Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK.
International Livestock Research Institute, Nairobi, Kenya; Natural Resources Institute, University of Greenwich, London, UK.
Lancet Planet Health. 2022 Sep;6(9):e760-e768. doi: 10.1016/S2542-5196(22)00116-4.
The emergence of COVID-19 has drawn the attention of health researchers sharply back to the role that food systems can play in generating human disease burden. But emerging pandemic threats are just one dimension of the complex relationship between agriculture and infectious disease, which is evolving rapidly, particularly in low-income and middle-income countries (LMICs) that are undergoing rapid food system transformation. We examine this changing relationship through four current disease issues. The first is that greater investment in irrigation to improve national food security raises risks of vector-borne disease, which we illustrate with the case of malaria and rice in Africa. The second is that the intensification of livestock production in LMICs brings risks of zoonotic diseases like cysticercosis, which need to be managed as consumer demand grows. The third is that the nutritional benefits of increasing supply of fresh vegetables, fruit, and animal-sourced foods in markets in LMICs pose new food-borne disease risks, which might undermine supply. The fourth issue is that the potential human health risks of antimicrobial resistance from agriculture are intensified by changing livestock production. For each disease issue, we explore how food system transition is creating unintentional infectious disease risks, and what solutions might exist for these problems. We show that successfully addressing all of these challenges requires a coordinated approach between public health and agricultural sectors, recognising the costs and benefits of disease-reducing interventions to both, and seeking win-win solutions that are most likely to attract broad policy support and uptake by food systems.
新冠疫情的爆发使卫生研究人员强烈关注到食物系统在产生人类疾病负担方面的作用。但新发的大流行病威胁只是农业与传染病之间复杂关系的一个方面，这种关系正在迅速演变，特别是在正在经历快速食物系统转型的低收入和中等收入国家（LMICs）中。我们通过当前的四个疾病问题来考察这种不断变化的关系。第一个问题是，为提高国家粮食安全而加大灌溉投资会增加媒介传播疾病的风险，我们用非洲的疟疾和水稻案例来说明这一点。第二个问题是，在 LMICs 中加强畜牧业生产会带来像囊尾蚴病这样的人畜共患病的风险，随着消费者需求的增长，需要对此进行管理。第三个问题是，增加 LMICs 市场中新鲜蔬菜、水果和动物源性食品供应的营养益处带来了新的食源性疾病风险，这可能会破坏供应。第四个问题是，农业中抗生素耐药性对人类健康的潜在风险因改变了的畜牧业生产而加剧。对于每一个疾病问题，我们探讨了食物系统转型如何产生无意识的传染病风险，以及针对这些问题可能存在哪些解决方案。我们表明，成功应对所有这些挑战需要公共卫生和农业部门之间的协调方法，既要认识到减少疾病干预措施对两者的成本和收益，也要寻求最有可能吸引广泛政策支持和被食物系统采纳的双赢解决方案。
