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Second Meeting of the WHO Regional Working Group on Food Safety, PEPAS, Kuala Lumpur, Malaysia, 17 - 21 August 1987 : report

31 décembre 1987 Organisation mondiale de la santé

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Texte intégral

ICP/RUD/001 -.

ENGLISH ONLY jEPORT SECOND ~ ~NG

OF THE WHO REGIONAL WORKING GROUP ON FOOD SAFETY Convened by the

WESTERN PACIFIC REGIONAL CENTRE FOR THE PR<X-10TION OF APPLIED STUDIES (PEPAS)

PEP AS. Kuala Lumpur. Malaysia 17-21 August 1987

Not for sale Printed and distributed -.

by the Western Pacific Regional Centre for the Promotion of Environmental Planning and Applied Studies (PEPAS) POBox 12550 50782 Kuala Lumpur Malaysia March 1988 -. Wt;11I ·.·'f'IH) LlHltAtn 'V!,;!~'. .

':.ilippines

13 MAY 1988

N~E

The views expressed in this report are those of the participants in the working group and do not necessarily reflect the policies of the World Health Organization •

...

This report has been prepared by the Western Pacific Regional Centre for the Promotion of Environmental.Planning and Applied Studies (PEPAS) for Governments of Member States in the Region and for the participants in the Second Meeting of the WHO Regional Working Group on Food Safety, held in Kuala Lumpur, Malaysia, from 17 to 21 August 1987.

... ... ... EXECUTIVE SUMMARY 1. INrRODUcrION .............................................................................................. ..

CONTENTS

iii

1 1

2. 3.

OPENING SESSION .. ...................................................................................... . OBJECfIVES .. ............................................................................................... . BACKGROUND .. ................................................................................................ . WORKING GROUP PROORAl-fME ........................................................................ ..

4. 5.

2 2

...

SUMMARIES OF SELECTED DISCUSSIONS •...•.•.....•••..••••...... 6.1 6.2 6.3 Public information and education ..•.•••••••••••••.••.•. Foodborne illness - case reporting •.•.••.••.••••••.••.. Salmonella ........................................................................................ .

5 5 5 6 6 6 6 6 7 7 7 7

...

6.4 Date-ma.rking .................................................................................... . 6.5 Routine medical examination of food handlers ••••••••••• 6.6 Rejection of imported food .••••.••••••••••.•••••••••... 6.7 Derived Intervention Levels for radionuclides in food •• 6.8 7. Consultants ................•................•...........

6.9 Computer data-base .••..•..•...•.•....•..•.•••••.•......

...

FINDINGS AND RECOMMENDATIONS 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9

............................... . .................................

Awareness promotion ................................... . Foodborne disease surveillance .•.•••..•..••••••••••.••• Consequences of food borne diseases ...•...•.•••......•.• Food legislation •.••.•••••••••..•..••..•••••••..•..•.••

... ...

Street vending of food Field tests for food contamination ••••••..•••••••.••••• Man power training ........•••................••••....... Monitoring of radionuclides in food .••••••••••••••••••• Exchange of information ..•..•.•.•...............•...•..

7.10 Evaluation of food safety programmes •.••••.••••••••••.• 7.11 Designation of field staff ...••.••.•..•.•••••...•..•...

7.12 Participation in Codex Activities •.••..•••••••••••••••. 7.13 Shellfish control •••...••.•..•..•. ~ •••...•...••••....•.

8 8 9 9 9 10 10 10 11 11 11

7.14 Joint FAO/WHO Food Contamination Monitoring Programme .......................................... 7.15 Food irradiation ....•.•••••••....••.•.•.•••••••.••..•.. 7.16 Extrabudgetary support •.•..•..•..•..•...••.••••.••••••. 1,17 Further Working Group meetings .•••..•• : •••...••.••....• c ••

12 12 12 12 13/14 13/14

... 8,

CONC!l..UDING SESSION .......•.....•............................

... / ...

...

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15 19 23 27 31 49 59

ANNEX 1 - LIST OF MEMBERS, OBSERVERS AND SECRETARIAT •••••••• ANNEX 2 - ADDRESSES PRESENTED AT OPENING SESSION .••••••••••• ANNEX 3 - PROVISIONAL AGENDA ................................ ANNEX 4 - LIST OF WORKING PAPERS, BACKGROUND DOCUMENTS AND ADDITIONAL REFERENCE MATERIALS ••.•.•••••.••••••••. ANNEX 5 - SUMMARIES OF COUNTRY REPORTS ••••••.••.•••••.•••••• ANNEX 6 - SUMMARIES OF WORKING PAPERS •••••••••••••••••.••.•. APPENDIX A - BIBLIOGRAPHY OF FOOD SAFETY PUBLICATIONS, 1979-1987 .••.••••.••••• ANNEX 7 - PUBLIC INFORMATION AND EDUCATION - SPECIFIC TYPES OF INFORMATION REQUIRED BY VARIOUS TARGET GROUPS •••••••••••••••••••••.•• ANNEX 8 - AWARENESS PROMOTION - PROPOSED FUNCTIONS OF A NATIONAL FOOD SAFETY CONSULTATIVE COUNCIL ..••••••••••.••••.•••••••••• ANNEX 9 - INDICATORS FOR MONITORING AND EVALUATION OF PROGRAMMES TO ENSURE FOOD SAFETY ••••••••••••..•.••

67/68

69/70 71

.. (iii)

