1. Aflatoxin Control in Tanzania
Pre-Read for Business Meeting: Overview of National Action Plan and Opportunities for Resourcing
May 2016

2. Aflatoxins are toxic fungi that currently contaminates up to 40% of maize and 20% of groundnuts in the worst affected areas in Tanzania
WHAT IS AFLATOXIN?
Aflatoxins are toxic fungi metabolites which contaminate staple foods
Aflatoxin-producing mold can affect grain and other food crops (particularly maize and groundnuts) but can also enter livestock value chains through contaminated feed
Millions of people living in Africa are exposed to high, unsafe levels of aflatoxins through their diet. Meanwhile, farmers miss out on export opportunities since their products do not meet international food safety standards
IN THE WORS AFFECTED AREAS IN TANZANIA, UP TO…
40% of MAIZE
20% of GROUNDNUTS
… MAY BE INFECTED WITH AFLATOXIN, BEYOND THE NATIONAL SAFETY STANDARDS
Aflatoxins disproportionately impact women, children and the poor.
Food-insecure households are more likely to consume contaminated food rather than sell it at lower prices or discard it. The poor may also not be able to adopt costly control strategies. Women are also less likely to have access to information and resources for aflatoxin control and mitigation. In addition, aflatoxin affects staple foods such as maize which is often used as one of the primary foods in infants diets.

3. DO NOT CIRCULATE – Work in progress DRAFT FOR DISCUSSION ONLY
Aflatoxins are most common in Eastern and Western zones of Tanzania, and low levels of awareness have made it challenging to overcome the problem
Tanzania has set the maximum acceptable limit for cereals at 10 parts per billion (ppb) for total aflatoxins and 5 ppb for aflatoxin B1. For groundnuts, the limit is set at 15 ppb for total aflatoxins and 5 ppb for aflatoxin B1.
What is the prevalence of aflatoxin in different regions of Tanzania?
How aware are stakeholders on aflatoxin in Tanzania?
In the Eastern zone, 43% of maize samples were above 5 ppb and in the Western zone 40% of samples were above 5 ppb, with average contamination of 50 ppb and 28 ppb, respectively.
The contamination of maize samples was much lower in other zones: in the Northern zone 9% of the samples were above 5 ppb; in the Southern Highlands only 4% were above 5 ppb; and in the Southern zone none of the samples were above 5 ppb.
Policy makers
Activities by PACA and others within the MoALF have increased the extent to which government actors, donors and other policy decision makers are informed about the risks posed by aflatoxin and some mitigation strategies.
Continued stakeholder engagement is required to create widespread action behind the issue
Farmers and Consumers
Groundnut samples with aflatoxin B1 contamination above 5 ppb were found in the Northern, Southern, and Western zones with 20%, 20%, and 18%, respectively, with respective mean contaminations at 20 ppb, 18 ppb, and 20 ppb.

4. Tanzania make significant loses in trade, and spends up to 264 million USD treating the health effects associated with aflatoxin annually
AGRICULTURE
Tanzania loses make significant annual losses due to loss of trade of aflatoxin affected agricultural commodities
Major challenges include:
Food insecurity and limited dietary diversity
Economic losses and barriers to trade
HEALTH
Tanzania loses approximately 96,686 (Disability-Adjusted Life Years) DALYs based on the morbidity and mortality associated with aflatoxin
Treating the health effects related to aflatoxin consumption require approximately 264 million USD
Major challenges include:
Poisoning (i.e., aflatoxicosis) and death
Increased liver cancer risk, particularly for hepatitis B virus (HBV) positive populations
Child stunting
Immune suppression and greater susceptibility to human immunodeficiency virus (HIV), tuberculosis, and malarial infection

5. The action plan activities ensure the full cycle of program implementation can be realized
Aflatoxin control activities can be characterized in terms of a four-stage cycle (“the HOW”)
Understand the scope of the problem and evidence about solutions
Mobilize financial and human resources for solutions to identified problems
Implement solutions including programs and interventions
Develop new solutions including policies, regulations and pilot programs

