Food safety: global perspective

The availability of safe food improves the health of people and is a basic human right. Safe food contributes to health and productivity and provides an effective platform for development and poverty alleviation; people are becoming increasingly concerned about the health risks posed by microbial pathogens and potentially hazardous chemicals in food.
Up to one-third of the populations of developed countries are affected by foodborne illness each year, and the problem is likely to be even more widespread in developing countries.
The poor are the most susceptible to ill health. Food and waterborne diarrhoeal diseases, for example, are leading causes of illness and death in less developed countries, killing an estimated 2.2 million people annually, most of whom are children. Diarrhoea is the most common symptom of food borne illness, but other serious consequences include kidney and liver failure, brain and neural disorders, and death.
The debilitating long-term complications of foodborne disease include reactive arthritis and paralysis.
Trends in global food production, processing, distribution and preparation present new challenges to food safety. Food grown in one country can now be transported and consumed halfway across the world. People demand a wider variety of foods than in the past, they want foods that are not in season and often eat away from home.
Institutionalising children in schools and childcare facilities and a growing number of elderly persons in hospitals and nursing homes means that food for many is prepared by a few and can therefore be the source of major foodborne disease outbreaks. Greater life expectancy and increasing numbers of immuno-compromised people mean a larger vulnerable population for whom unsafe food is often an even more serious threat.
FOOD SAFETY AS AN ESSENTIAL PUBLIC HEALTH ISSUE: Serious outbreaks of foodborne disease have been documented on every continent, illustrating both the public health and social significance of these diseases. Consumers everywhere view foodborne disease outbreaks with ever-increasing concern.
Outbreaks are likely, however, to be only the most visible aspect of a much broader, more persistent problem. Foodborne disease most seriously affect children, pregnant women, the elderly and people already affected by other diseases.
Foodborne disease not only significantly affects people's health and well being, but they also have economic consequences for individuals, families, communities, business and countries. Poor people tend to live from day to day, and loss of income due to foodborne illness perpetuates the cycles of poverty.
NEW CHALLENGES: The integration and consolidation of agricultural and food industries and the globalisation of the food trader are changing the patterns of food production and distribution. These conditions are creating an environment in which both, known and new, foodborne diseases can become prevalent. Food and feed are distributed over far greater distances than before, creating the conditions necessary for widespread outbreaks of foodborne illness.
Other factors account for the emergence of food safety as a public health issue. Increasing urbanisation leads to greater requirements for transport, storage and preparation of food.
Increasing wealth, an urban lifestyle and sometimes a lack of facilities mean that people eat much of their food away from home. In developing countries, food is often prepared by street vendors. In developed countries, up to 50% of the food budget may be spent on food prepared outside the home. All these changes lead to situations in which a single source of contamination can have widespread, even global consequences.
Developing countries in particular are experiencing rapid change in their health and social environments, and the strains on their limited resources are compounded by expanding urbanisation, increasing dependence on stores foods are insufficient access to safe water and facilities for safe food preparation.
The globalisation of the food trade offers many benefits to consumers, as it results in a wider variety of high-quality foods that are accessible, affordable and safe, meeting consumers demand. A diversity of foods in a balanced diet improved nutritional status and health.
The global food trade provides opportunities for food-exporting countries to earn foreign exchange, which is indispensable for the economic development of many countries and for improving the standard of living of many people. However, these changes also present new challenges to safe food production and distribution and have been shown to have widespread repercussions on health.
Food safety programs are increasingly focusing on a farm-to-table approach as an effective means of reducing foodborne hazards. This holistic approach to the control of food-related risks involves consideration of every step in the chain, form raw material to food consumption, and hazards can enter the food chain on the farm and can continue to be introduced or exacerbated at any point in the chain until the food reaches the consumer.