EXECUTIVE SUMMARY

On 17 August 1987, the WHO Regional Office for the Western Pacific convened the second meeting of the Regional Working Group on Food Safety consisting of fifteen authorities from thirteen countries or areas in the Region. The week-long meeting was held at the WHO Western Pacific Regional Centre for the Promotion of Environmental Planning and Applied Studies (PEPAS), which is located near Kuala Lumpur, Malaysia. As at the first meeting in 1979, the Working Group identified priority food safety problems in the Region and provided recommendations to WHO and its Member States on improving the food safety situation in the Region. The meeting also afforded an opportunity to brief the members on the food safety activities of WHO and other international agencies as well as to discuss the latest developments in emerging issues, such as radionuclide contamination of food. Nineteen recommendations were made, including proposals for a wide range of activities to be undertaken by WHO and Member States in strengthening regional and national food safety programmes. In recognizing the need for awareness promotion among important groups in society, the Working Group recommended that WHO convene, if possible, a regional conference on food protection at the ministerial level. The Group also recommended that Member States establish national consultative councils for food safety education and promotion as a means of raising the level of food safety consciousness among important target groups in their countries. The Working Group urged that steps be taken to better document the health and economic impact of food safety, especially in regard to food borne disease surveillance. Member States were also urged to improve monitoring of the progress of their food safety programmes by using a basic set of indicators which were developed at the meeting. The Working Group endorsed a plan by PEPAS to establish a data-base of relevant food safety information for the Region, including data on radionuclide contamination of food. The Working Group recommended that Member States contribute to the data-base and actively participate in other international programmes related to food safety, such as the Codex Alimentarius Commission and the Joint FAO/WHO Food Contamination Monitoring Programme. The Group made a number of other recommendations on specific topics to Member States, among them, shellfish sanitation and food irradiation. WHO was also asked to undertake studies and convene seminars on topics of regional interest, such as legislation, foodborne disease surveillance, street vending of food, and simple field tests for chemical and microbiological contamination and adulteration of food.

...

... 1.

INTRODUCTION

...

The second meeting of the WHO Regional Working Group on Food Safety was held at the WHO Western Pacific Regional Centre for the Promotion of Environmental Planning and Applied Studies (PEPAS), on the campus of the University of Agriculture, Malaysia (Universiti Pertanian Malaysia), Serdang, Selangor, MalaYSia, from 17 to 21 August 1987. The meeting was attended by fifteen members invited by WHO from thirteen countries or areas in the WHO Western Pacific Region and by three observers. A list of the members, official observers and secretariat members is presented in Annex 1. 2. OPENING SESSION

In his introductory remarks, Mr S. Unakul, Director, PEPAS expressed his pleasure at the convening of the Working Group, which was particularly timely, in view of the growing awareness of the magnitude of the health and economic problems arising from illness due to contaminated food. Mr Unakul drew attention to the report of the previous Western Pacific Regional Working Group on Food Hygiene and Food Safety which had met at PEPAS in October 1979. He expressed the hope that the members would review progress made since 1979, identify food safety problems which were of concern to countries of the Region, and propose appropriate actions. This, in turn, would facilitate the development of strategies for the implementation of activities by both Member States and WHO. The full text of Mr Unakul's remarks is given in Annex 2A.

On behalf of Dr H. Nakajima,Regional Director, WHO Regional Office for the Western Pacific, Dr L.R. Verstuyft, WHO Representative for MalaYSia, Singapore and Brunei Darussalam, welcomed the members. Great importance was attached by WHO to the deliberations of the Working Group, particularly as it was recognized that illness due to contaminated food was perhaps the most widespread health problem in the Region and an important cause of reduced economic productivity. The full text of his address is given in Annex 2B. An official welcome to Malaysia and to the University of Agriculture, Malaysia was extended to the Group by Professor Dr Haji Badri bin Muhammad, Dean, Faculty of Science and Environmental Studies of the University. Dr Badri emphasized the need to improve food safety awareness along the entire food chain from farmers to consumers. The full text of his remarks is given in Annex 2C. 3. OBJECTIVES

The terms of reference of the Working Group were: (a) to review the status of national food safety programmes in the light of recommendations of the previous Working Group;

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(b) (c)

to develop approaches for the rationalization of food inspection systems and promotion of food safety education; to recommend the programme scope and gUiding principles for implementation of food safety information sharing within the Region; and to recommend specific activities to be undertaken by WHO at regional and national levels in promoting, developing, strengthening and evaluating food safety programmes. 4. BACKGROUND

(d)

The first WHO Regional Working Group on Food Hygiene and Food Safety was hosted by PEPAS from 1 to 5 October 1979. The Working Group met to identify, review and highlight the major food safety problems of concern to countries of the Region, with a view to establishing long-term strategies for the control of biological and chemical agents of food borne diseases. In its report, the Working Group recognized that food borne diseases posed a serious and major health problem within the Region. In particular, gastroenteritis was among the ten most common diseases of the Region, ranking only second to respiratory diseases as a major cause of infant mortality. Food played an important role as a vehicle ·of transmission for these diseases. In the absence of improved food handling practices in the home and in food service and retail establishments, little improvement in disease incidence could be expected. The major problems relating to food safety in the Region were recognized as falling into the following broad categories: difficulties in implementing effective national programmes; inadequate food borne disease reporting and epidemiological investigation; inadequate laboratory services in support of enforcement; difficulties in laboratory confirmation of etiological agents; deficiencies in number and types of trained public health and food control specialists; and the increasing danger of chemical contamination of food with pesticides and other agricultural chemicals, environmental pollutants and food additives and processing chemicals. In addition to recommendations for strengthening regional and national food safety programmes, the Working Group recommended that a subsequent Working Group be convened to review the status of food safety programmes in the Region and assess progress in the implementation of the recommendations of the first Working Group. 5. WORKING GROUP PROGRAMME

Dr Ronald A. Perry (Hong Kong) was elected Chairman and Mrs Catalina C. Sanchez (Philippines) was elected Vice-Chairman. Mr Chia Hong Kuan (Singapore) was appointed Rapporteur. The provisional agenda, as proposed, was adopted. The agenda and list of working papers, background material and additional reference materials provided to the participants are given in Annexes 3 and 4, respectively.

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The Chairman invited the members to present a view to identifying particular constraints, as recent years. Each presentation was followed by Brief summaries of the country reports are given

their country reports with well as progress made over questions and discussions. in Annex 5.