6. The action plan covers four thematic areas
Solutions for aflatoxin control in Tanzania fall into four main categories (“the WHAT”)
TECHNOLOGY
Research and development of new technology for aflatoxin control
Application of technologies for aflatoxin control in the field
Use of technology to gather data about aflatoxin contamination
INFORMATION AND AWARENESS
Preparation of public facing information resources for key stakeholders
Implementation of training and educational programs (e.g., for farmers)
Public dissemination of information on aflatoxin contamination and control opportunities
Capacity building for leadership/mgmt. throughout lifecycle for other aflatoxin control solutions
QUALITY INFRASTRUCTURE AND POLICY
Efforts to mainstream aflatoxin control in national policymaking
Research and development to introduce new quality standards
Implementation of standards and conformity assessments
Capacity building throughout ecosystem for quality and conformity
Incentives for market actors to change market behavior
LEADERSHIP AND MANAGEMENT
Enactment or enhancement of bodies to oversee aflatoxin control including PACA secretariat
Introduction of accountability frameworks and use of M&E tools

7. PACA program staff will be responsible for periodic monitoring the activities and outcomes of country implementation

8. To implement all the activities outlined in the Action Plan will require the equivalent of USD 9 million in financial and in kind support
Funding required (USD thousands)
Total investment
Technology
Information, Awareness and Behavior Change
Quality Infrastructure And Policy
Leadership and Management
Funding for these activities will be sought from a variety of stakeholders, in addition to government financial and in-kind contributions
Source: Tanzania Aflatoxin Action Plan

9. Why is technology important?
Technology interventions aim to increase outputs of aflatoxin risk and mitigation technologies by 50%, over the lifecycle of the program
Why is technology important?
Impact spotlight
Research and scaling of new technologies can significantly reduce the extent to which aflatoxin is prevalent in major value chains
This could include additional research into aflatoxin resistant planting materials, storage and drying techniques, and other processing technologies, biocontrol products (such as aflasafe), and alternative uses of unsafe commodities
The interventions outlined in the aflatoxin control strategy aim to increase aflatoxin risk and mitigation technologies, by 50% over the lifecycle of the program
This should result in:
Agricultural impact: A significant decrease in the volume of aflatoxin contaminated produce reaching the market
Health impact: A corresponding decrease in the amount of aflatoxin contaminated food ingested by consumers (with a particular focus of women, children and the vulnerable poor) which will improve health outcomes
Trade/economic impact: A significant increase in the volume of traditionally aflatoxin infected crops available to be traded on the international market
What are some of the priority intervention areas a funder could contribute to
Improved Storage Infrastructure: Researching, piloting and scaling improved storage infrastructure, aimed at reducing the spread of aflatoxins after harvest
New Biological Technology: Adapting best practices in other geographies conducting additional research, piloting and scaling the dissemination of biocontrol technology (including aflasafe) and aflatoxin resistant seed varieties
New Uses for Commodities: Researching, piloting and scaling alternative uses for aflatoxin contaminated commodities, as well as creating FMCGs created using aflatoxin free commodities

10. Estimated costs: What financial and in kind support is required to implement the technology activities?
Amount required (USD thousands)
Total
Design regional friendly models of improved Post harvest handling and storage facilities for all agro ecological zones
Develop a regional friendly model of improved storage facilities for all the agro ecological zones
Deploy models of improved storage facilities to each agro-ecological zone
Conduct trails for identification and formulation of Bio-controls for maize and groundnuts
Assess the risk of CPA contamination and exposure from bio control produced maize and groundnuts, annually
Assess impact on the environment of atoxigenic fungi bio control application
Research alternative uses of aflatoxin contaminated produce
Support breeding of aflatoxin resistant maize and groundnut varieties
Determine on annual basis at least two crops and proportions that can be used to substitute for maize and groundnuts in complementary foods and incorporate them in the national nutrition guidelines
1,801