Although significant progress has been made in many countries in making food safer, thousand of millions of people become ill each year from eating contaminated food. The emergence of increased antimicrobial resistance in bacteria-causing disease is aggravating this picture. The public is increasingly aware of the risks posed by pathogenic micro-organism and chemical substances in the food supply.
The introduction of new technologies, including genetic engineering and irradiation, in this climate of concern about food safety is posing a special challenge. Some new technologies will increase agricultural production and make food safer, but their usefulness and safety need to be demonstrated if they are to be accepted by consumers. Furthermore, the evaluation must be participatory, transparent and conducted using internationally agreed methods.
MICROBIOLOGICAL HAZARDS: Food borne illness caused by micro-organism is a large and growing public health problem. Most countries with systems for reporting cases of foodborne illness have documented significant increases over the past few decades in the incidence of diseases caused by micro-organism in food, including pathogens
Approximately 1.8 million children in developing countries (Excluding China) died from diarrhoeal disease in 1998, caused by microbiological agents, mostly originating from food and water. One person in three in industrialised countries may be affected by foodborne illness each year. In the USA, some 76 million cases of food borne illness, resulting in 325000 hospitalisation and 5000 deaths, are estimated to occur each year.
There are only limited data on the economic consequences of food contamination and foodborne disease. In the USA in 1995, it was estimated that the annual cost of the 3.3 - 12 million cases of foodborne illnesses caused by seven pathogens was US $6.5-35 billion.
The medical costs and the value of the lives lost during just five foodborne outbreaks in England and Wales in 1996 was estimated at UK£300-700 million.
The cost of the estimated 11500 daily cases of food poisoning in Australia was calculated at AU$ 2.6 billion annually.
The increased incidence of foodborne disease due to microbiological hazards is the result of a multiplicity of factors, all associated with our fast-changing world. Demographic profiles are being altered, with increasing proportions of people who are more susceptible to micro-organisms in food. Changes in farm practices, more extensive food distribution systems and the increasing preferences for meat and poultry in developing countries all have the potential to increase the incidence of foodborne illness.
Changes in eating patterns, such as a preference for fresh and minimally processed foods, the increasingly longer interval between processing and consumption of foods and the increasing prevalence of eating food prepared outside the home all contribute to the increased incidences of foodborne illness ascribed to microbiological organism.
CHEMICAL HAZARDS: Chemical contamination of food can affect health after a single exposure or, more often, after long-term exposure, however, the health consequences of exposure to chemicals in food are often inadequately understood. While assessments of the risks associated with exposure to pesticides, veterinary drugs and food additives are usually supported by extensive information; fewer data are available on the toxicology of contaminants in food. New understanding of the potential for chemicals to affect the immune, endocrine and developing nervous systems should continue to be incorporated into hazard characterisations of chemicals in food.
Risk assessments much take into account the potential risks of sensitive population groups such as children, pregnant women and the elderly. They must also address concern about cumulative, low level exposure to multiple chemicals. Testing procedures and other methods of assessment for adequate evaluation of these potential risks are being developed and validated. Estimates of the exposure of specific subpopulations are often hampered by inadequate data on dietary intake and on levels of contamination of food.
This lack of information is exacerbated in developing countries, where little reliable information is available on the exposure of their populations to chemicals in food.
Public awareness about chemicals in food is relatively high, and consumers continue to express concern about the risks to health due to the deliberate addition of chemicals to food. Increasing concern is also being expressed about the introduction of contaminants into the food chain from industrial pollution of the environment.
Recognition that some pesticide residue and other chemicals may affect the hormonal system has further heightened public concern about persistent organic pollutants (POPs).
NEW TECHNOLOGIES: New technologies, such as genetic engineering, irradiation of food, ohmic heating and modified atmosphere packaging, can be used to increase agriculture production, extend shelf life or make food safer. Their potential benefit for public health is great, for example, genetic engineering of plants has the potential to increase the nutrient content of foods, decrease their allegenicity and improve the efficiency of food production. However, the potential public health effect of these technologies has raised concern globally during the past decade.