In addition to the information contained in the country reports, the members were requested to complete the summary of identified elements (Table 1) which gives an overview of national food safety programmes in countries or areas of the Western Pacific Region. The Secretariat presented a number of working papers to inform the Working Group of developments in food safety that had taken place since the previous Working Group. Copies of the working papers distributed to the members are not attached to this report. However, summaries of these papers are given in Annex 6. In addition to the plenary seSSions, the members were divided into three discussion groups to consider the following topics: Group I: Strategies for further programme development to assure food safety, including: rationalization of food inspection systems food safety information sharing Moderator Rapporteur Technical secretary Mrs Catalina C. Sanchez (Philippines) Mr Phil Busby (New Zealand) Dr Gerald G. Moy (WHO) Mr Uraia N. Lesu (Fiji) Dr Harrison Aziz (Malaysia) Dr Nguyen Hoang Thao (Viet Nam) Group II: Advocacy and support: awareness promotion public information and education

....

Moderator Rapporteur Technical secretary

Dr James N. Soosaipillai (Malaysia) Dr Leticia V. Espaldon (Guam) Dr F.I. Iaferstein (WHO) Dr Chen Junshi (China) Dr Y. Saito (Japan) Mr Igo Sere (Papua New Guinea) Mr C. Nathan (WHO)

Group III: Monitoring and evaluation of programmes to ensure food safety Development of indicators

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TABLE I

STATUS or NATIONAL rOOD SAFETY PROGRAHHES IN CO~ES OR AREAS OF THE WESTERN PACIFIC REGION - SUMMARY or IDENTIrIED ELEMENTS

FOOD SAFETY ELEMENTS

.. . " ~ X

.f;!

POOD SAFETY POLICY FOOD SAFETY LEGISLATION AND

Poli.cy

Strategiea

I Baa:Le Foo. '00.

food law

xx Ixx xx I

is xx xx xx

:=i ...

... ..,

.... X

REGULATIONS 'ood atreet

xx x xx X xx xx. x'

ADHINISTlATION OF rOOD REGULATIONS

Food

•••

fool

xx . xx xx I

xx xx xx xx XX

xx x xx x x a XX

xx XX XX

xx x

xx xx 0

xx xx xx xx xx xx xx xx xx xx xx xx

~~ ~ III ' " 8 ~ .. " " ~

.. ..~ ;5 N

'" !l!l

..~

eI ;:l g;

... xx xx xx xx ·X

.. ~ ... ... i .. . ., 0

~ z

xx xx xx x X

xx xx xx

-xx

xx xx xx xx xx xx

xx xx xx

xx xx

a IXX 0 0

xx xx X

xx x -x

xx x x x

iii

xx 0

a a

xx xx xx xx

xx xx xx

x xx

xx xx xx xx xx xx

xx xx xx n

xx xx

x xx n n

xx xx xx x yy

xxX

xx X

and CODEX ALIHENTARIUS JOINT UNEP/ rAO/WHO rOOD CONTAMINATION KONITOIliNG PROGRAHHE LABORATORY SUPFORT SERVICES DISEASE REPORTING AND

x x XX

Xx- yy x x xx xx xx x xx xx xx 0

yyX

x XX

Codex me.bar

a xx xx XX

X X

Collaborating CeDtre Participating IU8titution

XX 0

a 0

0 0

a 0

xx 0

0 0

xx 0

0 0

0 X

X XX

XX XX

M ••

nMnl.

XX XX 0

XX XX

Food .uentio"a! ., N. ' .

xx XX XX XX

x XX XX XX

xx XX XX X X XX

X XX XX XX XY

xx 0

xx XX XX

XX 0

XX X XX X X X X X XX

n 0

.. .. ~

XX ,

X XX X XX X XX X XX XX XX XX

X X XX

XX XX

EPIDEHIOLoGICAL INVESTIGATION Food " Heat TRAINING

U~ft'.

X XX

XX XX XX XX !

X XX

XX XX

X¥ XX XX

XX X X

XX XX

XX XX XX YV

XX XX XX XX

XX XX

HEALTH

EDUCATION AND INFORIIATION CONSUMER AFFAIRS

'* .~

'X XX

.. ., publie

X X X XX

x XX

xx yy

XX XX .n n

XX XX

x XX

xx X y

x '000

X X X

XX 0

x X

x XX XX XX

x XX

X X

XX XX XX XX XX

XX XX

X XX X XX 1/ X XX X XX X XX

X X Y

xx XX XX XX XX XX

x X X X X X

X XX XX XX

X XX XX

X 0 0

XX XX

X X

XX XX

1 Currently subject ot Par11 . . entary inquiry.

Lelend:

xx -

ExistinS Not developed

o -

X - Planned and/or not fully developed

GGH/WIl/nm

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Moderator Rapporteur Technical secretary

Dr Ronald A. Perry (Hong Kong) Dr Gordon De Cean (Australia) Mr Robert F. Davies (WHO) Dr Mr Mr

Chen Yaojun (China) Chia Hong Kuan (Singapore) Sesela Siimoa (Samoa)

The views expressed in the discussion groups were summarized by their respective officers at a plenary session of the Working Group; these are reflected in the Findings and Recommendations Section of this report. A visit was also made to the Malaysian Agricultural Research and Development Institute (MARDI) where the members were briefed on the training and educational activities of the Food Technology Division •

SUMMARIES OF SELECTED DISCUSSIONS

The discussions that followed each country report and working paper were enthusiastic and useful. From the papers presented and from the deliberations of the three discussion groups, the following important issues emerged, which were not, however, addressed in a Working Group recommendation. Discussions of issues related to specific recommendations are presented in the Findings and Recommendations section.

...

