1 1 High-Level Preparatory (HLP) Meeting for the 63 rd Session of WHO/SEA Regional Committee, New Delhi, 28 June – 1 July 2010 Nutrition and Food Safety in the South-east Asia Region (SEA/RC60/R3) Agenda item 5.2 2 2 High-Level Preparatory (HLP) Meeting for the 63 rd Session of WHO/SEA Regional Committee, New Delhi, 28 June – 1 July 2010 Technical Discussions – recommendations [SEA/RC60/R3] For Member States National nutrition and food safety policy / plan of action Monitoring and / or surveillance systems that focus on diet, nutrition and food safety Strengthen and sustain prevention, control and elimination of micronutrient deficiency disorders of public health importance For WHO Technical assistance to member states for developing national policies / plans of action on nutrition and food safety Assessment, monitoring and surveillance of nutrition and food safety programmes Information networking and sharing of nutrition and food safety through the SEA- nutrition Research-cum-Action network, INFOSAN and Asia FoodNet Monitor and report progress of implementation and trend in the Region 3 3 High-Level Preparatory (HLP) Meeting for the 63 rd Session of WHO/SEA Regional Committee, New Delhi, 28 June – 1 July 2010 Background Overall per capita consumption of dietary energy has increased. Overall malnutrition rates (under-weight, stunting and wasting) in children below five years of age are on the decline in most Member States. Progress may be negatively affected by the on-going food price increase and economic crises leading to rise in household food insecurity and increasing number of under-nourished people. Food safety programmes have evolved considerably over the years. The regional ten-point food safety strategy has been adapted in Member States with various degrees of progress. Series of activities organized by WHO SEARO have continued to place focus on nutrition and food safety issues as well as emerging issues at the global and regional levels. 4 4 High-Level Preparatory (HLP) Meeting for the 63 rd Session of WHO/SEA Regional Committee, New Delhi, 28 June – 1 July 2010 Regional situation - Nutrition Nutrition Indicators Estimated proportion / number Exclusive breastfeeding for the first six months of life 25% [5% - 65%] Prevalence of low birth-weight 22% [7% – 30%] Underweight in children (0-5 years) 30% [9%-49%] Stunting in children (0 – 5 years) 33% [12% - 54%] Wasting [acute malnutrition] 12% [3% - 25%] Households with adequately iodized salt 65% Prevalence of anemia (6 – 59 months) 42% Prevalence of anemia in pregnant women 45% Vitamin A deficiency disorders in pre-school age children 33% Adoption of WHO growth standards (0-5 years) 9 Member States Adoption of WHO growth references (school children / adolescents) Nil [Under review in most Member States] Nutrition monitoring of infants and young children All Member States 5 5 High-Level Preparatory (HLP) Meeting for the 63 rd Session of WHO/SEA Regional Committee, New Delhi, 28 June – 1 July 2010 Regional situation – Food Safety Food Safety Indicators Estimated proportion / number Establishing national multisectoral group along with dedicated focal agencies for various food safety issues 10 Member States Comprehensive coordinating mechanism in food safety policy and a single national food safety authority Nil [Under consideration in some Member States] Membership in Codex Commission / INFOSAN /Asia FoodNet 10 Member States Revision of food laws and legislation in conformity to Codex and HACCP principles 5 Member States Food control and inspection activities based on HACCP principles 10 Member States Analytic capacities to assess foodborne outbreak investigations Limited Monitoring of domestic food market and commercial food establishments Limited 6 6 High-Level Preparatory (HLP) Meeting for the 63 rd Session of WHO/SEA Regional Committee, New Delhi, 28 June – 1 July 2010 Progress, achievements and way forward Strategic Focus Action taken Activities proposed Strengthening technical partnerships and alliances South-east Asia nutrition Research-cum- Action Network meeting Formulating integrated nutrition, food safety and security strategies / plan of action to address impact of climate change Improved communication between Codex Trust Fund and national Codex committees Food safety emergency preparedness Participation in the Global nutrition policy survey and ‘Infant Code’ survey Continued technical assistance to formulate national integrated nutrition, food safety and security strategies / plans of action Development and dissemination of standard protocols, procedures and guidelines Standardized approach for national IDD programmes Updating / amending national food safety legislation & laws Updating / amending existing food safety laws / legislation to conform to Codex standards Standardized approach to the management of severe & moderate malnutrition Monitoring and assessment of changes in population nutrition profile Assessments of national IDD programmes Assessment of national food safety programme Nutrition surveillance systems Technical assistance to strengthen national nutrition surveillance systems Introduction of current WHO recommendations / approaches for the control and prevention of micronutrient