While the COVID pandemic has highlighted the pathogen risks that can emerge from unsafe animal and food handling in traditional markets – those same markets are also sources of healthy, fresh food for billions of people around the world – healthier and fresher, in many cases, than what may be found on a supermarket shelf. 

Post-pandemic, traditional food markets need to be modernized and strengthened – so that they can fulfill their real potential in future food systems, said panellists at the event “Talking Food Safety” coinciding with World Food Safety Day. 

The event was hosted by EatSafe, a program funded by USAID, and led by the Global Alliance for Improved Nutrition (GAIN).

“Food safety, nutrition and food security are inextricably linked,” said Bonnie McClafferty, Director of Food Safety at GAIN and Chief of Party for USAID’s EatSafe. “Unsafe food creates a vicious cycle of disease and malnutrition.”

McClafferty was the moderator of a panel of experts on India, Nigeria and West Africa who explored the role of traditional markets in food systems – and how greater consumer and vendor awareness of food safety issues, along with stronger regulatory frameworks, could pave the way for a more vibrant future.  

Supporting traditional markets – in which food safety is well-assured – also supports food security, local farm production, and more sustainable agro ecosystems – as part of a “One Health” approach to food systems that WHO, the Food and Agriculture Organization, UN Environment, and other actors have committed to support as part of pandemic recovery. 

Nutrition & Food Safety Risks 

Over 600 million people fall ill and 420,000 people die every year from eating contaminated food. Children under the age of 5 are among the most vulnerable. Some 75% of foodborne illnesses are in Africa and Southeast Asia, panellists noted, citing the latest WHO data. 

The incidence of foodborne illnesses is 27 times higher in Africa as it is in Europe or North America – where countries often lack strong regulatory systems to control food safety from field to marketplace. 

Food safety risks occur when foods are not safely produced, stored, handled, or prepared; as a result they can contain harmful bacteria, viruses, toxins, parasites, as well as excessive pesticides and chemical residues used at farm sites, and even physical or mechanical contaminants, like shards of plastic, metal or glass from damaged packaging or processes. Any one of these hazards can result in illness or injury, as well as death. 

And such risks are not confined to traditional markets, panellists stressed. They can also be present in fresh or packaged foods on sale at supermarkets as well. So what is needed is a new approach to food safety, and to marketplaces overall. 

Until the eruption of SARS-CoV2, very little public or policymaker attention was accorded to food safety risks generally, or traditional markets more specifically.  However, the emergence of the virus around a Chinese traditional market in Wuhan, heightened public awareness, as well as policymaker sensitivities.  A WHO-convened team of scientists recently concluded that the virus “very likely” emerged from human exposure to infected wild animals or meat somewhere along the traditional market food production or supply chain – although other critics say the virus also could have escaped from a nearby laboratory. Whatever the final verdict over SARS-CoV2, however, most experts agree that the pandemic has created a milestone moment for addressing some of the bigger, and more systemic issues around food safety – and traditional marketplaces.  

The COVID-19 pandemic and the accompanying public health measures also disrupted delicate supply chains, access to food and sufficient nutrition, and the agricultural industry. Approximately 124 million more people were pushed into long-lasting poverty and hunger in 2020, according to a recent fact sheet by USAID’s “Feed the Future” initiative on global hunger and food security. 

The pandemic also changed the behaviour of both customers and vendors vis a vis traditional markets, according to research conducted by EatSafe between September and December 2020 in Nigeria, Kenya and Bangladesh, coordinated by McClafferty. 

Some changes were positive – others less so. 

On the one hand, more handwashing and sanitation stations were installed in markets, measures welcomed by consumers and vendors alike. Both shoppers and vendors began to pay more attention to hand hygiene, masking and social distances, which helped to control food safety risks as well as COVID infection spread.  

But across all three countries, consumers frequented markets less – affecting businesses and sales, the study found.  And in places like India, with a strong digital economy, the pandemic also seems to have accelerated a trend among younger shoppers away from fresh food markets to more online food purchases – which may also tip the balance to consumer reliance on more processed foods. Such trends, over the long-term, do not bode as well for the future of fresh food marketplaces, nutrition or health.  

“We at GAIN are concerned about that change in the diet, what are they turning to if they’re turning away from perishable foods. It’s very important that the [food] basket remains nutritious,” said McClafferty. 

Rather than abandoning markets, which play such a positive role in fresh food systems, what is really needed is greater awareness of food safety as a neglected public health problem – and measures to address shortcomings, said McClafferty and other panellists. 

“It’s ridiculous to think about shutting these [markets] down, they’re not going anywhere,” said McClafferty. “We need to strengthen them, we need to modernize them,…they need to be in demand.”

Traditional Markets – Hubs for “Nutrient Dense” Foods 

By their very nature, traditional markets provide ready access to healthy and affordable, albeit perishable, fresh foods that play critical roles in food security and nutrition. For example, in Nigeria, traditional and informal markets account for 70% of the entire food landscape and drive the local economy. 