11. Why is information and awareness important
Information and awareness interventions aim to increase consumer awareness by 30% and value chain awareness by 50%
Why is information and awareness important
Impact spotlight
Current levels of awareness of aflatoxin and its associated risks are low in Tanzania
In some cases this may be because aflatoxins are colorless and odorless toxic metabolites, and are not always visible to the human eye
Information intermediaries (farmer associations, schools, the media, local and national decision makers, agricultural extension services, etc.) lack the training and resources required to disseminate appropriate aflatoxin information
The interventions outlined in the aflatoxin control strategy aim to increase consumer knowledge of aflatoxin and its mitigation strategies by 30%
The interventions outlined in the aflatoxin control strategy aim to increase value chain actor knowledge of aflatoxin and its mitigation strategies by 50%
This should result in:
Agricultural impact: A significant decrease in the volume of aflatoxin contaminated produce reaching the market
Health impact: A significant decrease in the amount of aflatoxin contaminated food ingested by consumers (with a particular focus of women, children and the vulnerable poor) which will improve health outcomes
Trade/economic impact: A significant increase in the volume of traditionally aflatoxin infected crops available to be traded on the international market
What are some of the priority intervention areas a funder could contribute to
Capacity building activities: Capacity building aimed at institutional stakeholders, information intermediaries, farmers and consumers on the mitigation strategies associated with aflatoxin control
Information dissemination: Information dissemination aimed at institutional stakeholders, information intermediaries, farmers and final consumers on the risks associated with aflatoxin control and the resources available to them

12. Estimated costs: What financial and in kind support is required to implement the information and awareness activities? (1 of 4)
Amount required (USD thousands)
Total
Conduct advocacy and sensitization meetings with Management of the Ministry of Agriculture, Livestock and Fisheries
Develop and present strategies for implementation of food safety related policy statements of the National Agriculture Policy (2013) to stakeholders for validation
Conduct workshops to disseminate the GAPs and GAPHs for at least 30 districts agricultural extension officers and phytosanitary inspectors, annually
Support delivery of GAP and GAHP Guidelines to all districts
Facilitate meetings for formulation and validation of specific regulations for Aflatoxins in feed
Build capacity for and monitoring of aflatoxins in animal feeds
Conduct workshops for Quality control managers from all the cereal and oil seed based products on application of the Guidelines for Good Manufacturing Practices (GMP)/ HACCP plan for Aflatoxins control
Conduct advocacy and sensitization meetings with Management of the Ministry of Industries and Trade (MoIT)
Present the strategies for implementation of food safety related policy statements of the National Agricultural Marketing Policy (2008) to the stakeholders for validation
Advocate and sensitize the private sector stakeholders to facilitate establishment of a self regulatory mechanism
4,347

13. Estimated costs: What financial and in kind support is required to implement the information and awareness activities? (2 of 4)
Amount required (USD thousands)
Conduct sensitization meeting with the private sector to advocate for establishment of, at least, two farmers’ cooperative societies
Incorporate aflatoxin avoidance measures in the Guidelines on Infant and Young Child Nutrition
Distribute the new guidelines on Infant and Young Child Nutrition to all districts,
Conduct a workshop to train all district nutrition officers on aflatoxin issues and aflatoxin measures contained in the infant and young child Nutrition
Develop information and communication materials on dietary diversification
Air at least one radio program weekly, on the importance of dietary diversification as one of the measures to minimize aflatoxin exposure
Conduct advocacy to the Management of the Ministry of Health and Social Welfare on the synergistic effects between aflatoxin exposure and HBV
Conduct meetings with the MoHSW Management and Prime Ministers Office to advocate for establishment of a Risk Assessment framework under the Food Safety Policy
Perform situation analysis and prepare background paper and present it to relevant organs
Support short course training on aflatoxin risk assessment for at least 6 staff
Conduct meetings with MoHSW officials and Parliamentary Social Services Committee to advocate for transformation of the TFDA board

14. Estimated costs: What financial and in kind support is required to implement the information and awareness activities? (3 of 4)
Amount required (USD thousands)
Conduct a stakeholders meeting to validate amendment of the Tanzania Food Drugs and Cosmetics Act to establish a multi sectoral Advisory Board
Conduct a stakeholders meeting to validate amendment of the Tanzania Fees and Charges Regulations
Conduct a stakeholders meeting to validate amendment of The Treatment and Disposal of Unfit food regulations
Conduct a stakeholders meeting to validate the regulations for control of Aflatoxins contamination in maize and groundnuts
Conduct a stakeholders meetings to validate regulations for enforcement of aflatoxin standards in the informal internal market
Conduct meetings with relevant authorities to advocate for incorporation of aflatoxin aspects in the primary and secondary school levels
Prepare and present information to be incorporated in curricula for schools
Train at least 30 Science teachers of primary and secondary level education , annually, on food safety issues, including Aflatoxins
Sensitize the SUA and MuHAS Management and support review of Curricula for undergraduates
Sensitize NM-AIST and SUA Managements and support review of postgraduate programs
Conduct two week course, annually, to processors and produce dealers in quality control and assurance with respect to aflatoxin contamination, annually

