Ayako Ebata

The One Health approach recognizes the interconnectedness of human, animal, and environmental health, yet its implementation has largely focused on biomedical issues such as zoonoses and antimicrobial resistance (AMR). This biomedical focus often overlooks the social and economic drivers that shape these challenges. In this article, we argue that applying a commercial determinants of health (CDoH) lens can enhance the analytical and policy relevance of One Health as CDoH defines how non-public actors, activities and incentives support as well as undermine health. Specifically, the CDoH framework enables a systematic analysis of the diverse actors, interests and market dynamics that shape intensified animal production, which creates trade-offs between positive (e.g., economic growth, poverty reduction, food security) and negative (e.g., increased zoonotic risk, AMR, environmental degradation) outcomes. Moreover, it supports engagement with sectors beyond health, helping to identify governance strategies that balance economic, social, and ecological objectives. By integrating CDoH into One Health research and policy, we propose a more context-specific and politically informed approach to managing health risks in a globalized and rapidly changing world.

This paper estimates consumers' willingness to pay (WTP) for meat certified to be safe for human consumption in Peru. Citizens in low- and middle-income countries (LMICs) are increasingly concerned about the safety of food they consume. Across LMICs, urban markets remain the most important source of fresh and nutritious produce and therefore policymakers need to ensure food safety in urban markets. Much focus has been put on providing producers and supply chain actors with economic incentives to improve food safety. However, such effort has had limited effect without addressing the overall market and food safety governance. In this paper, based on an innovative policy experience from Peru, we explore if and how much consumers are willing to pay for meat sold at market stalls that are certified to provide safe meat. Peru has employed a series of economic packages to incentivise market vendors to improve their practices, and in turn increase their revenue. Our analysis based on a consumer survey across three cities in Peru reveal that consumers are willing to pay 7.1%, 5.8% and 5.3% of the average retail prices of chicken, pork and beef, respectively. This amounts to an average of about 216USD/month of extra revenue for vendors.

Objectives To understand community antibiotic practices and their drivers, comprehensively and in contextually sensitive ways, we explored the individual, community and health system-level factors influencing community antibiotic practices in rural West Bengal in India. Design Qualitative study using focus group discussions and in-depth interviews. Setting Two contrasting village clusters in South 24 Parganas district, West Bengal, India. Fieldwork was conducted between November 2019 and January 2020. Participants 98 adult community members (42 men and 56 women) were selected purposively for 8 focus group discussions. In-depth interviews were conducted with 16 community key informants (7 teachers, 4 elected village representatives, 2 doctors and 3 social workers) and 14 community health workers. Results Significant themes at the individual level included sociodemographics (age, gender, education), cognitive factors (knowledge and perceptions of modern antibiotics within non-biomedical belief systems), affective influences (emotive interpretations of appropriate medicine consumption) and economic constraints (affordability of antibiotic courses and overall costs of care). Antibiotics were viewed as essential fever remedies, akin to antipyretics, with decisions to halt mid-course influenced by non-biomedical beliefs associating prolonged use with toxicity. Themes at the community and health system levels included the health stewardship roles of village leaders and knowledge brokering by informal providers, pharmacists and public sector accredited social health activists. However, these community resources lacked sufficient knowledge to address people’s doubts and concerns. Qualified doctors were physically and socially inaccessible, creating a barrier to seeking their expertise. Conclusions The interplay of sociodemographic, cognitive and affective factors, and economic constraints at the individual level, underscores the complexity of antibiotic usage. Additionally, community leaders and health workers emerge as crucial players, yet their knowledge gaps and lack of empowerment pose challenges in addressing public concerns. This comprehensive analysis highlights the need for targeted interventions that address both individual beliefs and community health dynamics to promote judicious antibiotic use.

Food systems employ billions of people across the world, many of whom are socially and economically marginalised. The livelihoods within the food systems these people rely on tend to be precarious and low in economic return, exacerbating social and economic inequality while preventing food systems from improving their ecological sustainability. In this paper, we review the different ways in which equitable livelihoods within food systems are conceptualised across academic communities, and what interventions are suggested to make food systems livelihoods more equitable. We analyse the tensions and complementarity between these different approaches and suggest an inter- and trans-disciplinary methodology.

Research findings reveal that disease-causing bacteria, including Salmonella, are widespread on pig farms of all sizes in Yangon Region, Myanmar, as well as in pig meat sold to consumers in the city and rural areas. This evidence provides a snapshot of how intensification in pig production can affect food safety – and points to potential responses.

This study explored how measures to curtail the spread of the coronavirus (Covid-19) in Vietnam affected the livelihoods and food and nutrition security of internal migrant workers. While Vietnam has made impressive progress towards food security in the past decades, marginalised groups of people such as ethnic minorities and migrants continue to face significant challenges. The project team investigated how the pandemic affected the precarity of these groups’ income-generating opportunities and how the level of income generated affected the quality, as well as the quantity, of food consumed by migrant workers in Hanoi, the capital, and the Bac Ninh province, which hosts large industrial zones. Our research shows that income for migrant workers significantly reduced as a result of Covid-19-related lockdown measures.

Migrant workers in Vietnam make up 7.3 per cent of the population. Despite rapid economic growth, they suffer from precarious working conditions and food insecurity, which Covid-19 control measures have exacerbated. Urgent action is needed to improve migrant workers’ access to nutritious food during crises and increase resilience to future economic shocks through: (1) short-term responses that provide nutritious food; (2) improving living conditions through effective enforcement of existing policies; (3) expanding coverage of the government social safety net; and (4) progressive reform of labour law to reduce their vulnerability to job loss and increase their bargaining power.

Agricultural intermediaries – traders and middlemen/women – play a critical role for food security in low- and middle-income countries (LMICs). Yet, their role in improving or undermining food safety, an indicator for food quality, is not well understood. As middle-class citizens increasingly demand high-quality perishable and nutritious produce, food safety has become an important issue in LMICs. The existing literature offers limited insights as to whether and, if so, how intermediaries manage information regarding food safety in LMICs. This article fills this gap based on an in-depth qualitative study on pig value chains in Myanmar. We document that intermediaries helped reduce transaction costs of trade by linking farmers to buyers based on an intricate socio-economic relationship. While we find no evidence of intermediaries actively concealing facts about invisible (i.e. microbiological or chemical) nature of pig products, they facilitated selling sick animals. On the other hand, intermediaries withheld information about potential buyers and sellers in order to maintain their role along the value chains. In order to improve food safety in LMICs, policies need to reduce transaction costs of trade as well as access to public health expertise.