinary approach will allow us to explore the challenge of ensuring the safety of meat supplied by these markets by simultaneously considering key interrelated elements, namely:
- the fate of microbiological hazards along traditional meat chains and their potential consequences in terms of morbidity, undernutrition and micronutrient deficiencies
- the relationships between stakeholders along the value chains and their perceptions of food safety issues
- the models of governance and public policy that can best address food safety without disrupting local food production
This multidisciplinary approach maximizes the potential impact of the proposal. The project will benefit both, consumers of animal-derived products (poultry and beef) and livestock producers whose livelihoods depend upon the production of these products. The project will also deliver impact through enabling researchers, decision makers and private actors from the agrifood sector to benefit from decision support tools that are currently largely limited to high-income settings such as quantitative microbiological risk assessment (QMRA). Peru has explicit national development priorities related with local economic development and public health, which, to be effective, need innovations in local governance institutions. The research will distil options of public policy that facilitate the emergence of effective food safety control in markets and supply chains, while considering how the interests of poor urban consumers and local small-scale producers can be affected by these policy options. The research will contribute specifically to sustainable development goal (SDG) 2, End hunger, achieve food security and improved nutrition and promote sustainable agriculture, SDG 3, Ensure healthy lives and promote well-being for all at all ages, and SDG 11, Make cities and human settlements inclusive, safe, resilient and sustainable. Finally, our project can have impact in other LMICs as they face similar needs to those of Peru regarding prevention of foodborne disease. To maximize this broader impact we will create a public repository of resources and make our models and data publicly available. We will also make use of our extensive international networks and portfolio of activities, such as the Royal Veterinary College's role as reference centre in veterinary epidemiology for the Food and Agriculture Organization of the United Nations (FAO).


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Description Two literature reviews were conducted. It became clear that published data on foodborne pathogens in Peru was scarce. This has prompt to contact Epidemiology Directorate of the Ministry of Health of Peru to request official data on foodborne outbreaks reported in the last 10 years.
Observations from initial exploratory visits to potential study areas suggest great heterogenicity regarding practices of relevance in terms of safety of animal products between and across markets. This will be considered when choosing study sites, and developing instruments (questioners and interviews) for the qualitative component of the project.
Exploitation Route The food safety unit of the animal health department (SENASA) is interested in making use of the online food risk assessment tool that has been developed. As the project generates empirical data regarding presence of foodborne pathogens in foods and information on governance and practices along the different food chains we expect relevant departments from the ministry of health and the ministry of agriculture to make use of the results for purpose of enhanced surveillance and food controls. We also envisage our findings to be of use for private stakeholders whose livelihoods are connected to formal and informal food chains. In all cases, during the first months of the project we have established strong channels of communication to facilitate future uptake of findings.
Sectors Agriculture, Food and Drink,Healthcare

Description • An initial workshop was held in September 2019. This workshop allowed all project partners to meet in person and define activities • Protocols for laboratory testing are being optimised, and ethical approval applications have been submitted. • Two literature reviews were conducted, it was clear that published data on foodborne pathogens in Peru was scarce. As a result, instead of conducting a qualitative risk assessment for specific pathogens, an assessment tool was developed and will be freely available as online application. This tool will allow us, and local authorities in the country, to assess the human risk of exposure (in a qualitative fashion) to different pathogens considering local characteristics. Crucially, the number of assessments that can be done is unlimited and in a short period of time. The first version of the tool has been shared with the government department in charge of food safety in Peru (SENASA) and they have confirmed their willingness to pilot it across the country. • Engagement with the Epidemiology Directorate of the Ministry of Health of Peru (Minsa) has been initiated and Minsa has agreed to provide data foodborne diseases outbreaks in Peru reported in the last 10 years. • An initial workshop on risk analysis has been delivered to members of SENASA and future areas of collaboration have been identified. • Exploratory visits to potential study areas were conducted to start understanding formal and informal arrangements within the food chain, as well as initiate communication with key stakeholders. There was a field reconnaissance trip to Tumbes on January 21 and 22, 2020. Then from February 9 to 17 trips were made to Huancayo and Huaral. During the field trips we carried out interviews with local authorities (Municipal Food safety units, SENASA, Municipal slaughterhouse, MINSA), vendor associations, and informal conversations with meat distributors and market vendors. These field trips will serve to define (in the upcoming months) which food chains and markets we will study in more detail. Furthermore, a range of incentives delivered from local policies to improve food safety have been identified. These incentives will be considered when drafting interviews in order to understand to what extent these governance mechanisms are shaping or can be expected to shape/define the food safety practices in the meat supply chains. • The project has raised interest among local students and an MSc student from Huancayo will do his thesis linked to the project.
First Year Of Impact 2019
Sector Agriculture, Food and Drink,Healthcare
Impact Types Societal,Policy & public services

Title Mendeley database 
Description A Mendeley database was created to store relevant publications identified from two literature reviews conducted. The aim of these literature reviews was to identify main food-borne pathogens previously reported in chicken meat and beef in Peru. One review was conducted from the microbiological perspective and the second review from the social angle. 
Type Of Material Database/Collection of data 
Year Produced 2019 
Provided To Others? No  
Impact The central data base facilitates access to published data for team members and other researchers who eventually may be interested. The database is therefore a valuable resource that will be made available to other researchers and stakeholders. So far, the data base has 40 references. 
Title Qualitative Risk assessment tool 
Description We have developed a qualitative risk assessment tool available online through a graphical user interface in order to evaluate the risk posed by meat-borne pathogens to consumers in scarce-data settings. 
Type Of Material Computer model/algorithm 
Year Produced 2020 
Provided To Others? Yes  
Impact The risk assessment tool has just been developed and it is in piloting stage. We envisage that this tool will be useful not only in Peru but in other places where data is scarce. Crucially, no previous knowledge on risk analysis is needed to use the app and as more data become available new estimates can be generated in a short period of time. SENASA has confirmed their willingness in piloting the tool across the different regions of Peru. 
Description Agreement with the Epidemiology Directorate of the Ministry of Health 
Organisation Government of Peru
Department Ministry of Health
Country Peru 
Sector Public 
PI Contribution An opportunity for collaboration between the research team and the Epidemiology Directorate of the Ministry of Health of Peru was identified.
Collaborator Contribution A formal agreement has been made with the Epidemiology Directorate of the Ministry of Health of Peru to have access to information regarding foodborne diseases outbreaks in Peru reported in the last 10 years.
Impact Data to be provided by Epidemiology Directorate of the Ministry of Health of Peru will be used in the quantitative component of the project and will help us to make recommendations aligned with the country needs.
Start Year 2020
Description Project start-up workshop 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Study participants or study members
Results and Impact The objectives of this workshop were (i)give the opportunity for all partners in the project to meet in person, and (ii) discuss and agree on the schedule for the different project activities.
Year(s) Of Engagement Activity 2019
Description ResearchGate project 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Undergraduate students
Results and Impact As part of the communication plan we have created a project page in ResearchGate. The objectives are to present a brief description of the project; give the opportunity to other scientists and the public in general to engage with the project by asking questions and/or recommending the project; and keep the scientific achievements up to date (academic activities and publications related to this project will be registered on this page). In addition, the project is linked to the project partners' profiles.
The page was created in September 2019 and so far it has been read 75 times and recommended once.
Year(s) Of Engagement Activity 2019