deficiencies 7 7 High-Level Preparatory (HLP) Meeting for the 63 rd Session of WHO/SEA Regional Committee, New Delhi, 28 June – 1 July 2010 Progress, achievements and way forward Strategic Focus Action taken Activities proposed Developing and enhancing national nutrition programmes Technical assistance to formulate national food- based dietary guidelines (FBDG) Capacity development for promoting infant and young child feeding Strengthening national capacities in growth monitoring and national IDD programmes Regional consultation on FBDG and continued assistance to develop national FBDGs Technical support to scale up interventions for improving infant and young child nutrition Developing policies and strategies for the prevention and control of foodborne diseases and food hazards Technical assistance for food contamination studies Promotion of healthy markets and safe street foods Regional workshop on safety of street foods Promoting healthy markets Continued support to strengthen national capacities for responding to foodborne epidemics [Asia Foodnet] Standard-setting, monitoring and documentation for microbiological and chemical risks related to food Strengthen / establish various food safety networks in member states [INFOSAN / CODEX / FOODNET] Total Diet Studies as part of Global Environmental Monitoring Systems Total Diet Studies to address contamination of food items with heavy metals, residual pesticides and other toxic products in relation to food consumption 8 8 High-Level Preparatory (HLP) Meeting for the 63 rd Session of WHO/SEA Regional Committee, New Delhi, 28 June – 1 July 2010 Support from Member States To increase political commitment in order to promote the national nutrition and food safety programmes To mainstream nutrition and food safety issues in all national health policies and strategies and confirm the implementation of the global strategies on infant and young child feeding; food safety; diet, physical activity and health into national health programmes To strengthen nutrition surveillance systems and implement the WHO Child Growth Standards and Growth References by their full integration into child and adolescent health programmes To develop and maintain sustainable comprehensive preventive measures for reducing the burden of foodborne diseases encompassing the complete food-production chain from farm to consumption To strengthen the laboratory capacity for investigating and reporting on foodborne diseases outbreaks To enable active and appropriate participation of national authorities in the activities of Codex Alimentarius Commission, INFOSAN and other international networks 9 9 High-Level Preparatory (HLP) Meeting for the 63 rd Session of WHO/SEA Regional Committee, New Delhi, 28 June – 1 July 2010 Thank you
High-Level Preparatory (HLP) Meeting for the 63 rd Session of WHO/SEA Regional Committee WHO/SEARO, New Delhi, 28 June – 1 July 2010 Agenda item 5.2 SEA/HLP-Meet/5.2 22 June 2010 Follow-up action on pending issues and selected Regional Committee resolutions/decisions for the last three years: Nutrition and food safety in the South-East Asia Region (SEA/RC60/R3) The working paper on nutrition and food safety in the South-east Asia Region provides a brief overview of the nutrition and food safety situation in Member States of the South-East Asia (SEA) Region. It indicates that while overall food consumption has increased and nutrition indicators have shown improvement, the global economic crisis and climate change may lead to food insecurity and increase in the number of malnourished individuals. The paper describes some of the key nutrition and food safety indicators in the Region. Activities in nutrition and food safety undertaken during the reporting period and proposed activities to be conducted in the biennium are also tabulated. It concludes by identifying a range of supportive actions from Member States with regard to the promotion of nutrition and food safety in the SEA Region: to increase political commitment in order to promote national nutrition and food safety programmes; to mainstream nutrition and food safety issues into all national health policies and strategies and ensure the implementation of global strategies on infant and young child feeding, food safety, diet, physical activity and health; to strengthen nutrition surveillance systems and implement the WHO Child Growth Standards and Growth References through their full integration into child and adolescent health programmes; to develop and maintain sustainable and comprehensive preventive measures for reducing the burden of foodborne diseases encompassing the complete food-production chain from farm to consumption; to enable active and appropriate participation of national authorities in activities of the Codex Alimentarius Commission, INFOSAN and other international networks; and to strengthen the laboratory capacity for investigating and reporting on foodborne diseases outbreaks. The attached working paper (Doc. SEA/RC63/17) is submitted to the High-Level Preparatory (HLP) Meeting for its review and recommendations. The recommendations made by the HLP Meeting will be submitted to the Sixty-third Session of the Regional Committee for its consideration.
