# Zoonoses and wet markets: beyond technical interventions

Tony Barnett, Guillaume Fournié

► To cite this version:

Tony Barnett, Guillaume Fournié. Zoonoses and wet markets: beyond technical interventions. Lancet Planetary Health, 2021, 5 (1), pp.e2-e3. 10.1016/S2542-5196(20)30294-1. hal-04596631

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https://hal.science/hal-04596631

Submitted on 31 May 2024

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Distributed under a Creative Commons Attribution 4.0 International License
# Zoonoses and wet markets: beyond technical interventions

Tony Barnett, Guillaume Fournié

► To cite this version:

Tony Barnett, Guillaume Fournié. Zoonoses and wet markets: beyond technical interventions. Lancet Planetary Health, 2021, 5 (1), pp.e2-e3. 10.1016/S2542-5196(20)30294-1. hal-04596631

HAL Id: hal-04596631

https://hal.science/hal-04596631v1

Submitted on 31 May 2024

HAL is a multi-disciplinary open access
archive for the deposit and dissemination of sci-
entific research documents, whether they are pub-
lished or not. The documents may come from
teaching and research institutions in France or
abroad, or from public or private research centers.

L'archive ouverte pluridisciplinaire HAL, est
destinée au dépôt et à la diffusion de documents
scientifiques de niveau recherche, publiés ou non,
émanant des établissements d'enseignement et de
recherche français ou étrangers, des laboratoires
publics ou privés.

<figure><img src="image_1.png" /></figure>

Distributed under a Creative Commons Attribution 4.0 International License
<figure><img src="image_2.png" /></figure>

ELSEVIER

Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website.

Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
<figure><img src="image_2.png" /></figure>

ELSEVIER

Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website.

Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
# Zoonoses and wet markets: beyond technical interventions

<figure><img src="image_3.png" /></figure>

<figure><img src="image_4.png" /></figure>

CrossMark

Following initial suspicions that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) might have emerged in a wet market in Wuhan, China, calls have been made to ban wet markets¹ or implement technical interventions mitigating disease risk while minimising business disruptions.² Regardless of the role of wet markets in the emergence of SARS-CoV-2, they do pose public health threats and should be targeted by disease control interventions. A recent Comment in *The Lancet Planetary Health*² called for “standardised global monitoring of water, sanitation, and hygiene (WASH) conditions” in such markets. Monitoring is one thing, but the way forward to sustainable change does not lie with standardised interventions in isolation.

As shown with the response to the threat of avian influenza virus (AIV), local context and detailed understandings are crucial in effective responses.³ Novel disinfection programmes, separating poultry species, and limiting the length of poultry stay successfully reduced AIV prevalence in the specific political circumstances of Hong Kong live bird markets. Yet, the transfer of those interventions to other lower income and quite different political settings was less effective. Although WHO guidelines⁴ recommended desirable practices in food markets and their promotion through awareness and education programmes, an evaluation of these interventions did not find substantial changes.⁵ Our and others' recent studies in Bangladesh revealed that there was no difference in the prevalence of AIVs in poultry⁶ or in the practices of workers for food markets that had or had not benefitted from UN-funded biosecurity-upgrading programmes. The needs of retailers and butchers to assure income in the immediate term and show confidence to consumers about their stock, as well as long standing practices of workers, all contributed to risky behaviours. Together, these factors resulted in low uptake of personal protective equipment, disinfection programmes, and desirable poultry management practices. Similar observations were made on backyard farms.⁷

Of course, hand washing, toilet facilities, and water supplies are important parts of the response, but perhaps not the most important parts. Behaviour change can only be enforced through regulation if national and local social, cultural, and financial factors—the social and economic structures constraining behaviours—are

understood and addressed. If this is not done, interventions will probably fail. The key to the problem lies in structural interventions that are informed by detailed knowledge of local situations, of what is happening on the ground—however wet and slippery that ground may be!

Zoonotic disease emergence and transmission will not be stopped by one-size-fits-all interventions across a diverse range of settings and, in any given setting, across a diverse range of actors. Beliefs and practices along poultry trading networks are heterogeneous.⁸ The paths and transaction nodes whereby hazards become risks are also diverse. Even in a single market, large-scale slaughterers on the edge of a wet market might do business differently, work within different financial structures, and have a different perception of risk compared with somebody in a small booth with slow throughput. Actors behave in relation to their position in the trading structures and consequently have distinct sociocultural perspectives on risk, depending on the contexts in which they experience it.⁸⁻¹⁰ People's risk calculations have to be understood within those contexts: people's social interactions, how they make sense of their situation, and how these reflect the convergence of constraints and individuals' aspirations.⁸ That this is the case should be at the forefront of thought when considering how to mitigate the zoonotic disease risk generated by wet markets.