6.1

Public information and education

The Working Group recognized that one of the obstacles in gaining support for food safety programmes is the widespread perception by many that food borne illness is at most an inconvenience. There was agreement on the need to correct this perception. The Group felt that, besides information and education for the general pUblic, specific groups should be targeted. In particular, the need to improve food safety in the home was stressed. WHO is currently collaborating with United Nations Educational, Scientific and Cultural Organization (UNESCO) to provide educational material for use by primary school teachers on food safety and other related environmental health issues. In view of the limited resources available to governments, there was also a suggestion to involve the food industry in the preparation and dissemination of health education messages • At the same time, governments should be careful to avoid endorsing specific products. 6.2 Foodborne illness - case reporting

It was acknowledged by members that, without-exception, gross underreporting of episodes of food borne illness occurs in all Member States. This was attributed to the lack of incentives for medical practitioners to report, and to the perception that food borne illness are trivial. Despite the fact that in some countries foodborne diseases are notifiable, it was also accepted that the situation is not likely to improve in any appreciable way in the near future. There was general agreement that an effective food borne disease surveillance system is an essential element of any national food safety programme. For this, a functioning notification system for food borne diseases is a basic requirement •

... -66.3 Salmonella

The Working Group noted that the problem of Salmonella, especially in poultry, is widespread. So far, efforts to eradicate Salmonella in poultry have not been successful. The Working Group felt that more work on the problem should be carried out. Food irradiation was suggested as a possible approach for eliminating Salmonella at the end of the poultry processing train. While some developed nations require seafood to be Salmonella-free, they, at the same time, tolerate the presence of Salmonella on poultry. It was pointed out that the issue was whether or not Salmonella could be eliminated by adhering to good manufacturing practices. 6.4 Date-marking

Some Member States have date-marking legislation, some do not. Even among countries that have such legislation, approaches vary considerably. It was the experience of some members that controlling the sale of expired food that had been labelled "BEST IF USED BY" was more difficult than if it was labelled "USE BY", or words to that effect. The former was not intended to have a legal connotation as its primary function was that of stock control. A greater public awareness of date-marking and its implied warranty is indicated. The Working Group concluded that greater uniformity in date-marking processed food should be promoted. 6.5 Routine medical examination of food handlers

The Working Group questioned the relevance of routine medical examination of food handlers. It was noted that a national programme to screen food handlers medically would invariably be expensive. Members pointed out that the health of food handlers could only be ascertained at the time of examination and provided no assurance of their subsequent health status. In view of the scarce resources, the Working Group concluded that national efforts on food safety should not be channelled into this area. 6.6 Rejection of imported food

Some members of the Working Group related instances where food intended for importation was rejected but was then released for diversion to other countries. The problem of transshipment of rejected food that could pose a hazard to health was not adequately addressed within the Region. Such practices raise a question of ethics. The Working Group urged Member States to comply with the provisions of the Codex Code of Ethics for International Trade in Food. While the Code is not mandatory, it does impose a moral obligation on both importing and exporting countries. 8;7

Derived intervention levels for radionuclides in food

The Working Group was informed that WHO was in the process of developing derived intervention levels. An outline document* had been

*Draft WHO Guideline - Values on Derived Intervention Levels

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.. sent to selected Member States for comments. Some recipients reserved their position concerning the high levels proposed in the document and indicated that there was a move to reduce current permitted levels in their respective countries. The Secretariat took cognizance of the views expressed by some members of the Working Group and informed the Group that the levels mentioned were still at the preliminary stage. 6.8 Consultants

The Working Group pointed out that there had been occasions when consultants provided by international organizations were not altogether adequate to the task, either as regards relevance of qualifications or language capability. Members expressed reluctance to accept such consultants because it could prove counterproductive. The Working Group noted, however, that host governments have the prerogative to reject, responsibly, those consultants who are found unsuitable. 6.9 Computer data-base

The usefulness of computerization of data derived from food safety programmes was noted by the Working Group. In view of the costeffectiveness of such a data and information system, the Group urged countries to examine the possibility of procuring the necessary computer equipment and programmes to improve the management of their food safety programmes.

7. 7.1 Awareness promotion

FINDINGS AND RECOMMENDATIONS

The Working Group was of the opinion that awareness of both the health and economic consequences of contaminated food is generally lacking among various important groups in society. These groups include: (a) policy/decision-makers and others in influential positions (politicians; government administrators; media personalities; leaders of religious, community, business and trade groups, including women's groups, youth groups, consumer groups, and labour unions; health insurance industries; hotel associations; and tourist promotion boards); food industry (primary producers in agriculture and fisheries, food processors, caterers, tourist industry; and other food services); professional groups (health care providers; scientists; pharmaCists; and teachers); and consumers (parents; pregnant women; school children; homemakers; tourists; and general public)

(b) (c) (d)

In considering the type of information to be provided to the above groups, the Working Group concluded that the information should be tailored to the particular needs and functions of each group. Annex 7 gives examples of target groups and the types of information each requires.

The Working Group further concluded that the establishment of national consultative councils for food safety education and promotion is desirable. Annex 8 outlines the proposed functions of a national food safety consultative council. In view of the importance of informing policy-makers of the health and economic implications of food borne diseases, the Working Group recommended that: Recommendation 1 WHO should consider convening a regional conference on food protection at the ministerial level.' The Working Group also recommended that: Recommendation 2 Member States should convene national seminars on food safety comprising of representatives from all involved groups in society, including decision- and policy-makers, influential groups, food industry, professional and community groups and consumers. 7.2 Foodborne disease surveillance

To convince certain influential target groups such as policy-makers of the urgent need to improve food safety, the Working Group concluded that SCientifically based estimates of the health and economic consequences of inadequate food safety programmes are necessary. To this end, the Working Group proposed that WHO should consider the establishment of a programme on food borne disease surveillance for the Western Pacific Region to obtain national data on: (a) (b) (c) food borne morbidity and mortality rates; causes (etiology) of food borne disease; and factors responsible for food contamination leading to food borne diseases. The Working Group recommended that: Recommendation 3 WHO should convene a regional consultation on food borne disease surveillance to include consideration of the establishment of a programme for food borne disease surveillance in the Western Pacific Region. 7.3 Consequences of foodborne diseases

In order to obtain reliable estimates of the economic consequences of food borne diseases, the Working Group agreed that Member States should collect information on:

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(a) (b) (c) (d)

cost to the country of lost productivity and treatment for foodborne diseases; value of food losses due to spoilage; value of food losses due to condemnation, especially costs associated with the rejection of export shipments; and value of losses suffered by the tourist industry.

In several countries of the Region, nationwide collection of information on the health and economic consequences of contaminated food is not feasible. Accordingly, the Working Group recommended that: Recommendation 4

•

WHO, with Member States, should initiate appropriate studies in small representative areas, especially in regard to determining the actual incidence and cost of food borne diseases. 7.4 Food legislation

The Working Group, in conSidering the various types of legislation in the Region, concluded that a basic understanding of the laws and regulations of other countries is essential for improving communication and for resolving certain trade problems. Therefore, the Working Group recommended that: Recommendation 5 WHO should convene a regional seminar on food legislation.

