Foodborne diseases and public health governance: comparing food safety, consumer preferences and governance in the supply of meat to urban markets

我们将研究鸡肉和牛肉的安全性，穷人如何获得这些肉类，以及如何改善其安全性，以增加秘鲁人民的营养和健康。我们之所以选择研究肉类，是因为1)肉类是高质量蛋白质和营养素的极好来源（对儿童和青少年尤其重要），但2)肉类消费通常与食源性疾病有关，特别是在秘鲁等低收入和中等收入国家。腹泻和营养不良的相互作用是公认的，幼儿特别容易受到伤害。在秘鲁，腹泻是儿童最常见的疾病之一，造成长期营养不良，并对婴儿和儿童的健康造成问题。对于成年人来说，这些疾病会导致疾病，有时甚至导致死亡。因此，重要的是要了解秘鲁肉类产品的安全程度，穷人从哪里购买肉类，以及如何提高穷人消费的肉类质量。我们将研究三种肉类摊贩：超市、菜市场和街头摊贩。秘鲁人每天的大部分食物都是从菜市场和街头小贩那里购买的。然而，超市也变得越来越重要。尽管迄今为止的研究假设超市出售的肉类质量更好、更安全，但这还没有得到证实。世界各地的政策制定者都建议从传统的菜市场转移到超市，以提高食品安全。我们需要进行研究，首先测试食品安全是否在不同类型的供应商之间存在差异，并确定为所有公民改善肉类安全的最佳方法，包括贫穷的消费者和为传统市场供货的农民。我们将在秘鲁三个中等城市开展调研。我们选择这些城市是因为它们接收来自秘鲁不同地区和秘鲁以外的鸡肉和牛肉。我们将与参与鸡肉和牛肉生产和消费的人一起进行研究。更具体地说，我们想回答以下问题：1。与进口肉类或大型养殖户生产的肉类相比，小规模养殖户本地供应的肉类有哪些食品安全风险？2. 农民、贸易商、加工商、食品供应商和贫穷的城市消费者如何看待和应对食品安全风险？消费者如何看待这与他们/他们孩子的营养健康的联系？哪些食品卫生措施可以提高来自不同供应链的肉类的安全性？哪些治理模式可以在不破坏当地食品生产的情况下改善食品安全和公共卫生？我们将首先研究秘鲁有哪些法律确保超市、菜市场和街头摊贩的食品安全。然后，我们会询问供应商他们的肉类是如何获得的，从谁那里获得的，他们对肉类安全的看法，以及他们在销售肉类时如何确保食品安全。我们将评估哪些供应商的做法会增加食品安全风险，并对肉类中是否存在某些导致人类疾病的病原体进行生物学测试。我们将使用一种细菌肉类安全指标：大肠杆菌和产肠毒素菌株大肠杆菌0157:H7是引起儿童结肠炎和溶血性尿毒症综合征的主要肉源病原体之一，它与其他常见的食源性胃肠道病原体有相同的暴露途径，它的存在（大肠杆菌本身，不一定是产肠毒素）可以作为食物链上的卫生指标。我们将使用模拟模型来测试潜在控制的影响，并将询问消费者和其他参与者他们如何看待食品安全以及他们如何改进食品安全。在项目结束时，我们将在邀请秘鲁决策者、农民、贸易商、屠宰商、供应商、消费者和秘鲁研究人员的活动上传达我们的发现。这次活动将确保我们的研究成果被受影响的人使用，并有能力改善秘鲁的食品安全成果，这对营养和健康至关重要

We will study the safety of chicken meat and beef, how poor people access these meats and how can their safety be improved to increase people's nutrition and health in Peru. We have chosen to study meat because 1) meat is an excellent source of high-quality protein and nutrients (especially important for children and adolescents), but 2) consumption of meat is often associated with foodborne illness, in particular in low- and middle-income countries such as Peru. The synergistic interactions of diarrhoea and undernutrition are well recognized and young children are particularly vulnerable. In Peru, diarrhoea is one of the most common illness for children, causing long-lasting malnutrition, and problems in infants' and children's health. For adults, these diseases lead to illness and at times death. Therefore, it is important to understand how safe meat products are in Peru, from whom poor people buy meats, and how the quality of meats poor people consume can be improved. We will study three kinds of meat vendors: supermarkets, wet markets, and street vendors. Peruvian people buy much of their everyday food from wet markets and street vendors. However, supermarkets are becoming important as well. Even though research to date assumes that supermarkets sell better quality and safer meat, this has not been proven. Policy makers across the world have suggested moving from traditional wet markets to supermarkets in order to improve food safety. We need research to first test whether food safety differs across the types of vendors and identify the best ways to improve meat safety for all citizens, including poor consumers and farmers who supply traditional markets. We will conduct research in three medium-sized cities in Peru. We selected these cities because they receive chicken and beef from different parts of Peru and outside of Peru. We will conduct our research with people who are involved with production and consumption of chicken and beef. More specifically, we want to answer the following questions:1. What are the food safety risks of locally supplied meat by small-scale farmers compared with imported meat or meat produced by large-scale farmers? 2. How are food safety risks perceived and addressed by farmers, traders, processors, food vendors and poor urban consumers? How do consumers perceive the link to their/their children's nutritional health?3. What food hygiene measures can improve safety of meat sourced from different supply chains?4. What governance models can improve food safety and public health without disrupting local food production?We will first study what laws exist in Peru that ensure food safety in supermarkets, wet markets and street vendors. Then, we will ask vendors how they obtain their meats, from whom, what they think about meat safety, and how they ensure food safety when selling meats. We will evaluate what vendor practices can increase food safety risks, and biologically test if certain pathogens that cause human illness exist in meats. We will use one type of bacteria meat safety indicator: E.coli and the enterotoxigenic strain E.coli 0157:H7 is one of the major meat-borne pathogen causing colitis and haemolytic-uremic syndrome in children, it shares exposure routes with other common foodborne gastrointestinal pathogens and its presence (of E.coli itself, not necessarily enterotoxigenic) can be used as hygiene indicator along the food chain. We will use simulation models to test the impact of potential controls and will ask consumers and other actors how they think about food safety and what they do to improve it. At the end of the project, we will communicate our findings at an event where we invite Peruvian policy makers, farmers, traders, slaughterers, vendors, consumers and Peruvian researchers. This event will ensure that our research is used by people who are affected and are in the position to improve food safety outcomes in Peru that are important for nutrition and health