A Proposed Framework for Ranking and Prioritizing Food Safety Risks in Low Resource Settings Using Foodborne Disease Burden Metrics: A Case Study in Ethiopia

Barbara Kowalcyk, Center for Foodborne Illness Research and Prevention, The Ohio State University, Columbus, OH, USA; Translational Data Analytics Institute, The Ohio State University, Columbus, OH, USA; Milken Institute School of Public Health, George Washington University, Washington, DC, USA. Electronic address: barbara.kowalcyk@gwu.edu.
Leon Gorris, Food Safety Futures, Nijmegen, The Netherlands.
Janet Buffer, Center for Foodborne Illness Research and Prevention, The Ohio State University, Columbus, OH, USA; Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Kathryn Stolte-Carroll, Center for Foodborne Illness Research and Prevention, The Ohio State University, Columbus, OH, USA; Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Bashiru C. Bakin, Center for Foodborne Illness Research and Prevention, The Ohio State University, Columbus, OH, USA.
Allison Howell, Center for Foodborne Illness Research and Prevention, The Ohio State University, Columbus, OH, USA.
Desalegne Degefaw, Global One Health Initiative, The Ohio State University, Columbus, OH, USA.
Binyam Moges, Global One Health Initiative, The Ohio State University, Columbus, OH, USA.
Kara Morgan, Center for Foodborne Illness Research and Prevention, The Ohio State University, Columbus, OH, USA.
Laura Binkley, Global One Health Initiative, The Ohio State University, Columbus, OH, USA.
Getnet Yimer, Global One Health Initiative, The Ohio State University, Columbus, OH, USA; Department of Genetics and Penn Center for Global Genomics & Health Equity, Perelman School of Medicine University of Pennsylvania, Philadelphia, PA, USA.
Arie H. Havelaar, Emerging Pathogens Institute, Global Food Systems Institute, Animal Sciences Department, University of Florida, Gainesville, FL, USA.

Document Type

Journal Article

Publication Date

5-1-2025

Journal

Journal of food protection

DOI

10.1016/j.jfp.2025.100525

Keywords

decision-making; risk analysis; risk prioritization; risk ranking; risk-based food safety management systems

Abstract

Risk-based food safety systems are recognized as the best way to address food safety in an effective and efficient manner. Central to risk-based food safety systems is an assessment, ranking, and prioritization of risks associated with foodborne hazards that informs objective, evidence-based decisions on risk mitigation in a systematic and transparent manner. While the importance of such approaches is well recognized, many governments struggle with where to begin. We adapted and implemented a framework for risk-based decision-making in low resource settings using Ethiopia as an example, engaging Ethiopian stakeholders in a multi-phase process to identify food safety priorities. First, stakeholder representatives were engaged to define statements of concern and purpose; identify foodborne hazards of public health relevance in Ethiopia; and select appropriate risk metrics for risk ranking and prioritization. Second, estimates for each risk metric were calculated for selected foodborne hazards using World Health Organization (WHO) data and expert elicitation. Third, stakeholder representatives were engaged in ranking the hazards as High, Medium, or Low risk; notably, mortality was the preferred risk metric in decision-making. Fourth, attribution estimates to food groups were developed for hazards ranked as High risk using expert elicitation to supplement WHO data. Lastly, stakeholder representatives were engaged in a risk prioritization exercise that identified key control points in four food supply chains and quantified their impact on risk through mitigation of hazards or prevention of contamination. Our proposed framework provides a systematic, evidence-based and adaptable method for prioritizing allocation of public sector resources. The process can generate the evidence needed to strengthen regulatory systems and support efficient implementation of national-level food safety strategies that span from farm to fork to improve public health.

Department

Exercise and Nutrition Sciences

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