7.5

Street vending of food

In view of the high potential for microbiological contamination, the Working Group concluded that, without controls, itinerant street vendors (hawkers) represent a significant risk to the public health. Because some countries in the Region have already taken control actions, the Working Group recommended that: Recommendation 6 WHO should conduct a review and evaluation of different methods that Member States have evolved to improve the preparation, storage and general sanitation of food sold by \tinerant street vendors. 7.6 Field tests for food contamination

Because laboratory services in many developing countries or areas are inadequate, especially in rural areas, the Working Group concluded that the Chinese field test kit which was demonstrated to the participants offers great potential for strengthening food inspection services. The Working Group, therefore, recommended that:

•

-10Recommendation 7 WHO should coordinate the development of field tests for chemical and microbiological contamination of food. 7.7 Manpower training

The Working Group concluded that lack of manpower still continues to be a major constraint in implementing food safety programmes in the Region. To facilitate the training of food control staff, the Working Group recommended that: Recommendation 8 WHO should survey existing training programmes and prepare gUidelines for basic training of food inspectors as well as advanced training in specialized food inspection areas. 7.8 Monitoring of radionuclides in food

The Working Group concluded that the extensive resources many countries of the Region still expend on radionuclide monitoring are unwarranted in view of the low levels of contamination that are being reported by most Member States. The Working Group therefore recommended that: Recommendation 9 In order to facilitate reV1s1on of national monitoring programmes for radionuclide contamination which were imposed following the Chernobyl accident, WHO should undertake the collection, collation and dissemination of nationally derived monitoring results from Member States within and outSide the Region as a matter of urgency. In order that maximum benefit can be obtained from these data in assisting Member States in the revision of their radionuclide monitoring programmes, the information should be avaiLable at the earliest possible date. 7.9 Exchange of information

The Working Group concluded ~hat national food safety programmes in the Region routinely need accurate information regarding food safety issues. In addition, timely, unbiased reports and information are required during times of crisis. To facilitate improved systems of communication within the Region, the Working Group recommended that: Recommendation 10

•

WHO should establish a data-base on food safety accessible to all Member States and initiate channels of communication for other data determined to be appropriate by those participating. Recommendation 11 (a) Member States should make available to WHO all relevant data and information on food safety that may be useful to the other Member States in the Region.

-11, (b) In the interim, Member States should promote the exchange of information bilaterally as a first step towards better communication in the Region.

7.10' Evaluation of food safety programmes A functioning notification· system of food borne diseases is so basic to the monitoring and evaluation of programmes to ensure food safety that its development should be a primary aim of all governments despite the known difficulties in its implementation. While child mortality rates resulting from gastroenteritic diseases only is a crude index of the incidence of food borne disease, it is a statistic available to most governments. Accordingly, the Working Group concluded that, as an interim measure, its use to monitor and evaluate ongoing food safety programmes could be valuable if supplemented with other appropriate indirect indicators. The Working Group agreed that the monitoring and evaluation of programmes to ensure food safety are essential in order to monitor the progress of those programmes, reformulate policies, and to determine appropriate measures for programme development. After considering a number of sppropriate indirect indicators, the Working Group recommended that: Recommendation 12 Member Ststes should institute monitoring and evaluation of their programmes to ensure food safety using the basic list of indicators formulated and sgreed upon by the Working Group (See Annex 9).

7.11 Designation of field staff In considering the important role of the food inspector in the educational process, the Working Group concluded that the use of the traditional term "food inspector" does not convey the advisory and educational services usually rendered by such personnel. Therefore, the Working Group recommended that: Recommendation 13 Member States should consider the use of other designations such as "Food Safety Officer" for designating persons responsible for inspecting food establishments instead of the term "food inspector".

7.12 Participation in Codex Activities In reviewing the paper on the Codex A1imentarius Commission, the Working Group expressed appreciation of the work of the Commission over the past twenty-five years in consumer protection and promotion of international trade in food. However, the involvement of the health sector in Codex activities was conSidered to be inadequate in some countries or areas. Therefore, the Working Group recommended that: Recommendation 14 (a) All Member States in the Region should join the Codex A1imentarius Commission.

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(b)

Member States who belong to the Commission should actively participate in its work, including meetings of the Codex Regional Coordinating Committee for Asia. Member States sho~ld promote the full participation of the health. sector and other parties by establishing national Codex coordinat1ng mechanisms to ensure balanced deliberations on Codex matters, especially consumer protection issues. Shellfish control

(c)

7.13

In view of the growing economic importance of the shellfish industry to many countries of the Region and the potential health risks from a variety of contaminants, the Working Group recognized that greater emphasis should be placed in programmes to assure that such products do not present a health hazard. The Working Group therefore recommended that: Recommendation 15 Member States should strengthen their national shellfish control programmes.

7.14

Joint FAO!WHO Food Contamination Monitoring Programme

The Working Group considered that participation by countries in the ongoing Joint FAO/WHO Food Contamination Monitoring Programme can strengthen their existing programmes for food safety. The Working Group accordingly recommended that: Recommendation 16 Those Member States of the Region who are not yet participating in the Joint FAO/WHO Food Contamination Monitoring Programme should consider the possibility of designating a collaborating centre or a participating institution in their countries.

7.15

Food irradiation

The Working Group concluded that food irradiation is a process that has application in the prevention of food borne illness and food losses. The meeting, however, recognized that food irradiation is not a panacea for all food safety problems, and is not a substitute for good manufacturing practices. The Working Group therefore recommended that: Recommendation 17 Member States should consider the possibilities offered by the irradiation of selected foods provided that the process is not used as a substitute for good manufacturing and food handling practices. 7.16

Extrabudgetary support

The Working Group concluded that many food safety programmes are unable to provide adequate food safety services for their countries or areas because of inadequate funding. The Working Group, therefore, recommended that:

-13/14Recommendation 18 WHO and Member States should intensify their efforts in seeking extrabudgetary support for regional and national food safety programmes in the Region.

