Safeguarding human health in the Anthropocene epoch: report of The Rockefeller Foundation–Lancet Commission on planetary health

Wheat is fundamental to human civilization and has played an outstanding role in feeding a hungry world and improving global food security The crop contributes about 20 % of the total dietary calories and proteins worldwide Food demand in the developing regions is growing by 1 % annually and varies from 170 kg in Central Asia to 27 kg in East and South Africa The developing regions (including China and Central Asia) account for roughly 53 % of the total harvested area and 50 % of the production Unprecedented productivity growth from the Green Revolution (GR) since the 1960s dramatically transformed world wheat production, benefitting both producers and consumers through low production costs and low food prices Modern wheat varieties were adopted more rapidly than any other technological innovation in the history of agriculture, recently reaching about 90 % of the area in developing regions One of the key challenges today is to replace these varieties with new ones for better sustainability While the GR “spared” essential ecosystems from conversion to agriculture, it also generated its own environmental problems Also productivity increase is now slow or static Achieving the productivity gains needed to ensure food security will therefore require more than a repeat performance of the GR of the past Future demand will need to be achieved through sustainable intensification that combines better crop resistance to diseases and pests, adaptation to warmer climates, and reduced use of water, fertilizer, labor and fuel Meeting these challenges will require concerted efforts in research and innovation to develop and deploy viable solutions Substantive investment will be required to realize sustainable productivity growth through better technologies and policy and institutional innovations that facilitate farmer adoption and adaptation The enduring lessons from the GR and the recent efforts for sustainable intensification of cereal systems in South Asia and other regions provide useful insights for the future

/pdf/crops-that-feed-the-world-6-past-successes-and-future-57mr5z3ily.pdf

Crops that feed the world 6. Past successes and future challenges to the role played by maize in global food security

BackgroundHepatocellular carcinoma (HCC), or liver cancer, is the third leading cause of cancer deaths worldwide, with prevalence 16–32 times higher in developing countries than in developed countr...

Global Burden of Aflatoxin-Induced Hepatocellular Carcinoma: A Risk Assessment

Aflatoxins and fumonisins (FB) are mycotoxins contaminating a large fraction of the world's food, including maize, cereals, groundnuts and tree nuts. The toxins frequently co-occur in maize. Where these commodities are dietary staples, for example, in parts of Africa, Asia and Latin America, the contamination translates to high-level chronic exposure. This is particularly true in subsistence farming communities where regulations to control exposure are either non-existent or practically unenforceable. Aflatoxins are hepatocarcinogenic in humans, particularly in conjunction with chronic hepatitis B virus infection, and cause aflatoxicosis in episodic poisoning outbreaks. In animals, these toxins also impair growth and are immunosuppressive; the latter effects are of increasing interest in human populations. FB have been reported to induce liver and kidney tumours in rodents and are classified as Group 2B 'possibly carcinogenic to humans', with ecological studies implying a possible link to increased oesophageal cancer. Recent studies also suggest that the FB may cause neural tube defects in some maize-consuming populations. There is a plausible mechanism for this effect via a disruption of ceramide synthase and sphingolipid biosynthesis. Notwithstanding the need for a better evidence-base on mycotoxins and human health, supported by better biomarkers of exposure and effect in epidemiological studies, the existing data are sufficient to prioritize exposure reduction in vulnerable populations. For both toxins, there are a number of practical primary and secondary prevention strategies which could be beneficial if the political will and financial investment can be applied to what remains a largely and rather shamefully ignored global health issue.

/pdf/mycotoxins-and-human-disease-a-largely-ignored-global-health-d33u8z26x8.pdf

Mycotoxins and human disease: a largely ignored global health issue

Aflatoxin: a 50-year odyssey of mechanistic and translational toxicology.

Consecutive outbreaks of acute aflatoxicosis in Kenya in 2004 and 2005 caused > 150 deaths. In response, the Centers for Disease Control and Prevention and the World Health Organization convened a workgroup of international experts and health officials in Geneva, Switzerland, in July 2005. After discussions concerning what is known about aflatoxins, the workgroup identified gaps in current knowledge about acute and chronic human health effects of aflatoxins, surveillance and food monitoring, analytic methods, and the efficacy of intervention strategies. The workgroup also identified public health strategies that could be integrated with current agricultural approaches to resolve gaps in current knowledge and ultimately reduce morbidity and mortality associated with the consumption of aflatoxin-contaminated food in the developing world. Four issues that warrant immediate attention were identified: a) quantify the human health impacts and the burden of disease due to aflatoxin exposure; b) compile an inventory, evaluate the efficacy, and disseminate results of ongoing intervention strategies; c) develop and augment the disease surveillance, food monitoring, laboratory, and public health response capacity of affected regions; and d) develop a response protocol that can be used in the event of an outbreak of acute aflatoxicosis. This report expands on the workgroup's discussions concerning aflatoxin in developing countries and summarizes the findings.

Gilbert N. Kibata

Papers

Workgroup Report: Public Health Strategies for Reducing Aflatoxin Exposure in Developing Countries