Sub-Saharan Africa is experiencing a food-related health risk problem in informal food environments

An urgent need for science and policy actions

Abstract

Introduction

Sub-Saharan Africa’s (SSA) food systems have been transformed by science-driven gains in pro­ductivity and market access, yet a health crisis is intensifying within its vast informal food environ­ments. Agricultural research and technology invest­ments have strengthened smallholder systems (Shilomboleni & De Plaen, 2019) and expanded food availability (Clark & Hobbs, 2023), while rising socioeconomic conditions escalate nutri­tional demands (Blekking et al., 2022; Djurfeldt, 2015) and propel calls for dietary diversity (Paulo et al., 2024; Usman & Haile, 2022). However, these advances are harshly undermined by the burden of foodborne diseases. An estimated 91 million peo­ple in Africa fall ill annually from food-related ill­nesses, generating over US$15 billion in medical costs and 137,000 deaths (Nigussie et al., 2025; World Health Organization [WHO] Africa, 2019), with downstream economic losses in tourism (Chen et al., 2021). Agrochemical residues, poor hygiene, and weak legislative enforcement in Africa’s largely informal food sectors drive this burden. 

Here, we synthesize health threats in informal food environments and call for an urgent agenda to protect public health across SSA. This viewpoint provides a snapshot of health-risk exposures across the three dominant value chains: fruits and vegeta­bles, livestock, and aquatic foods. It emphasizes that while food availability, affordability and acces­sibility reduce food insecurity, they mask uncon­trolled hazards. Addressing this demands research to characterize risks, quantify health and economic burdens, and develop context-specific interven­tions. Integrated science-policy action must follow to safeguard populations relying on these environments.