Ensuring evidence informs policy decisions: The experience of the Ministerial Advisory Committee on Foodborne Illness following six fatal child terbufos poisonings in South Africa
1
School of Public Health, University of Cape Town, Observatory, Cape Town, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
ABSTRACT:
Background. In October 2024, six children from Soweto died after ingesting terbufos granules, likely in food contaminated with this extremely toxic organophosphate pesticide. Terbufos has been used in rat bait in poor South African communities because of inadequate refuse removal. Public responses blamed owners of informal community (spaza) shops for selling pesticide-contaminated food. Responding to the disaster, the President announced the establishment of a Ministerial Advisory Committee on Foodborne Illnesses (MACFBI). Methods. The MACFBI convened in December 2024, comprising 15 members with skills and experience across diverse areas, both public and private, supported by senior Department of Health staff. The MACFBI examined data from the National Health Laboratory Services (NHLS), National Institute for Communicable Disease (NICD), Forensic Chemistry Laboratories, the national Poisons Information Helpline, clinical laboratories, published literature and information from environmental health experts. Analysis of the policy landscape was undertaken. Results. Terbufos was found to be responsible for 375 deaths in South Africa in 2023/24 of which 35% were children. There were 453 notifications of children with pesticide poisoning in 2024 and approximately 1400 annual cases of patients whose NHLS lab tests indicated acute poisoning by organophosphates or carbamates. Despite a 2010 policy committing to phase out of Highly Hazardous Pesticides (HHPs) in line with United Nations Environment Programme and World Health Organisation guidelines, no progress had been made to prevent unauthorised access to terbufos. Conclusion. Terbufos poisoning, an endemic problem in South Africa, is a critical cause of preventable mortality, particularly in children. Given the failure of product stewardship, widespread unauthorised access to terbufos, South Africa’s constitutional commitment to the best interests of the child, and existing national and global policies that motivate for phasing out HHPs, the MACFBI recommended to Cabinet that terbufos be banned, a recommendation adopted by Cabinet in June 2025.
Background. In October 2024, six children from Soweto died after ingesting terbufos granules, likely in food contaminated with this extremely toxic organophosphate pesticide. Terbufos has been used in rat bait in poor South African communities because of inadequate refuse removal. Public responses blamed owners of informal community (spaza) shops for selling pesticide-contaminated food. Responding to the disaster, the President announced the establishment of a Ministerial Advisory Committee on Foodborne Illnesses (MACFBI). Methods. The MACFBI convened in December 2024, comprising 15 members with skills and experience across diverse areas, both public and private, supported by senior Department of Health staff. The MACFBI examined data from the National Health Laboratory Services (NHLS), National Institute for Communicable Disease (NICD), Forensic Chemistry Laboratories, the national Poisons Information Helpline, clinical laboratories, published literature and information from environmental health experts. Analysis of the policy landscape was undertaken. Results. Terbufos was found to be responsible for 375 deaths in South Africa in 2023/24 of which 35% were children. There were 453 notifications of children with pesticide poisoning in 2024 and approximately 1400 annual cases of patients whose NHLS lab tests indicated acute poisoning by organophosphates or carbamates. Despite a 2010 policy committing to phase out of Highly Hazardous Pesticides (HHPs) in line with United Nations Environment Programme and World Health Organisation guidelines, no progress had been made to prevent unauthorised access to terbufos. Conclusion. Terbufos poisoning, an endemic problem in South Africa, is a critical cause of preventable mortality, particularly in children. Given the failure of product stewardship, widespread unauthorised access to terbufos, South Africa’s constitutional commitment to the best interests of the child, and existing national and global policies that motivate for phasing out HHPs, the MACFBI recommended to Cabinet that terbufos be banned, a recommendation adopted by Cabinet in June 2025.
| eISSN: | 2654-1459 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