Some new technologies benefit the health and economy of communities and contribute to sustainable development. However, countries should be provided with the results of objective, rigorous assessments of the potential risks associated with these technologies before being asked to accept them. Moreover, countries should be assisted in developing capacities to evaluate such results.
The basis for the safety assessments should be easy to understand and well communicated, so that the public can be involved at the early stages of this process.
The evaluation should be based on internationally agreed principles that include factors other than considerations of safety and risk, such as (health) benefits, socio-economic factors, ethical issues and environmental assessments.
CAPACITY BUILDING: Most countries continue to expand the capacity to protect their populations from exposure to unacceptable level of micro-organisms and chemicals in food. Public awareness of the risks involved is relatively high in developed countries, and many governments have made clear commitments to improve food safety.
Developing countries have many competing priorities in their health agendas, and food safety has not, in the past, been recognised as a vital public health issue. However, it is becoming clear that foodborne disease has a significant impact on health. The globalisation of the food trade and the development of international food standards have also raised awareness of food safety in developing countries. Placing food safety, the political agenda is the first vital step in reducing foodborne illness.
Many developing countries are poorly equipped to respond to existing and emerging food safety problems. They lack technical and financial resources, an effective institutional framework, trained manpower and sufficient information about the hazards and risks involved.
A WHO survey, in 1989, of national capacities for effective protection against adverse environmental factors, including a clean water supply, basic sanitation and food safety, showed that less than 10% of the 136 developing countries had adequate capacities. Few of these countries had adequate legislation, standards or regulations or the capacity to enforce and assess them. Most lacked adequately skilled staff, effective mechanisms for inter-sectoral actions and adequate financing and strategies to overcome these limitations. Therefore, while the identification of hazards and risk in food is vital in strategic planning, the capacity to assess and manage those risks is fundamentally lacking in many developing countries.
WHAT ARE WE UP TO? The National Quality Policy developed by the Pakistan National Accreditation Council is a good step forward though belated. It however lays down implementation/launching a time-frame ranging from 1-5 years, which is too long a period to meet the ensuing challenges emanating from the WTO obligations. The policy has many flaws which need to be corrected. Giving one example, it would be sufficed to say that it does not adequately address the core issue of food safety in the context of global trade and protecting the local population from the hazards of contaminated food that is being marketed and sold with impunity by the food processing and catering industry, including the hotels and the restaurants. We have cases of food poisoning every day in various parts of the country but we do not budge to address this issue of public importance. The reason is very simple, we do not have, in place, an effective and purpose-oriented mechanism or the legislation regulating the operations of the catering companies and the establishments selling food to the consumers. As a consequence they are selling and marketing all kind of sub-standard food/confectionery products to the consumers, thereby taking a heavy toll on the poor population.
Objectively speaking, the Pakistan National Accreditation Council (PNAC) itself is poorly equipped and not capable to deal with the gigantic task of Quality Control of the products and services. It is ill structured in terms of competence and paraphernalia to discharge functions of immense importance. We need to induct experts, of professional level, to make it a vibrant organisation to meet the challenges of quality assurance. Its charter should also empower it to take punitive action against the defaulters.
Concurrently, the provincial governments should also come up with effective legislation laying down quality standards for food safety and it should be mandatory for the catering industry, hotels and the restaurants to abide by the HACCP standards.
For the purpose, the food industry/establishments can be categorised, based on their service standards, to bring them into the monitoring net, not only ensuring "value for money" but also safe food to the consumers. In a nutshell, PNAC has huge task to perform and its charter and obligations need to be redefined making it an effective body that has the potential, the resources and the competence to come up to the people's expectations in association with the NGO's to protect the consumers.
Let it be borne in mind that the council has to perform with a missionary zeal and fervour and quickly respond to the need of the hour as we are lagging behind in this vital area of the economy, by providing strength to the industry to meet the challenges of globalisation.