15. Estimated costs: What financial and in kind support is required to implement the information and awareness activities? (4 of 4)
Amount required (USD thousands)
Conduct two week course, annually, to at least 30 district extension workers on food safety and aflatoxin control.
Conduct a two week course to at least 30 health practitioners, annually
Support two higher Education institutions to improve aflatoxin risk assessment training capacity
Train at least 30 undergraduates on risk management for Aflatoxins
Train at least 15 post graduates on aflatoxin risk assessment and management
Develop a strategy for communication of the aflatoxin problem and mitigation measures
Provide a short course, on annual basis, to Communication personnel from all key sectors for aflatoxin management
Develop Leaflets, posters and feature stories to suit various needs
Conduct two advocacy campaigns, annually, for policy makers and politician
Conduct Seminars, workshops, meetings, exhibitions, Road shows, 10 radio , 10 TV programmes and 20 cinema shows on Aflatoxins, annually
Conduct a forum involving at least 30 participants, on Aflatoxins, annually
1,380
690

16. Why is quality infrastructure and policy important
Quality infrastructure interventions aim to increase aflatoxin compliant products in the market by 50%, over the lifecycle of the program
Why is quality infrastructure and policy important
Impact spotlight
Aflatoxin consumption has significant averse effects on the health and nutrition of consumers. Creating quality infrastructure for aflatoxin control helps increase consumer safety
Tanzania does not have a policy which provides for establishment of a food risk assessment body
There is currently no evidence of testing for aflatoxins in the domestic maize and groundnut markets in Tanzania. This may be because there are no incentives for testing; and no difference in price between contaminated and non-contaminated food
The interventions outlined in the aflatoxin control strategy aim to increase the rate of aflatoxin compliant products in the market by 50%, over the lifecycle of the program
This should result in:
Agricultural impact: A significant decrease in the volume of aflatoxin contaminated produce reaching the market
Health impact: A corresponding decrease in the amount of aflatoxin contaminated food ingested by consumers (with a particular focus of women, children and the vulnerable poor) which will improve health outcomes
Trade/economic impact: A significant increase in the volume of traditionally aflatoxin infected crops available to be traded on the international market
What are some of the priority intervention areas a funder could contribute to
Development of Quality Standards: Research and development of new quality standards, and mainstreaming of aflatoxin control in national policymaking
Implementation of Quality Standards Enforcement: Implementation of standards and conformity assessments, including capacity building throughout ecosystem for quality and conformity
Behavioral change incentives: Financial and in-kind behavioral incentives for value chain actors aimed at encouraging activities related to aflatoxin mitigation

17. Estimated costs: What financial and in kind support is required to implement the quality infrastructure and policy activities? (1 of 2)
Amount required (USD thousands)
Total
Formulate codes for prevention of aflatoxin contamination during pre-harvest and post-hravest operations for food crops and feeds
Integrate aflatoxin control measures in the GAPs, and GAHPs, for all cereal crops and oil seed produce
Develop guidelines for evaluation of effectiveness and efficacy of bio-control products
Develop Market-based incentives for production of safer food
Disseminate market-based incentives to all international markets in Tanzania (e.g. Kibaigwa) for maize millers and groundnuts processors
Develop Guidelines on application of GMP/HACCP plan to control Aflatoxins in manufacture of cereal and oil seed based food and feed
Support set up of a voluntary mechanism for self-regulation of food safety and quality
At least one referral hospital in each of the five zones equipped with facilities for screening patients for aflatoxin exposure
Monitor aflatoxin exposure in at least 500 individuals annually
Support formulation of a legal instrument for establishment of an autonomous food risk assessment body
1,129

