or prevent illness, and antimicrobial resistance is widely present in bacteria in animals, animal environments, and animal source foods. Tere is increasing consensus that resistance to antimicro- bials of human importance has been generated in animals and has since spread to humans.25 At pres- ent, there is litle evidence regarding the contribu- tion of livestock and fish farming to the burden of human disease resulting from antimicrobial resis- tance. However, creation of antimicrobial resistance is likely to be especially problematic in emerging economies, where large amounts of antibiotics are manufactured and used with minimal regula- tion or reporting. 26 One study estimated that the Asia-Pacific region has nearly half of the global anti- microbial market by volume (although only 8 per- cent by revenue).27 Other health impacts of agriculture include


occupational disease, poisoning from plant toxins, the creation of environments suitable for disease or disease vectors, and contributions to climate change with indirect effects on disease dynamics.28


GLOBAL FOOD SAFETY


In an increasingly globalized world, a food safety problem created in one place can easily spread to others. Food safety and the prevention of emerging diseases can be seen as global public goods whose management requires international coordination and effort. Since the World Trade Organization agreement of 1994, which established an interna- tional framework for assessing food safety and dis- ease introduction risk, there has been increasing consensus on the need for risk-based approaches and coordination between the standard setters for plant and animal health and food safety. These bodies include WHO, International Plant Protec- tion Convention, World Animal Health Organiza- tion (OIE), and Codex Alimentarius Commission, a joint committee of the Food and Agriculture Organization of the United Nations (FAO) and WHO. There has been some progress in improving global surveillance, but underreporting remains a major problem in most countries. In developed economies, most notably in Europe, private standards for food, whether for export or


domestic consumption, are oſten more stringent than public standards. Producers have incentives to ensure the quality and safety of their products because “food scandals” can have serious negative


Once again, emerging antimicrobial resistance threatens to leave humanity highly vulnerable to infectious diseases, which before the modern era were responsible for the majority of human deaths.


economic, legal, and reputational consequences. Tis concern is increasingly being felt around the globe, including in developing countries. One exam- ple of this is the International Food Standard (IFS), originally developed by retailers and wholesalers in Germany to ensure the safety of own-brand prod- ucts. Version 6 of IFS Food, which is the latest ver- sion, is a collaboration of retail federations from all over the world.29


TOWARD BETTER MANAGEMENT OF FOOD SAFETY


Fortunately, foodborne disease is largely a fixable problem, as illustrated by developed economies. Food safety systems came into being more than a hundred years ago. Te first systems relied on visual inspection at retail, during processing, and on farms. But with time came codes of good practices (for both agriculture and manufacturing), voluntary stan- dards, regulatory limits, testing for hazards, and methods for ensuring that food-handling processes remain within safe limits. However, these methods require expertise and incur costs, and uptake has been limited in many emerging and least devel- oped economies. Food safety management has traditionally relied


on “control and command”—the seting of strict standards and the enforcement of these standards by


FOOD SAFETY 47


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