Aflatoxins are more than a barrier to trade for smallholders— they are a serious risk to public health. The US Centers for Disease Control and Prevention estimate that 4.5 billion people are chronically exposed to the toxin through the consumption of staple foods, leading to cancer and childhood stunting as well as contributing to immune disorders. Over the past decade, efforts to tackle aflatoxin contamination in Africa have focused on practices within formal export value chains. In countries like Malawi, however, 60 percent of groundnuts are sold on poorly regulated local or regional markets, exposing populations to high levels of the toxin and undermining food security and nutrition interventions. Improvements to processing, storage, and trading practices are therefore urgently needed along the smallholder groundnut supply chain in order to sustainably address the economic and health impacts of aflatoxins.