Particularly in low- and middle-income countries, many consumers rely on traditional markets to purchase the most important, nutrient-dense foods in their diets, such as animal-sourced foods as well as fresh fruits and vegetables, nuts, and legumes.

But such markets, located in public venues and comprising dozens or hundreds of individual vendors, often fall through the net of government food safety standards and regulations, which in many LMICS may be weak or poorly enforced. And the rules that exist may not be enforced to the same degree in a marketplace as they are in a supermarket, which is under a single roof and controlled by a single corporate entity.  

The infrastructure of traditional markets, provided by government authorities or vendors’ associations, may also be of poor quality. Good storage facilities for products are often lacking, including no concrete flooring, no access to water for wash stations, and vendor stalls exposed to the elements, hot or cold, rainy or humid.  

Vendors and Consumers Lack Knowledge and Tools

Against this landscape, both vendors and consumers often lack the knowledge and tools to ensure food safety, said Mohamed Nasser, West Africa’s Regional Advisor for Food Safety and Quality Assurance at the World Food Programme (WFP). 

Better training for market vendors in food hygiene, safe food preservation and prevention of waste are all important measures essential to establishing and maintaining safer traditional markets, Nasser said. Other measures include raising food safety awareness among market workers and customers, and better enforcement of regulations. 

The education of consumers, particularly children and parents, on food safety practices is essential because consumer demands can shift the behaviour of vendors and marketplaces, added Priya Prakash, campaign lead at the NGO Act4Food in New Delhi, India. 

“There needs to be a consumer campaign…that enables and empowers people to make better decisions” about food purchases and hygiene with food in the home, said Prakash.

“The consumer is central to food safety because it’s a demand and supply issue: if consumers begin to push for a cleaner and safer product, vendors are going to respond positively,” added Professor Olugbenga Ben Ogunmoyela, Executive Director of Consumer Advocacy for Food Safety and Nutrition Initiative in Lagos, Nigeria.

Key practices, he noted, include frequent cleaning and disinfection of work surfaces, preventing direct contact between shoppers, live animals and contaminated surfaces, and complying with personal hygiene practices. 

Improving Hygiene Practices 

Despite the devastation COVID-19 has caused, including to food market cultures, hygiene practices that were strengthened and enforced as part of COVID-19 responses have improved food safety in traditional markets, panellists agreed:

“One of the positive points of COVID-19 actually is just to bring back the basic hygiene requirements to be implemented…This is something basic for any traditional market,” said Nasser. 

His comments were based on findings from the biweekly consumer and vendor surveys conducted by GAIN in traditional markets of Bangladesh, Kenya, and Nigeria across the autumn and winter of 2020 – inputs that contributed to the broader USAID-supported study, soon to be published.  

According to those surveys, all three countries saw the implementation of at least some COVID safety measures, such as social distancing, wearing of face masks, hand washing or sanitising, and temperature checks upon entering the market.

The enforcement of the COVID rules, however, varied, with 85% of consumers in Kenya witnessing a strong investment in COVID protocols in marketplaces, as compared to only 35% of consumers in Bangladesh.

Some 80% of vendors surveyed in Kenya in January 2021, also reported a decrease in the number of customers over the previous nine months. In all three cases, consumers reduced their frequency of shopping in the market and avoided peak shopping hours. Decreased sales and customers also were reported by two-thirds of Nigerian vendors, although only 35% reported difficulties in accessing products to sell, while 42% reported difficulties in transporting goods, during the pandemic.

Sustaining Food Safety Measures Post-Pandemic

Key concerns about shopping in the market, as reported by consumers in Nigeria, included the fear of contracting COVID-19 (70%), food unavailability (34%), and the inconvenience of taking protective measures (32%).

Despite their inconvenience, significant numbers of consumers still welcomed the new safety and hygiene measures. In Bangladesh, some 46.2% of consumers saw the disinfection of marketplaces as the most useful COVID measure implemented, while 57.5% of vendors considered mask mandates to be the most effective. 

As pandemic fears wane, a major concern of panelists is whether newly adopted safety and hygiene measures can be maintained.

“I’m happy to have [basic safety measures] everywhere and applied by everybody, but at the same time, this is basic and should be continued. It’s nothing related to COVID-19, it’s something related to the fact that we need to ensure the safety of the food,” said Nasser. 

Already in some cases pandemic fatigue seems to be setting in, with vendors and customers abandoning the masks and gloves and reverting back to their original purchasing practices. 

Improving awareness and education will be important to sustain the improvement to food safety brought by COVID, the panellists concluded.

Despite the shortcomings in the COVID response, “we can take quite a few things from this particular experience to strengthen our traditional markets,” observed Ogunmoyela. Those lessons include ensuring that governments provide basic infrastructure support and guidelines so that basic safety standards can be met.

“We have to look at how to change attitudes through messaging that will go directly to both consumers and vendors at the market centres,” he added, saying: “The radio jingle is a very effective tool in this environment, and even infographics…that as people are approaching these markets, they know the do’s and don’ts.” 