7.17

Further Working Group meetings

The Working Group agreed that this meeting afforded members with valuable opportunity to exchange views and experiences on food safety matters of national, regional and international significance. In recognizing the need to periodically review the course of national and regional food safety programmes, the Working Group recommended that: Recommendation 19 WHO should convene within five years a subsequent Working Group to review progress in implementing food safety activities and to formulate further recommendations to address critical food safety problems of concern to countries or areas of the Region. 8.

CONCLUDING SESSION

The Chairman, in concluding the meeting, thanked the members for their contributions, which had resulted in a clearer understanding by all of the problems of food safety in the Region. Mr S. Unakul, Director of PEPAS, thanked the Working Group members for their cooperation and active participation. The problems identified together with the findings and recommendations would provide valuable guidance to WHO and PEPAS in the formulation of food safety activities in the Region. He urged the members to continue to share their experiences among the countries and areas within the Western Pacific Region. He also encouraged them to make use of the services and facilities provided by PEPAS in the food safety area. Implementation of the recommendations made during the Working Group meeting would require follow-up action, and he hoped that members would initiate such action with the appropriate authorities in their country or area. He wished the participants a pleasant and safe journey home and declared the Working Group meeting formally closed. The Chairman, on behalf of the participants, expressed his thanks to the World Health Organization and the staff of PEPAS for the organization of a most successful meeting from which he was sure all participants had benefited. The Working Group also wished to express its thanks and appreciation to: (a) (b) the authorities of the UniverSity of Agriculture, Malaysia (Universiti Pertanian Malaysia, UPM) for their assistance and cooperation; and the Food Technology Division, Malaysian Agricultural Research and Development Institute (MARDI), for organizing the field visit to their facilities, and for their report on the status of ongoing activities in the area of food safety and quality control.

-15-

,.. LIST OF MEMBERS, OBSERVERS AND SECRETARIAT Country/area Australia Members Dr Gordon De Cean Director Food Administration Section Commonwealth Department of Community Services and Health Canberra P.O. Box 100 Woden, A.C.T. 2606

ANNEX 1

China

Fiji

Dr Chen Junshi Associate Professor Deputy Director Institute of Nutrition and Food Hygiene Chinese Academy of Preventive Medicine 29 Nan-Wei Road Beijing

Dr (Mrs) Chen Yao Jun Associate Professor Head of the Research Management Office Institute of Food Safety Control and Inspection Ministry of Public Health 29 Nan-Wei Road Beijing Mr Uraia N. Lesu Senior Health Inspector, Food Control Ministry of Health Suva Dr Leticia V. Espaldon Director Department of Public Health and Social Services Government of Guam P.O. Box 2816 Agana Dr R.A. Perry Hygiene Adviser Hygiene Division, Municipal Services Branch Government Secretariat 10th Floor, Harbour Centre 25 Harbour Road Wanchai

Guam

Hong Kong

-16Country/area Japan Members Dr Y. Saito Director, Division of Foods National Institute of Hygienic Sciences 1-18 Kamiyoga 1-Chome Setagaya-ku Tokyo 158 Dr (Mrs) Harrison Aziz Assistant Director of Health Food Quality Control Unit Ministry of Health Government Offices Complex Jalan Dungun Damansara Heights Kuala Lumpur Dr J.N. Soosaipillai Director Health Department City Hall P.O. Box 11022 50732 Kuala Lumpur New Zealand Mr Phil Busby Principal Health Protection Officer Department of Health P.O. Box 5013 Wellington ~,

,..,

Malaysia

Papua New Guinea

Mr Igo Sere Senior Health Inspector (Food and Quarantine) Department of Health P.O. Box 3991 Boroko Mrs Catalina C. Sanchez Director Bureau of Food and Drugs Department of Health Manila Mr Sesela Siimoa Health Inspector Department of Health Private Bag Apia Mr Chia Hong Kuan Head Food Control Department Ministry of the Environment Environment Building 40 Scotts Road Singapore 0922

Philippines

Samoa

Republic of Singapore

-17-

Country/area Socialist Republic of Viet Nam

Members Dr Nguyen Hoang Thao Chief Hygiene Microbiological Laboratory National Insitute of Nutrition 48 Tang Bat Ho Str. Hanoi

Observers Mr R. Dawson* . Senior Officer Food Quality and Consumer Protection Group Food Policy and Nutrition Division Food and Agriculture Organization of the United Nations Via della Terme di Caracalla 00100 Rome Italy Mrs Tengku Hanidza binti Tengku Ismail Lecturer Environmental Health Department of Environmental Sciences Faculty of Science and Environmental Studies University of Agriculture, Malaysia 43400 Serdang, Selangor Malaysia Dr Abu Bakar bin Hussin Research Officer Malaysian Agricultural Research and Development Institute (MARDI) P.O. Box 12301 50774 Kuala Lumpur Malaysia Observers

Dr Gulam Rasul Head Department of Food Science Faculty of Food Science and Biotechnology University of Agriculture, Malaysia 43400 Serdang, Selangor Malaysia

*Invited but unable to attend.

-18-

Secretariat Mr Dr Mr Mr Dr Dr Dr Dr Mr Ms S. Unakul F.K. Kaferstein R.F. Davies C.J. Nathan G.G. Moy K.W. Bentley P. Guo H. Ogawa S.P. Sardana Tan Yit May Director, PEPAS Manager, Food Safety Unit, WHO, Geneva Scientist, Food Safety Unit, WHO, Geneva Technical Officer, (SMA/CWS/001), Apia Food Safety Adviser, PEPAS Chemical Safety Adviser, PEPAS Water Quality Management Adviser, PEPAS Environmental Systems Engineer, PEPAS Administrative Officer, PEPAS Special Assistant, PEPAS

-19ANNEX 2

INAUGURAL ADDRESSES

INTRODUCTORY REMARKS BY THE DIRECTOR, PEPAS

The present Regional Working Group on Food Safety consists of fifteen members and a number of observers from thirteen countries or areas of the Region. The convening of this Working Group was recommended in the report of the earlier WHO Western Pacific Region Working Group on Food Hygiene and Food Safety, which was held in Kuala Lumpur in October 1979. This meeting is particularly timely in view of the growing awareness over recent years of the magnitude of the health and economic problems associated with contaminated food. The terms of reference of this second Regional Working Group are:

(a) (b) (c)

to review the status of national food safety programmes in the light of recommendations of the previous Working Group; to develop approaches for the rationalization of food inspection systems and promotion of food safety education; to recommend the programme scope and gUiding principles for implementation of food safety information sharing within the Region; and to recommend specific activities to be undertaken by WHO at regional and national levels in promoting, developing, strengthening and evaluating food safety programme.

