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Scharff to lead analysis of foodborne illness cost in Ethiopia

Janet Kiplinger Ciccone
March 14, 2019

$3.4 million grant to reduce foodborne illness, enhance nutrition in Ethiopia

The College of Education and Human Ecology will play a major role in the fight against foodborne illness in Ethiopia, thanks to a $3.4 million grant from the Bill & Melinda Gates Foundation and the U.K. Government’s Department for International Development.

Robert Scharff, associate professor of consumer sciences, is leading the economic analysis of illnesses caused by contaminated foods in Ethiopia. The four-year Ohio State research project will emphasize making food safe, while keeping it affordable and nutritious for all.

“Ethiopia and other low- and middle-income countries don’t have the data collection systems that we have in the United States,” Scharff said. “This project endeavors to create a model for assessing burden of illness that can be used in countries with less developed information collection systems. To our knowledge, our approach has not been tried before.”

Diarrheal diseases are the leading cause of death in Ethiopia and the third highest cause of death among the country’s population of children under five.

Most diarrheal diseases originate in food or water. Children who are malnourished are especially vulnerable to diarrheal disease.

The international project team will address critical knowledge gaps in understanding the burden of foodborne illness by collecting data in and around three Ethiopian cities. This data is critical for risk-based decision-making.

Scharff will calculate the cost caused by three types of bacteria found in commonly eaten foods in Ethiopia – raw beef and raw dairy.

Four interventions that are sensitive to gender and cultural norms will be evaluated for their ability to improve the safety of raw beef and dairy products. Scharff will evaluate the cost-effectiveness of these interventions.

“We are pleased to have Rob Scharff play a crucial role in this major project,” said Don Pope-Davis, dean of the College of Education and Human Ecology. “If the interventions are shown to be effective and accepted by the population, then the research model may be used in other locations in Ethiopia, as well as in other countries lacking robust data collection systems.”

Measuring the illness burden, evaluating cost-benefit of interventions

Scharff explained the difference between data from the World Health Organization (WHO) about food safety and foodborne illness and the data to be collected by the new project.

“WHO has cost analyses based on disability-adjusted life years, or overall loss of productivity measures,” he said.

“This is not the same as accounting for the different types of costs caused by specific pathogens. Understanding these types of costs, which have not been estimated in countries like Ethiopia, are important for policymakers faced with scarce resources.”

The three pathogens, each common to diarrheal diseases, are:

  • Nontyphoidal Salmonella
  • Diarrheagenic Escherichia coli
  • Campylobacter

Scharff works with Barbara Kowalcyk, an assistant professor of food science and technology in Ohio State’s College of Food, Agricultural and Environmental Sciences, who is the principal investigator of the research and capacity-building project.

Kowalcyk, a member of Ohio State’s Translational Data Analytics Institute, builds on the strong foundation of food safety work conducted at Ohio State.

Kowalcyk’s project team will collect data about confirmed cases of foodborne illness in and around Addis Ababa, Gondar and Haramaya. They will survey hospitals and laboratories, health care workers and the general population

Scharff will calculate the economic burden of these illnesses based on gathered data about:

  • Out-of-pocket expenses
  • Medical costs
  • Lost work productivity
  • Loss in life expectancy

The interventions will be designed for the people who usually process beef – men, and for those who usually process dairy and prepare food – women. Hence the importance of sensitivity to gender and cultural norms.

“The results of the intervention studies will demonstrate whether they are effective and, if so, the associated decrease in illnesses expected from wider implementation.” Scharff said. “I will then be able to estimate the economic benefits and costs of the interventions.”

Because implementing change across the entire country could be difficult, Scharff will also calculate the value of using these interventions in more localized areas.

The project has the potential for profound results.

“Even if a country doesn’t currently collect the data needed for our analyses, we’ll show how other researchers can gather the data needed for these types of evaluations,” Scharff said. “People haven’t used this approach before because it’s been considered most appropriate for countries that already have the data.”

The model produced will offer a valid way to determine whether it makes sense to implement a given intervention, Scharff said.

Research with international collaborators

Scharff and Kowalcyk are working with more than a dozen partners at Ohio State and in the United States, Ethiopia and Europe.

In Ethiopia, Ohio State will work with the Ethiopian Public Health Institute, Ethiopian Food, Medicine and Healthcare Administration and Control Authority and relevant units within the Ministry of Agriculture and Livestock Resources, such as the Ethiopian Meat and Dairy Development Institute.

Faculty at the Ethiopian universities of Haramaya, Gondar and Addis Ababa will collaborate.

The project also involves faculty and research expertise from Ohio State’s College of Public Health, College of Veterinary Medicine and the Global One Health initiative, as well as the University of Florida’s Feed the Future Innovation Lab for Livestock Systems.

Additionally, the team will collaborate with researchers and scientists from the International Livestock Research Institute based in Kenya, the Technical University of Denmark, the Food and Agriculture Organization of the United Nations and the World Health Organization.

The project team also will work collaboratively with its sponsors, the Bill & Melinda Gates Foundation and the U.K. Government’s Department for International Development (DFID), to ensure project success.


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