Policy homogeneity is certainly cheaper and often politically appealing in the short term. The question of whether it is cost-effective or merely cheap is something to be borne in mind when developing policy. Heterogeneity, localism, and consultation might be more expensive, but are also more cost-effective in both the short and longer term.

We declare no competing interests. TB and GF are supported by the UK Research and Innovation Global Challenges Research Fund One Health Poultry Hub (BB/S011269/1), one of 12 interdisciplinary research hubs funded under the UK government's Grand Challenge Research Fund Interdisciplinary Research Hub initiative.

Copyright © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license.

*Tony Barnett, Guillaume Fournié

abarnett@rvc.ac.uk

Veterinary Epidemiology, Economics and Public Health Group, Pathobiology and Population Sciences Department, Royal Veterinary College, North Mymms, Hatfield AL9 7TA, UK
# Zoonoses and wet markets: beyond technical interventions

<figure><img src="image_3.png" /></figure>

<figure><img src="image_4.png" /></figure>

CrossMark

Following initial suspicions that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) might have emerged in a wet market in Wuhan, China, calls have been made to ban wet markets¹ or implement technical interventions mitigating disease risk while minimising business disruptions.² Regardless of the role of wet markets in the emergence of SARS-CoV-2, they do pose public health threats and should be targeted by disease control interventions. A recent Comment in *The Lancet Planetary Health*² called for “standardised global monitoring of water, sanitation, and hygiene (WASH) conditions” in such markets. Monitoring is one thing, but the way forward to sustainable change does not lie with standardised interventions in isolation.

As shown with the response to the threat of avian influenza virus (AIV), local context and detailed understandings are crucial in effective responses.³ Novel disinfection programmes, separating poultry species, and limiting the length of poultry stay successfully reduced AIV prevalence in the specific political circumstances of Hong Kong live bird markets. Yet, the transfer of those interventions to other lower income and quite different political settings was less effective. Although WHO guidelines⁴ recommended desirable practices in food markets and their promotion through awareness and education programmes, an evaluation of these interventions did not find substantial changes.⁵ Our and others’ recent studies in Bangladesh revealed that there was no difference in the prevalence of AIVs in poultry⁶ or in the practices of workers for food markets that had or had not benefitted from UN-funded biosecurity-upgrading programmes. The needs of retailers and butchers to assure income in the immediate term and show confidence to consumers about their stock, as well as long standing practices of workers, all contributed to risky behaviours. Together, these factors resulted in low uptake of personal protective equipment, disinfection programmes, and desirable poultry management practices. Similar observations were made on backyard farms.⁷

Of course, hand washing, toilet facilities, and water supplies are important parts of the response, but perhaps not the most important parts. Behaviour change can only be enforced through regulation if national and local social, cultural, and financial factors—the social and economic structures constraining behaviours—are

understood and addressed. If this is not done, interventions will probably fail. The key to the problem lies in structural interventions that are informed by detailed knowledge of local situations, of what is happening on the ground—however wet and slippery that ground may be!

Zoonotic disease emergence and transmission will not be stopped by one-size-fits-all interventions across a diverse range of settings and, in any given setting, across a diverse range of actors. Beliefs and practices along poultry trading networks are heterogeneous.⁸ The paths and transaction nodes whereby hazards become risks are also diverse. Even in a single market, large-scale slaughterers on the edge of a wet market might do business differently, work within different financial structures, and have a different perception of risk compared with somebody in a small booth with slow throughput. Actors behave in relation to their position in the trading structures and consequently have distinct sociocultural perspectives on risk, depending on the contexts in which they experience it.⁸⁻¹⁰ People’s risk calculations have to be understood within those contexts: people’s social interactions, how they make sense of their situation, and how these reflect the convergence of constraints and individuals’ aspirations.⁸ That this is the case should be at the forefront of thought when considering how to mitigate the zoonotic disease risk generated by wet markets.

Policy homogeneity is certainly cheaper and often politically appealing in the short term. The question of whether it is cost-effective or merely cheap is something to be borne in mind when developing policy. Heterogeneity, localism, and consultation might be more expensive, but are also more cost-effective in both the short and longer term.

We declare no competing interests. TB and GF are supported by the UK Research and Innovation Global Challenges Research Fund One Health Poultry Hub (BB/S011269/1), one of 12 interdisciplinary research hubs funded under the UK government's Grand Challenge Research Fund Interdisciplinary Research Hub initiative.