(d)

The WHO Secretariat looks forward torece1v1ng your guidance on these and other food safety issues of particular relevance to the Western Pacific Region. If there is anything we can do for you to make your brief stay with us fruitful and enjoyable, please do not hesitate to let us know. Thank you. B. OPENING ADDRESS BY THE WHO REGIONAL DIRECTOR*

On behalf of Dr H. Nakajima, Regional Director of the WHO Regional Office for the Western Pacific Region, I have pleasure in welcoming you to PEPAS to attend this Working Group on Food Safety, and to share with you some of the Regional Director's thoughts on the food safety situation in the Region.

*Address was delivered by Dr L.R. Verstuyft, WHO Representative for Malaysia, Singapore and Brunei Darussalam

-20-

Food safety is one of those important public health areas that seem to remain in the background until SOme emergency or crisis abruptly brings them to public attention. While the most serious cases of contaminated food frequently appear in the headlines of our newspapers, the real problems of food safety are less well known, but are much more pervasive. Most incidents of food borne disease are either huried in unintelligible statistics under Itgastroenteritis" or, as is corrunonly the case, not

...

reported at all. Only recently have the scope and cost of food borne diseases become fully appreciated. In its report, the Joint FAO/WHO Expert Committee on Food Safety held in 1983 states, "illness due to contaminated food is perhaps the most widespread health problem in the contemporary world and an important cause of reduced economic productivity". I believe this alarming statement is true for this Region and requires us to take immediate action at all levels to counter the threat posed by contamination entering our food supply. Almost ten years ago, the International Conference on Primary Health Care held at Alma-Ata, USSR, defined the essential elements of primary health care. One of these is the promotion of food supply and proper nutrition. An adequate, balanced diet is essential if people are to live socially and economically productive lives. But it is equally important that this food does not give rise to food borne diseases. Chief among these are the diseases caused by microorganisms which can be prevented to a great extent simply by improving sanitary conditions and personal hygiene. It was therefore ullfortunate that food safety was not integrated into primary health care initiatives from the start since clearly, the promotion of proper food handling by people also tends to contribute to higher levels of sanitation throughout society and thereby reduces the incidence of other diseases as well. Indeed, awareness of food safety by the general public should be considered by the Working Group as its greatest challenge - one that ultimately holds far reaching health benefits for the whole of society. On the other hand, far more sophisticated approaches are required to monitor and control health hazards posed by chemical contamination of food. Most countries in the Region, especially those that are rapidly industrializing, have an urgent need to strengthen their informational and laboratory capabilities to deal with these types of problems. Even in the most developed countries, chemical contamination posed by pesticide residues and aflatoxins may present serious health risks. The importation of food contaminated by chemicals is of concern to all countries in the Region. In the aftermath of Chernobyl, we have learned to aprt<'c l"te the extent of international trade in food and the potential for ".'1t i~fla).,,_g';:.oblems to become regional or even global problems. One lesson '-", •• t,l'. "iil!rn'Q,byl incident is that better communication among food control '1ut orlt hR' . , 'b' "1'" l~~ '. I' rt _t e eg10n 1S necessary not only to deal w1th emergencies ut a so cO cC>;';r' J. t t· t · · t· h' h· 1 . " . \,'J nIna e more rou l.ne ac l.V1 l.es W:I.e 1nvo ve common ~~t~r~~ts, &tHEg ,ir.cess to accurate, unbiased information is essential for tAil Ilf9W~f fiHiEl ioning of national food safety programmes, the issue of ~~~~MlI~Rtfig " r~g1onal information sharing network is perhaps the one of dll' mo .. t lmportant areas for possible WHO cooperation to be discussed by tfl(" Working Group. I want to thank.you in advance for your efforts to gUide us in this important work. I w1sh you every success in your meeting and look forward to your valuable contributions and recommendations.

...

-21-

C. WELC(}IE FACULTY OF SCIENCE UNIVERSITY OF (UNIVERSITI

ADDRESS BY THE DEAN, AND ENVIRONMENTAL S'lUDIES, AGRICUL'IURE, MALAYSIA PERTANIAN MALAYSIA)

I am honoure~ in having been invited to be with all of you this morning for the opening ceremony of this meeting of the Regional Working Group on Food Safety. Such a meeting as this one is commendable, particularly when it is possible to bring together expertise from different countries and areas for a good common cause. I am sure this will be beneficial to governments, private sectors and citizens alike.

