Updated WHO estimates published in June 2026 found that 42 foodborne hazards caused 866 million illnesses and 1.52 million deaths in 2021, a burden comparable to that of tuberculosis, HIV/AIDS, or malaria [1, 2]. The greatest burden falls on the WHO African and South-East Asia Regions, and children under five fall ill 2.7 times as often as older children and adults [1]. For the first time, the estimates include metals such as inorganic arsenic and lead, which are among the leading contributors to the overall burden [1]. Antimicrobial-resistant bacteria could not yet be included because of insufficient data
SaniPath assessments map the dominant routes by which people are exposed to fecal contamination. Across four municipalities in Greater Accra, Ghana, E. coli was detected in street food, raw produce, municipal water, and packaged water, with street food and raw produce the leading exposure routes for both adults and children. ESBL-producing (antibiotic-resistant) E. coli and a Vibrio cholerae gene marker were also detected across food and water pathways. Household research showed that WASH infrastructure, knowledge, and social norms must work together for safe food hygiene to become routine, which is why awareness campaigns alone fall short [3]. In flood-prone Paikgacha Municipality, Bangladesh, E. coli was detected in 80% of 217 environmental samples, including every floodwater, raw produce, and surface water sample and 77% of drinking-water samples. In Tanga, Tanzania, children were especially exposed to fecal contamination through open drains and street food.
In Ghana, the team trained more than 60 Environmental Health Officers on SaniPath and worked with government stakeholders to develop a Food Safety and Hygiene Solutions Compendium and an updated national food safety and hygiene inspection guideline.
Mapping contamination pathways across food preparation, storage, and consumption; food hygiene in households, schools, and informal markets; risks to young children and other vulnerable groups; and emerging environmental contaminants, including microplastics, pharmaceuticals, lead, and other heavy metals.
A multi-country initiative advancing sanitation, hygiene, climate resilience, health security, digital decision systems, and healthy institutions in low- and middle-income countries
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