18. Estimated costs: What financial and in kind support is required to implement the quality infrastructure and policy activities? (2 of 2)
Amount required (USD thousands)
Formulate a protocol for aflatoxin risk assessment
Review the Fees and Charges Regulations aimed at resource mobilization for food safety activities
Review the Treatment and Disposal of Unfit food regulations being enforced by TFDA
Draft specific regulations for control of Aflatoxins in food
Draft regulations for enforcement of aflatoxin standards in the informal internal market
Design and set up a mechanism, for monitoring implementation of the informal sector regulations
Routinely monitor Aflatoxins in cereal and groundnut based foods in the market
Establish aflatoxin screening capacity in at least two zonal offices of TFDA, annually
Determine hot spots and risk factors of aflatoxin contamination and exposure in all regions of Tanzania, on continuous basis
460

19. Why is leadership and management important
Adequate human resources are required to manage the complex multi-sector stakeholder coordination outlined in the aflatoxin action plan
Why is leadership and management important
Efforts to combat aflatoxin require multi-sector stakeholder coordination given the impact of aflatoxin to agriculture, health, trade, and industry
Africa wide efforts spearheaded by PACA are also an important component to reducing the spread of aflatoxin in Tanzania as this initiative allows for the sharing and scaling of regional best practices
What are some of the priority intervention areas a funder could contribute to
Support to new and existing aflatoxin control bodies: Enactment or enhancement of bodies to oversee aflatoxin control including PACA secretariat
Development and implementation of accountability frameworks: Introduction of accountability frameworks and use of M&E tools

20. Estimated costs: What financial and in kind support is required to implement the leadership and management activities? (1 of 2)
Amount required (USD thousands)
Total
Support PACA secretariat activities aimed at coordinating Africa wide aflatoxin control
Train at least two staff for evaluation of effectiveness and efficacy of bio-control products
Monitor released Biocontrol products
At least two staff in each referral hospital in each of the five zones trained on how to screen patients for aflatoxin exposure
Procure materials for universal vaccinations against HBV annually
Employ at least six individuals in the Food safety Risk Assessment body
Equip the Food safety Risk Assessment body
Equip the multi-sectorial Aflatoxins advisory committee (National Mycotoxin Steering Committee)
Support travel and operations for committee meetings
Engage consultants to advise on the informal sector regulation
Employ and retain three staff, expert in aflatoxin issues in TFDA, TBS, and MALF and an administrative secretary
1,770

21. To ensure sustainable delivery, the action plan aims to establish mitigation strategies, ensure projects are scalable, and prioritize financial sustainability
Implementation sustainability
Intervention scaling and replication
Financial sustainability
Ensuring mitigation strategies are included in existing long term government implementation
Policy: Inclusion of aflatoxin mitigation in national agriculture, health and trade policies
Regulation: Inclusion of aflatoxin monitoring and control in national quality and standards programs
Implementation: Inclusion of aflatoxin education in national programs including agricultural extension services, national health services, public education curriculum
Ensuring relevant interventions are piloted in representative geographies and sufficient capacity building is undertaken to allow for replication
New technology: Development of biological and physical (storage etc.) technology that is appropriate for the multiple agro ecological zones in [insert country]
Program implementation: Development of awareness and behavioral change interventions tailored to the needs and challenges of various communities in [insert country]
Capacity building: Significant training for implementation personnel and program shadowing for staff prior to program replication
Ensuring diversified funding sources including significant government financial and in-kind support
Government support: Allocating government resources towards activities that will have transformative impact across multiple sectors (agriculture, health, trade) and geographies
Exit strategies: Ensuring monitoring and evaluation of program implementation to exit relevant activities and divert resources towards higher priority activities

22. Objectives and key questions for the business meeting
Solicit feedback on the country action plan
What do you see as being the highest priority interventions in the action plan?
Are there any activities you feel should be added, or others you feel should be deprioritized?
Understand what activities stakeholders are already taking towards aflatoxin mitigation
What synergies exist between current interventions and the action plan?
What are best practices from Tanzania and the region that we can learn from?
Discuss resource mobilization strategy
What activity areas would stakeholders be interested in contributing to?
What types of strategic guidance, complementary action and/or financial support would stakeholders be willing to provide?
Identify concrete next steps
What activities will the PACA secretariat, the government and other stakeholders undertake in the short term to ensure program success