A Working Group of world-leading experts convened by the International Agency for Research on Cancer (IARC) with support from the Bill & Melinda Gates Foundation (BMGF) reviewed the health effects of aflatoxins and fumonisins. The panel concluded that these mycotoxins are not only a cause of acute poisoning and cancer but are also a likely contributor to the high levels of stunting in children in affected populations. The Working Group also identified effective measures to reduce exposure in developing countries. These recommendations have been published in the report Mycotoxin Control in Low-and Middle-Income Countries, which is available in English, French, and Spanish.[1]

"The report stresses the need for a coordinated international response to the problem of mycotoxin contamination of food," says Dr Christopher Wild, Director of IARC. "Its health impact has been neglected for too long. We have the tools to make a difference. Now we must find the political will."

An estimated 500 million of the poorest people in sub-Saharan Africa, Latin America, and Asia are exposed to the pervasive natural toxins, aflatoxins and fumonisins, on a daily basis by eating their staple diet of groundnuts, maize, and other cereals. Exposure occurs throughout life at levels far in excess of internationally accepted norms. This contrasts starkly with the situation in developed countries, where people and livestock are protected by good agricultural practices, regulation, and legislation.

Exposure to mycotoxins at these high levels substantially increases mortality and morbidity. Aflatoxin is a cause of human liver cancer, and fatalities from outbreaks of acute aflatoxin poisoning occur in Africa and Asia. Evidence from population studies and the effects of the toxins in animals also suggest that mycotoxins contribute to stunting in young children.

"Worldwide, more than 160 million children younger than 5 years are stunted. Improving mycotoxin control could have a far-reaching health benefit," says Dr J. David Miller, Chair of the IARC Working Group. "It is time to put the existing knowledge and technology into action to control mycotoxin food contamination in low-income countries."

The panel also evaluated 15 interventions against mycotoxins, considering the strength of the evidence as well as its completeness and transferability at an individual, community, or national level. Four of the measures were judged to be ready for implementation.

"The IARC Working Group Report's recommendations provide a reliable foundation for investment of public, nongovernmental organization, and private funds to tackle this neglected problem," says Dr Sindura Ganapathi of the Global Health Program at the BMGF. "What is needed now is effective translation of the vast body of science through to subsistence and smallholder farmers in order to make a difference."