Public health

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Public health tradeAn international
perspective on Food Safety
Workshop on Agro-Food Safety issues, Beijing, PR
China 09-11 September 2002
Peter Karim Ben Embarek
Food Safety Programme
World Health Organization (WHO), Geneva,
Switzerland
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Content

• Limitations of traditional food safety controls
• Recent developments
• WHO/FAO/Codex involvement
• China MoHs Action plan for food safety and the
  challenges ahead

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Food safety - An international concern

• Developing countries
• - Diarrhea (foodborne or waterborne) 2 million
  deaths per year
• Industrialized countries
• up to 30 of population gets diseased
• up to 20 per million die
• World wide
• 4-6 billions cases of foodborne diarrhoea (WHO,
  2002)

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Foodborne Diseases in Europe
Campylobacteriosis trends
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Practice, hazard and risk Three waves of food
safety

• Good hygiene practices
• Focus on general hygiene in production and
  preparation

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Limitations with the traditional approach

• Not a Farm to Fork approach
• Focus on GHP/GMP inspections end product
  testing
• Test and eliminate strategies are not efficient
  when dealing with low prevalence of a pathogen
• Lack of interdisciplinary collaboration

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Practice, hazard and risk Three waves of food
safety

• Good hygiene practices
• Focus on general hygiene in production and
  preparation
• HACCP or HACCP like thinking
• Focus on the pathogen in the food

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HACCP

• Developed in the 60 for the US space programme.
• Introduced in the 70 in the canning industry.
• WHO FAO developed training and guidelines in
  the 80 90.
• Codex guidelines in 1997.
• Mandatory in seafood processing in 1992-1997 in
  Canada, EU and USA. Today 70 international fish
  trade is bound to HACCP.
• Present being introduced as part of integrated
  risk based food control programmes in most
  countries.
• Not adapted in its current form to catering and
  small businesses.

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Practice, hazard and risk Three waves of food
safety

• Good hygiene practices
• Focus on general hygiene in production and
  preparation
• HACCP or HACCP like thinking
• Focus on the pathogen in the food
• Risk assessment
• Focus on human outcome and the whole food chain

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Risk based - Science based Improvements

• Food control systems re-allocate resources from
  senseless control to Risk Assessment data
  gathering
• Combination of active surveillance and new typing
  systems to enable source attribution
• New thinking relative to industry data -
  transparent responsibility

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MRA in future Improved Food Safety (IFOS)

• Link risk to hazard in food(s) MRA Epi
• Define attributable fractions (and transfer
  factors?)
• Perform total food MRA
• Suggest reduction targets at relevant point in
  chain
• Monitor evidence of reduction
• Share evidence with other countries (Global Forum)

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World Health Assembly Resolution May 2000

• Requests the Director General
• to work towards integrating food safety as one
  of WHOs essential public health functions, with
  the goal of developing sustainable, integrated
  food-safety systems for the reduction of health
  risk along the entire food chain, from primary
  producer to the consumer

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WHO Food Safety Strategy

• Surveillance of Foodborne diseases
• Improving Risk Assessment
• Methods for safety assessment of products of new
  technologies (GM, novel foods,)
• Strengthening capacity building in Member States,
  training of staff
• Enhancing Risk Communication and advocacy
• Improving International national cooperation
• Increase WHO involvement in Codex

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Codex Recent development

• WHO in cooperation with FAO is designing a Codex
  Participation Trust Fund for developing
  countries
• A FAO/WHO review and evaluation of food
  standards, including Codex operations and
  procedures, is underway and
• A draft Medium-term Work Plan for 2003-2007,
  based upon the Strategic Framework has been
  circulated for review and comment.

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1) Bioterrorism intentional contamination

• 2002 WHO Expert Consultation on bioterrorism and
  the food supply.
• Report provides guidance on
• -Prevention
• -Preparedness
• -Response
• available this month.

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2) Regional Local Food Safety issues Ex.
Fish borne Parasites

• Over 40 million people world-wide infected (WHO,
  1995)
• In China
• National Infection rate (i.r.) 0.37
• In highly infected provinces i.r. 16-75
• Guangxi province i.r. 20. (1.6-36).
• Endemic provinces covers 572 M persons.
• Due to consumption of raw lightly processed
  freshwater fish crabs.
• Second Intermediate host 84 species of fresh
  water fish
• Parasite Clonorchis sinensis

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FBT in China Change in the epidemiology

• Increase in living standards increased
  infection rate
• People can now afford more easily expensive
  traditional raw fish dish.
• Raw fish dish becoming more fashionable
• Difference between cities country side
  diminish
• Infection rate increase with social status.
• Endemic areas expending
• Increased trade in live fish and contaminated
  fish fries.
• Aquaculture expanding fast in endemic region like
  Guangxi.
• Problem may be exported
• Fresh water fish from endemic region is exported
  to Hong Kong, Macao, Korea, Japan, Malaysia, USA,
  Europe, Australia.
• Live fresh water fish exported to Europe.

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3) Antibiotic residues

• 2001-2002
• increased reporting in Europe and North America
  on imported and domestic products.
• 2002 Switzerland
• 25 of aquacultures fish contained residues
• 8 above max. limits
• Main problem with domestic producers (20 of
  producers non conform to regulations).
• 2001-2002
• CAP Nitrofurans residues in shrimps, chicken,
  honey from Asia
• Trade disrupted. Expensive bans on export to
  Europe.
• Large difference world-wide in regulations

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China MoHs Action Plan for Food Safety

• Main challenges
• Recent entry to WTO.
• A fragmented management approach to food safety
  control.
• Developing science-based food control systems
  with focus on consumer protection.
• Restructuring food inspection services to a
  preventative approach - Capacity building.
• HACCP Communication implementation
  strategies.
• Growing consumer awareness on food safety.
• Focus on real hazards/improved hazard analysis
  (Link to Risk assessments) to optimize use of
  limited resources.

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China MoHs Action Plan for Food Safety

• Describe strategies and actions to enhance a
  risk-based farm to table food safety control in
  China.
• With the aim of
• reducing the burden of foodborne disease in China
  and
• develop an integrated and convincing food safety
  management program to domestic stakeholders and
  main external trading partners.

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China MoHs Action Plan for Food Safety

• Health policy and the Food Hygiene Law.
• Enhancing foodborne disease surveillance.
• Information gathering through contaminant
  monitoring risk assessment.
• Towards equivalent enforcement of legislation
  across provinces, districts and counties.
• Adoption of food safety management systems based
  on the principles of HACCP within the food
  industry

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Improved Food Safety Developing countries Win-Win
Improved food safety less illness, medical and
social costs, poverty
Improved health improved participation in
development
Health-based Standards protect public
health international trade capability
Trade access development and wealth, better
health
Development
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• Http//www.who.int/fsp
• benembarekp_at_who.int