The Case of India 

A strong shift away from markets and to online food orders has been particularly evident in India, and among younger generations – who have made use of new digital apps to order food deliveries – rather than venturing out to marketplaces where they feared being infected with COVID. 

“The process of going to a traditional market has broken down and now the distance from the consumer to the traditional market has started to increase,” said Prakash. Foods on sale in the traditional markets are often perceived as less sanitary than supermarkets, she added, even though that may not at all be the case. 

“We need to understand that the interaction and relationship that the younger generation will have with traditional markets will probably not be the same and it might have to change,” said Prakash. 

During the pandemic, “the way commerce is done has fundamentally changed for a lot of people,” she observes. People who never had a bank account set up digital accounts online, and moved to using digital money, which has now become central to the way in which money is exchanged. 

The digital transformation also was encouraged by the Indian government, which created apps that were required for people to register for vaccinations and to enter and exit certain venues, as part of surveillance and contact tracing efforts. 

“A large chunk of the population has started operating in this way in a very accelerated, unprecedented span of time,” Prakash said. Now, she says, traditional markets need to enter digital age as well – in order to remain vibrant centers of commerce post-COVID. 

“The first basic thing that traditional markets can empower themselves with is the entire concept of digital money and transactions,” said Prakash.

“The whole concept of cash being given, which was a typical operating principle in the traditional markets, is changing rapidly. We need to introduce technology as a means to try to connect and [put] these traditional markets on the map for younger generations,” said Prakash.

“There might be a different way that [traditional markets] interact with consumers, with businesses, with technology companies, but traditional markets will always be at the heart of any food system. Going forward, there will be a transition where a lot of these farmers, a lot of these vendors will be empowered enough to sell directly online or represent themselves directly online,” said Prakash. 

“That is going to take a long period of time…[but] we’re looking at this decade of technology transformation…and I feel like that’s the future direction.” 

Updating and Transforming Traditional Market Design

But for the billions of consumers who will also continue to frequent markets in person, new effort also need to be invested in upgrading and modernizing markets’ physical facilities to ensure their safe design, the panellists emphasised. 

The markets “need to be reshaped, we need to build nutrition and food safety education into the system, we need to identify the critical needs and priorities across the landscape, and ensure that policies actually…embrace these markets,” said Ogunmoyela. 

Much closer attention to the details of the physical layout, facilities and organisation of marketplaces can provide the basis for promoting safer and healthier food and reducing the risk of transmission of foodborne and zoonotic disease. 

Governments need to invest in implementing basic infrastructure, including an adequate water supplies for cleaning, water drainage systems, and toilets with hand-washing facilities. 

In addition, any market stalls or cages holding live animals, which are high risk areas for the transmission of pathogens, should be located far away from consumers – with the slaughtering process carried out in separate facilities, the panelists stressed. Such measures also have been the focus of new WHO guidance for traditional marketplaces.

Architects and urban designers can become critical intervenors in traditional markets – insofar as improving market design is critical to better food safety. Key measures should include “the use of better spacing, less crowding, [and] better traffic flow,” said McClafferty. 

While stronger regulatory frameworks also are key, consultations with consumers and vendors are also critical before new regulations are put in place, so as to gain a greater understanding of real market conditions, and ensure the uptake of any new rules and policies.  

“Food safety best practices should be customized based on the situation of each group,” said Nasser. “It is not something you can put in [a single set of] guidelines and it will be applicable everywhere in the world.”

Transforming Agri-Food Systems 

Rediscovering the value of traditional markets sits within a wider picture on the food chain – facing a wide range of challenges. 

At farm level, pesticide and bacterial contamination still need to be addressed in order to assure that food reaching the marketplace is healthy and safe. As a result, efforts to change behaviours should also be focused on the small food producers that supply the markets – farmers, fishermen, and butchers – to ensure that they reduce their use of pesticides and other potential chemical contaminants in all stages of the food production cycle. 

“Behaviour can be changed, not just by creating the knowledge, but also by actually demonstrating it and by reinforcing the messages across the landscape,” said Ogunmoyela.

In the marketplace, food quality assurance needs to be improved, in particular, for most sensitive products, like milk, cheese and meat, in countries that have warm climates or even tropical conditions.  

“We have a golden opportunity this year to transform our agri-food system to be safer, to be more inclusive, more resilient, and to really feed the whole population with nutritious and safe food,” said Ismahane Elouafi, FAO Chief Scientist, speaking separately, at a joint press briefing with WHO on World Food Safety Day, in which WHO released a new handbook to help countries assess their own foodborne disease burden, and identify food safety system needs. 

“Food should sustain and support human health, not harm it,” said Dr Tedros Adhanom Ghebreyesus, WHO Director General, at the briefing. “When food safety is improved, we reduce hunger, malnutrition and infant mortality; children miss fewer days at school; adults increase their productivity; and the strain on health systems is reduced.”

Image Credits: Michael Casmir, Pierce Mill Media, Pierce Mill Media, Michael Casmir/Pierce Mill Media, Deutsche Welle, GAIN, Madina Maishanu , Pierce Mill Media.