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The Codex Alimentarius Commission (CAC), a gathering of countries to set food safety and labeling standards, has a reputation for being a slow deliberative body focused more on international trade than consumer protection. Yet, its rapid action to address an issue of great importance to consumers and small business owners and vendors in low- and middle-income countries is worthy of highlighting, as an example of the value of CAC for countries and consumers broadly beyond its recognized value in setting standards for international trade.

The Guidelines for Food Hygiene Control Measures in Traditional Markets for Food provides standards important for reducing the risks of foodborne and zoonotic diseases, like avian influenza, from spreading in local markets. These global disease control objectives are supported through this new CAC document that provides advice to national, local governments, and traditional market authorities, with benefits to the consumers and vendors that rely on the markets for food and income.

The CAC administers the Joint FAO/WHO Food Standards Programme and helps countries develop the tools and standards to administer effective national food programs. It was established in 1963 with the mission to protect consumer health and promote fair practices in food trade. Open to all member countries of the Food and Agriculture Organization of the UN (FAO) or WHO, it currently has 188 member countries and one member organization (the European Union) in addition to over 240 observers who represent intergovernmental organizations or international nongovernmental organizations.

The CAC met in November 2024 as it does every year, with over 160 countries from every world region in attendance. As they met to discuss and adopt international food standards, guidelines, and codes of practice developed by its various thematic committees, one unique set of guidelines proposed by the Food Hygiene Committee sparked a lot of support. Delegates from low- and middle-income countries from Africa, Asia, and South America raised flags to speak particularly warmly—even passionately—in favor of the adoption of the guidelines for traditional food markets. This blog explores the reasons behind this widespread support and the implications for global public health and for implementation at national and local levels.

As a CAC product, the guidelines are unique in several respects.

First, the Guidelines for Food Hygiene Control Measures in Traditional Markets for Food recognize the importance of traditional markets for food as a key component of global agrifood systems, central to food security, livelihoods, and economic activity. In many low- and middle-income countries, traditional markets are places where the local consumers source much fresh food, like meat, poultry, seafood, fruits, and vegetables. Those foods also frequently carry and spread pathogens that cause foodborne illness. WHO estimates that one in 10 consumers will experience a foodborne illness each year, and this burden of disease is disproportionately borne by consumers in low- and middle-income countries, particularly in Africa and Asia.

Many foodborne pathogens originate in animals, and those zoonotic diseases pose threats to both animals and humans that frequent the markets. Covid-19, for example, was spread through traditional markets, and current efforts to control avian influenza are assisted by zoonotic controls exercised at the level of local markets. Addressing the sources of food contamination in traditional food markets through the CAC guidelines is vital to reducing the global disease burden.

Second, this is an example of low- and middle-income countries taking the lead in developing the technical content of an international text within the CAC. Kenya, Nigeria, and Bolivia led the development of the guidelines that articulate good hygienic practices in terms that are useful not only for governments, but also for the operators of traditional food markets and the vendors and consumers that use them. The work progressed rapidly because street-vended foods (which frequently are colocated with traditional markets for food) had been addressed in four CAC regional guidelines/codes of practice. An international NGO and CAC observer organization, the Global Alliance for Improved Nutrition (GAIN), shared their comparative review of the four regional standards, highlighting the standards applicable to traditional markets. As the draft progressed in the working group, GAIN also provided significant feedback on implementation challenges on the ground, based on their experience working in traditional markets in countries in Africa and Asia.

This demonstration of leadership and ownership by low- and middle-income countries remains notable because it is still uncommon. A recent analysis by the Codex Secretariat showed that 75 percent of technical working groups are chaired by just 5 percent of CAC member countries. Recent efforts to raise the profile of technical working groups in the CAC and the publication of a handbook to support member countries that chair these groups will hopefully address this imbalance.

Third, this is an example of how the CAC can work rapidly where there is a high level of support and engagement among member countries. It took just two and a half years from the first, exploratory discussion paper in the food hygiene committee to the adoption of the final, complete text in November 2024. Much of this work was undertaken in the final year, as the proposal for this work was not formally endorsed by the CAC until November 2023. This was just the sixth example in the 60-year history of the CAC of an internationally agreed text that passed from endorsement of new work to adoption of the final text in just one cycle of the commission.

Of all the thousands of numerical standards and the dozens of codes of practice and guidelines that the CAC has developed over the decades, the Guidelines for Food Hygiene Controls in Traditional Markets for Food have huge potential to improve global food safety outcomes and increase nutritional outcomes for those living in low-income and marginalized communities, as unsafe food can prevent the uptake of nutrients from food, contributing to malnutrition. Yet, given the potential impact of these guidelines, lauded by CAC member countries as “a critical milestone in addressing food hygiene challenges and enhancing food safety practices while respecting the operational realities of traditional markets,” why then has it taken the CAC 60 years to undertake this work?

Some still erroneously characterize the CAC as a club for high-income countries in which international standards are set for the purpose of maintaining flows of agrifood commodities between and into their own economies. If this was ever true, it is certainly changing. The growing importance of trade between low- and middle-income countries, evidenced for example by the implementation of the African Continental Free Trade Area, is driving a new dynamic in the CAC where the interests of those countries are taking center stage. And given the gulf in foodborne illness rates between most and least developed countries, the CAC helps align with the UN commitment, supported by its member countries, to the Sustainable Development Goals and the principle of reducing those inequalities. It is also procedurally correct for the CAC to “give particular attention to the circumstances of developing countries.”

The CAC has recently recommitted itself to its dual statutory purpose when adopting its Strategic Plan 2026–2031, which highlights that “food safety has a critical role in the successful transformation of the agrifood system in order to meet the needs of the world.” This approach will be vital to address the food safety challenges exemplified by the guidelines for traditional markets, which empower countries to help reduce the burden of foodborne disease locally, nationally, and globally.

Steven Wearne served as the chair and vice chair of the Codex Alimentarius Commission from 2017 to 2024. He also served in the UK government for the Ministry of Agriculture, Fisheries and Food, and the UK Food Standards Agency, starting in 1990. Caroline Smith DeWaal is a senior associate (non-resident) for the Global Food and Water Security Program at the Center for Strategic and International Studies in Washington, D.C.