SEA/RC63/17 REGIONAL COMMITTEE Provisional Agenda item 16.2 Sixty-third Session SEA/RC63/17 Bangkok, Thailand 7–10 September 2010 22 June 2010 Follow-up action on pending issues and selected Regional Committee resolutions/decisions for the last three years: Nutrition and food safety in the South-East Asia Region (SEA/RC60/R3)
SEA/RC63/17 1. Wide-ranging public health interventions to improve the nutrition status of the populations have been introduced in Member States of the World Health Organization’s South-East Asia Region. Overall, per capita consumption of dietary energy has increased in most countries since 2002. However, this progress may be negatively affected by the ongoing food price increase and economic crisis resulting in rising household food insecurity and increasing numbers of undernourished people in several Member States. Similarly, the overall malnutrition rates (underweight, stunting and wasting) in children under five years are on the decline in most Member States, although these figures show wide variation between the Member States. 2. Food safety programmes in the Region have evolved considerably over the past decade. The ten-point regional strategy for food safety in the South-East Asia Region was developed in 1998 to serve as a framework for national food safety programme development while providing adequate resources to establish and strengthen national food safety programmes, with an emphasis on the preventive approaches. Due emphasis was placed on establishing analytical capacity and epidemiological systems; food safety policy and legislation; food control and inspection, and effective networking relationships with the consumers, industry and trade; research; and education and training. A series of activities organized by WHO-SEARO starting from 1998 have placed the focus on food safety issues, as well as emerging issues at the global and regional levels. 3. In the Region, the proportion of infants born with low birth weight ranges from 7% to 30% and the proportion of malnourished women in the childbearing age group ranges from 24% to 35.6%, indicating the need to ensure optimal nutrition for the mother, the growing fetus and the infant as a single unit. An estimated 25% of infants (range 5%–65%) receive exclusive breastfeeding up to the first six months of life. 4. Underweight for age which is a combined indicator of long-term and short-term nutrition challenges in early life, has been reported to range from a low of 1.3% to a high 44%. Stunting, an indicator of chronic malnutrition in children under-five ranges from a low of 4.5% to a high of 55.7%. Acute or short-term malnutrition described as wasting ranges from 3% to 25%. Stunting in preschool children remains a major challenge. 5. Among the micronutrient deficiencies of public health importance, iodine deficiency disorders (IDD), the most preventable risk factor for brain damage, remains a major public health problem in several Member States. Appropriate monitoring of salt iodization and urinary iodine excretion rates are often inadequate. Prevalence of anaemia in preschool children (below the age of five years) ranges from 25.2% to 81.5%, while its prevalence in pregnant women is reported to vary from 22.3% to 74.6%. The estimated proportion of vitamin A deficiency disorders in preschool children ranges from 9.4% to 62%, indicating a wide variation. 6. With regard to progress on the ten-point regional strategy for food safety, 10 out of 11 Member States have established national multisectoral groups along with dedicated focal agencies to review the existing national food safety policy. However, a comprehensive coordinating mechanism in food safety policy and a single national food safety authority have yet to be created. Ten of the eleven Member States are members of the Codex Alimentarius Commission. Technical assistance has been provided to Member States to revise their food laws SEA/RC63/17 Page 2 and legislation and bring these to par with the guidelines of the Codex and Hazard Analysis Critical Control Point (HACCP) principles. Most countries now conduct their food control and inspection activities based on the HACCP principles. The number of food inspectors in many countries is inadequate, however, and most of these inspectors are not sufficiently trained. Analytical capacity varies among the Member States. Most data are analysed and kept with the responsible agencies with a minimum amount of information-sharing and coordination among these agencies. Table 1: Progress and achievements Strategic focus Action taken Activities proposed Strengthening technical partnerships and alliances • Ninth South-East Asia nutrition research- cum-action (RCA) network meeting organized; RCA quarterly newsletter published to share information between Member States and other stakeholders; • Regional workshop to formulate integrated nutrition, food safety and security strategies to address the impact of climate change; • Improved communication established between Codex Trust Fund and national Codex Committees • Regional workshop on food safety emergency preparedness (Asia Foodnet). • Continued technical assistance to Member States for formulating integrated nutrition, food safety and security strategy/plan of action. Development and dissemination of standard protocols, guidelines and procedures • Regional workshop on a standardized approach to the monitoring and evaluation of national IDD control and prevention programmes; • Regional protocol for the management of severe malnutrition in children; • Technical support to update food safety legislation in Maldives. • Technical assistance to update/amend existing food safety laws and legislation to conform to Codex standards; • Regional training workshop on a standardized approach for the management of severe and moderate malnutrition in children; • Capacity building in Member States for the hospital management of children with severe malnutrition. SEA/RC63/17 Page 3 Strategic focus Action taken Activities proposed Monitoring and assessment of changes in nutrition profiles • Assessments of national IDD control and prevention programmes in Sri Lanka and Thailand; • Assessment of national food safety programme in Thailand; • Regional workshop on nutrition surveillance systems using WHO growth standards for preschool children and growth references for schoolchildren and adolescents; • Capacity building in the use and interpretation of WHO growth standards for children under five years; • Strengthening national capacities for the monitoring of national IDD control and prevention programmes in DPR Korea, India and Myanmar. • Continued assistance to strengthen national nutrition surveillance systems; • Regional workshops to introduce current WHO recommendations and approaches for the control and prevention of micronutrient deficiencies of public health importance. Developing and enhancing national nutrition programmes • Technical assistance to formulate national food-based dietary guidelines (FBDG) in Maldives, Nepal and Sri Lanka; • Capacity development for promoting infant and young child feeding in Myanmar, Nepal and Sri Lanka. • Regional consultation on FBDG; • Continued assistance for the development of national FBDGs. Developing strategies and policies for prevention and control of foodborne diseases and food hazards • Technical assistance for food contamination studies in India; • Promotion of healthy markets and safe street foods in India and Indonesia. • Regional training workshop on safety of street foods; • Continued assistance for promoting healthy markets; • Continued support to strengthen national capacity to respond to foodborne epidemics (Asia Foodnet network). Standard-setting, monitoring and technical documentation for microbiological and chemical risks related to food. • Technical assistance provided to strengthen/establish national CODEX, INFOSAN, FOODNET and GFIN networks in Member States; • Total diet studies undertaken in two states in India. • Total diet studies (as part of a global environmental monitoring system) proposed in interested Member States to address contamination of food items with heavy metals and residual pesticides and other toxic products in relation to food consumption.