Robin Lake, Brecht Devleesschauwer, Shannon E Majowicz, Lucy J. Robertson, Lea Sletting Jakobsen, Antonio Agudo, Sara M Pires, Martyn D Kirk, Elaine Scallan Walter, Karen H. Keddy, Carlotta Di Bari, Louise Vaes, Arie H. Havelaar, Charlee Roberts, Tesfaye Gobena, Mirjam E Kretzschmar, Gabriela F. Nane, Sandra Hoffmann, Lapo Mughini-Gras, Banchob Sripa, Kunihiro Kubota, Luria Leslie Founou, Li Bai, Mohammed Al Huthiel, Tety Rachmawati, Teresa Estrada‐García, Ashok Kumar, Fadi Al Natour, Steven Jaffee, Spencer Henson, Luc Ingenbleek, Richard Kumapley, Elaine Borghi, Yuki Minato
BACKGROUND: Foodborne diseases are important causes of illness and death. The first estimates of their burden were published by WHO in 2015. We updated WHO estimates of the global, regional, subregional, and national foodborne disease burden caused by 42 infectious and chemical hazards in 2021, including time trends for 2000-21. METHODS: We provide a high-level summary of foodborne disease burden, expressed as incidence, deaths, and disability-adjusted life-years (DALYs). Data for burden estimation were provided from a WHO-commissioned series of systematic reviews on the incidence, aetiology, sequelae, and case fatality or mortality of the hazards. Data were analysed using hierarchical meta-regression modelling with geographical clustering and a global linear time trend, disease-specific computational models, and uncertainty propagation through Monte Carlo simulations to calculate 95% uncertainty intervals. Attribution to foodborne transmission was principally based on a structured expert judgement process. Economic impact was measured as lost productivity. FINDINGS: For 2021, foodborne transmission of the 42 hazards caused 866 million (95% uncertainty interval 680-1090) illnesses, 1·52 million (0·783-2·51) deaths, and 57·1 million (39·4-81·1) DALYs. Inorganic arsenic, lead, and non-typhoidal Salmonella enterica (diarrhoeal and invasive disease) resulted in the most DALYs. The greatest burden of foodborne disease was in the African and South-East Asia regions. The incidence in children younger than 5 years was 2·7 times higher than in people aged 5 years or older, resulting in 4·3 times the rate of DALYs. The total burden from all hazards decreased over time. In 2021, these 42 hazards resulted in productivity losses of US$310 billion in nominal terms, and US$647 billion after adjusting for purchasing power parity. INTERPRETATION: Foodborne diseases causes a burden similar to that from tuberculosis, HIV and AIDS, or malaria. The high burden of both communicable and non-communicable foodborne diseases requires countries to prioritise developing strategies to improve the safety of the food supply. FUNDING: WHO.