Copyright © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license.

*Tony Barnett, Guillaume Fournié

abarnett@rvc.ac.uk

Veterinary Epidemiology, Economics and Public Health Group, Pathobiology and Population Sciences Department, Royal Veterinary College, North Mymms, Hatfield AL9 7TA, UK
1 The Lion Coalition. Open letter to the World Health Organization. April 4, 2020. https://lioncoalition.org/2020/04/04/open-letter-to-world-health-organisation/ (accessed Oct 20, 2020).

2 Nadimpalli ML, Pickering AJ. A call for global monitoring of WASH in wet markets. *Lancet Planet Health* 2020; **4**: e439–40.

3 Fournié G, Høg E, Barnett T, Pfeiffer DU, Mangtani P. A systematic review and meta-analysis of practices exposing humans to avian influenza viruses, their prevalence, and rationale. *Am J Trop Med Hyg* 2017; **97**: 376–88.

4 WHO. A guide to healthy food markets. Geneva: World Health Organization, 2006.

5 UNICEF Bangladesh. Evaluation of avian influenza communications for development initiative: improving biosecurity in live bird market. Lessons learned report. Dhaka: Centre for Communicable Diseases, 2014.

6 Biswas PK, Giasuddin M, Nahar N, Islam MZ, Yamage M. Biosecurity and circulation of influenza A(H5N1) virus in live-bird markets in Bangladesh, 2012. *Transbound Emerg Dis* 2017; **64**: 883–91.

7 Rimi NA, Sultana R, Ishtiak-Ahmed K, et al. Understanding the failure of a behavior change intervention to reduce risk behaviors for avian influenza transmission among backyard poultry raisers in rural Bangladesh: a focused ethnography. *BMC Public Health* 2016; **16**: 858.

8 Høg E, Fournié G, Hoque MA, Mahmud R, Pfeiffer DU, Barnett T. Competing biosecurity and risk rationalities in the Chittagong poultry commodity chain, Bangladesh. *BioSocieties* 2019; **14**: 368–92.

9 Barnett T, Pfeiffer DU, Ahasanul Hoque M, et al. Practising co-production and interdisciplinarity: challenges and implications for one health research. *Prev Vet Med* 2020; **177**: 104949.

10 Ebata A, MacGregor H, Loevinsohn M, Win KS. Why behaviours do not change: structural constraints that influence household decisions to control pig diseases in Myanmar. *Prev Vet Med* 2020; **183**: 105138.
1 The Lion Coalition. Open letter to the World Health Organization. April 4, 2020. https://lioncoalition.org/2020/04/04/open-letter-to-world-health-organisation/ (accessed Oct 20, 2020).

2 Nadimpalli ML, Pickering AJ. A call for global monitoring of WASH in wet markets. *Lancet Planet Health* 2020; **4**: e439–40.

3 Fournié G, Høg E, Barnett T, Pfeiffer DU, Mangtani P. A systematic review and meta-analysis of practices exposing humans to avian influenza viruses, their prevalence, and rationale. *Am J Trop Med Hyg* 2017; **97**: 376–88.

4 WHO. A guide to healthy food markets. Geneva: World Health Organization, 2006.

5 UNICEF Bangladesh. Evaluation of avian influenza communications for development initiative: improving biosecurity in live bird market. Lessons learned report. Dhaka: Centre for Communicable Diseases, 2014.

6 Biswas PK, Giasuddin M, Nahar N, Islam MZ, Yamage M. Biosecurity and circulation of influenza A(H5N1) virus in live-bird markets in Bangladesh, 2012. *Transbound Emerg Dis* 2017; **64**: 883–91.

7 Rimi NA, Sultana R, Ishtiak-Ahmed K, et al. Understanding the failure of a behavior change intervention to reduce risk behaviors for avian influenza transmission among backyard poultry raisers in rural Bangladesh: a focused ethnography. *BMC Public Health* 2016; **16**: 858.

8 Høg E, Fournié G, Hoque MA, Mahmud R, Pfeiffer DU, Barnett T. Competing biosecurity and risk rationalities in the Chittagong poultry commodity chain, Bangladesh. *BioSocieties* 2019; **14**: 368–92.

9 Barnett T, Pfeiffer DU, Ahasanul Hoque M, et al. Practising co-production and interdisciplinarity: challenges and implications for one health research. *Prev Vet Med* 2020; **177**: 104949.

10 Ebata A, MacGregor H, Loevinsohn M, Win KS. Why behaviours do not change: structural constraints that influence household decisions to control pig diseases in Myanmar. *Prev Vet Med* 2020; **183**: 105138.