Work of WHO in food safety

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Work of WHO in food safety

• Soren Bo Madsen
• Technical Officer, Food Safety
• WHO/EMRO

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Food safety

• Food safety is a public health issue
• Affects 1/3 of population every year
• Diarrhea most common health issue
• But also
• Organ failure
• Neurological disorders
• Cancer
• Death

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Food safety is complex

• Environmental management
• Agricultural practices
• Animal husbandry skills
• Veterinary services
• Industrial processing
• Trade
• Transport
• Wholesale
• Retail
• Food service practices
• Food handlers education
• Consumers knowledge

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Nature of food safety challenges

• Microbiological hazards
• bacteria
• vira
• parasites
• Chemical hazards
• Contaminants
• Residues (e.g. pesticides, veterinary drugs)
• food additives
• natural toxins

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Factors influencing food safety

• Changing lifestyle
• Changes in food trade and production patterns

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Regional challenges

• Food safety systems are often rigid and spread
  over several ministerial domains
• Weak role of health sector in food safety policy
  development
• Public perception in the region of FBD
• Episodes of diarrhea and fever are facts of
  life
• Self medication is common and drugs easily
  available
• Medical attention sought late

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What is WHO doing to help countries improve food
safety? (1)

• Developing and disseminating guidance for risk
  assessment of foods
• Supporting surveillance of foodborne diseases and
  monitoring of chemicals in food
• Facilitating exchange of information through
  INFOSAN and IHR between national authorities on
  foodborne disease outbreaks and food
  contamination events
• Providing guidance on containment of
  antimicrobial resistance

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What is WHO doing to help countries improve food
safety? (2)

• Coordinating Global Food-borne infections Network
  courses for laboratory and epidemiology staff
  (GFN)
• Providing an external quality assurance programme
  to laboratories (through GFN)
• Developing training and communication tools in
  support of safe food

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Public health threats originating from farm
animals

• Zoonotic diseases
• Veterinary drugs residues
• Anti-microbial resistance

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Antimicrobial resistance (AMR)

• Current antimicrobial usage patterns in
  industrial food animal production lead to
  development of AMR
• AMR is a problem in human infections and is a
  major emerging threat to public health
• Antibiotics are used in farm animals for
• Treatment of infections
• Disease prevention
• Growth promotion

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More than half of anti-microbial drugs are used
non-therapeutically in animal husbandry

• In industrial production, antibiotics may be
  added to drinking water to decrease diseases of
  crowding and as growth promoters
• Bacteria persistently exposed to low levels of
  antibiotics will develop resistance to these
  drugs
• AMR may spread through food or other transmission
  routes

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Resistance to critically important antibiotics
for human medicine

• Use of fluoro-quinolones in food animals has led
  to corresponding AMR in e.g. Salmonella and
  Campylobacter isolates
• AMR in Salmonella in human infections is
  associated with
• more frequent and longer hospitalization
• Longer periods of illness
• a twofold increase in the risk of death within
  two years after infection
• Treatment failure (rare for the time being)

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Policy response options (1)

• Ban or restrict use of antibiotics for growth
  promotion in farm animals
• Increase use of biosecurity measures incl. animal
  vaccines to reduce need for antibiotics for
  disease prevention and treatment
• Develop an integrated AMR approach among
  veterinary, food and health sectors

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Policy response options (2)

• Require antibiotics to be administered to animals
  only when prescribed by a veterinarian
• Reserve antibiotics identified as critically
  important in human medicine for use in humans
• Eliminate economic incentives that leads to
  inappropriate prescription of antibiotics both
  in animals and humans

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Surveillance

• The systematic, ongoing, collection, analysis,
  interpretation, and dissemination of data for
  public health action

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Surveillance pyramid

Case reported Lab identifies pathogen Sample
submitted to lab Doctor requests sample Person
goes to doctor Person has symptoms
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Surveillance in support of food safety

• Health systems may react on basis of FBD
  surveillance data
• Surveillance data needs to be transferred to food
  control and food production sectors for
  preventive action
• Data to be integrated with data from food
  monitoring and veterinary surveillance for best
  outcome

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Complexity Levels
Person has symptoms Person goes to doctor Doctor
reports case Doctor requests sample Sample
submitted to lab Lab identifies pathogen Case
reported Human cases compared to animal and food
data
No formal surveillance
Syndromic surveillance
Lab-based surveillance
Integrated surveillance
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Integrated surveillance

• Outbreak detection and identification of source
• Estimate burden of foodborne disease specifically
  by food/animal category in support of policy
  decisions
• Tool for assessment of effectiveness of food
  safety policies

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• Full value of surveillance data is only achieved
  through sharing and using all available data for
• PUBLIC HEALTH ACTION
• --------------------------------------------------
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Thank You

• Further information available at
  http//www.who.int/foodsafety/en/