The Political Economy of US Antibiotic Use in Animal Feed

Abstract

Foodborne diseases (FBD) represent a constant threat to public health and a significant impediment to socioeconomic development worldwide. At the same time, food safety remains a marginalized policy objective, especially in developing countries. A major obstacle to adequately addressing food safety concerns is the lack of accurate data on the full extent and burden of FBD. In 2006, the World Health Organization (WHO) launched an initiative to estimate the global burden of FBD, which was carried forward by the Foodborne Disease Burden Epidemiology Reference Group (FERG). FERG quantified the global and regional burden of 31 foodborne hazards, including 11 diarrheal disease agents, 7 invasive disease agents, 10 helminths, and 3 chemicals and toxins. Baseline epidemiological data were translated into disability-adjusted life years (DALYs) following a hazard-based approach and an incidence perspective. Data gaps were addressed using statistical imputation models, and food attribution estimates were generated through structured expert elicitation. In 2010, foodborne diseases were estimated to cause 600 million illnesses, resulting in 420,000 deaths and 33 million DALYs, demonstrating that the global burden of FBD is of the same order as the major infectious diseases such as HIV/AIDS, malaria, and tuberculosis. It is also comparable to certain other risk factors such as dietary risk factors, unimproved water and sanitation, and air pollution. Some hazards were found to be important causes of FBD in all regions of the world, while others were of highly focal nature, resulting in high local burden. Despite the data gaps and limitations of these initial estimates, it is apparent that the global burden of FBD is considerable and affects individuals of all ages, particularly children under the age of 5 and persons living in low-income regions of the world. By using these estimates to support evidence-based priorities, all stakeholders, both at national and international levels, can contribute to improvements in food safety and population health.