On behalf of Universiti Pertanian Malaysia, I take this opportunity to welcome you to our campus in Serdang and I hope that your visit will prove to be both rewarding and pleasant. Malaysia is among the many developing countries which are trying hard to overcome problems of malnutrition," especially in the rural areaa, and problems of unsafe food for consumption in both rural and urban areas alike. Only a few weeks sgo, the issue of high levels of pesticides in vegetables received prominent attention on our newsmedia - an episode which caused surveillance procedures to be tightened and upgrsded and which also showed that farmers were either ignorant of, or complacent to, the dangers of overapplication of pesticides. Examination of past official medical records also showed that large numbers of diarrhoea, cholera, food poisoning and typhoid cases, among others, occur each year because of unsafe food due to contamination from pesticides, chemicals, bacteria and parasites, and due to socio-cultural factors. Thus, food safety is an important topiC for us - indeed for all countries - because of its health, social and economic implications. Unfortunately, food safety is not given adequate priority in many national programmes. This meeting is thus timely • and of great interest to us. We hope that it will act as a catalyst to recommend specific activities and actions which can be undertaken by the authorities in promoting, developing, strengthening and evaluating food safety programmes. I do not wish to deliberate long "on matters of which you are all specialists. However, I wish to highlight the need for close interdisciplinary cooperative research in our efforts to reduce food safety problems. Let me cite a common example: Many people in the rural areas grow, process and consume their own foods, sometimes selling their surplus produce. As these foods do not move in trade, they are normally not subject to any form of control through the official food control system. The ssfety of such food depends solely on the people themselves. Similarly, in the marketplace, verbal bargaining for food items is normally accompanied by tasting and/or touching of food items by the consumer. It is common for a housewife to lift up or poke a piece of meat to assess both its quality and weight before making an offer of purchase to the butcher. Thus, various cultural aspects of human behaviour, for example in food handling, preparation and eating habits, have a great influence on the safety of food. Thus, the food scientist responsible for food safety will benefit from his colleague who is a specialist in the behavioural sciences in their effort to develop a pragmatic food control system.

-22-

The statement of the specific objectives of this meeting read in part, "the revision of national food safety programmes, development of approaches in food inspection systems, implementation of food safety information sharing systems", and many more. Let me conclude by saying that, by and large, there is a need to dwell seriously on the need to have an effective food inspection system and workforce. Rules and regulations alone are not enough to tackle the problem. The personnel involved must be strongly motivated to carry out their duties effectively. Lastly, I would like to wish you all success in your deliberations. Thank you.

-23ANNEX 3

PROVISIONAL AGENDA

Monday, 17 August 1987 0900 - 0945 Inaugural session - Introductory remarks by Mr Somnuek Unakul, Director, PEPAS - Opening address by Dr L.R. Verstuyft, WHO Representative for Malaysia, Singapore and Brunei Darussalam, on behalf of Dr H. Nakajima, Regional Director, WHO Regional Office for the Western Pacific Region - Welcome address by Prof Dr Haji Badri bin Muhammad, Dean, Faculty of Science and Environmental Studies, Universiti Pertanian Malaysia; - Introduction of participants by Dr Gerald Moy, Food Safety Adviser, PEPAS Election of officers Group photograph Break Administrative briefing - Mr S.P. Sardana, Administrative Officer, PEPAS

Agenda Item No. 1

0945 - 1000 1000 - 1015 1015 - 1030 1030 - 1045 1045 - 1100 1100 1120

Adoption of provisional agenda WHO's Food Safety Programme - An overview - Dr F.K. Kaferstein, Manager, Food Safety Unit, WHO, Geneva An overview of WHO food safety activities in the Western Pacific Region - Dr G. Moy, Food Safety Adviser, PEPAS International cooperation in food safety - Dr F.K. Kaferstein, Manager, Food Safety Unit, WHO Geneva Lunch Role of food safety in health and development - Mr R.F. Davies, Scientist, Food Safety Unit, WHO, Geneva Country reports Australia (CR-001) - China (CR-002)

4 5

1120 - 1140

1140 - 1200

1200

1330

1330 - 1415

1415 - 1515

-24Agenda Item No. 1515 - 1530 1530 - 1700 Break Country reports - Fiji (CR-003) - Guam (CR-004) - Hong Kong (CR-005) 9 (contd)

Tuesday, 18 August 1987: 0900 - 1030 Country reports - Japan (CR-006) - Malaysia (CR-007) - New Zealand (CR-008) Break Strategies for the prevention and control of food borne diseases by improvement of food safety - Mr R.F. Davies, Scientist, Food Safety, WHO, Geneva Public awareness and health education in the promotion of food safety - Dr R.A. Perry, Hygiene Adviser, Medical and Health Department, Hong Kong WHO consultation on health education in food safety, Geneva, 27 April - 1 May 1987 (summary of conclusions and recommendations) - Dr F.K. Kaferstein, Manager, Food Safety Unit, WHO, Geneva 1200 - 1330 1330 - 1415 Lunch Monitoring and evaluation of national food safety programmes - Mr R.F. Davies, Scientist, Food Safety Unit, WHO, Geneva Country reports - Papua New Guinea (CR-009) - Philippines (CR-OI0) Break Country reports - Samoa (CR-Ol1) - Singapore (CR-012) - Viet Nam (CR-013) 9 (contd) 12 10 9 (contd)

1030 - 1045 1045 - 1115

1115 - 1200

1415 - 1515 1515 - 1530 1530 - 1700

9 (contd)

Wednesday, 19 August 19B7: 0900 - 0945 Rationalizing food inspection systems - the New Zealand experience - Mr Phil Busby, Principal Health Protection Officer, Department of Health, New Zealand 13

-25-

0945 - 1030 Food irradiation - Dr F. K. Kaferstein, Manager, Food Safety Unit, WHO, Geneva Break Regional food safety information sharing - Dr H. Ogawa, Environmental Systems Engineer, PEPAS Joint FAO/WHO Food Contamination Monitoring Programme - Dr F.K. Kaferstein, Manager, Food Safety Unit, WHO, Geneva Lunch Radionuclide contamination of foods - Dr K. Bentley, Chemical Safety Adviser, PEPAS Codex Alimentarius Commission - Dr F.K. Kaferstein, Manager, Food Safety Unit, WHO, Geneva Break 1030 - 1045 1045 - 1130

Agenda Item No. 14

1130 - 1200

1200 - 1330 1330 - 1400

1400 - 1515

1515 - 1530 1530 - 1630

WHO Medium-Term Programmes on Food Safety (1990-1995) - Global - Dr F.K. Kaferstein, Manager, Food Safety Unit, WHO, Geneva; and - Regional - Dr G. Moy, Food Safety Adviser, PEPAS Review of topics for group discussions

1630 - 1700

Thursday, 20 August 1987:

0900 - 1200

Group discussions: Group I: - Strategies for further development to assure food safety, including: - rationalization of food inspection systems - food safety information sharidg Group II: - Advocacy and support - Awareness promotion - Public information and education 20(b) 20(a)

-26Agenda Item No. Group III: - Monitoring and evaluation of programmes to ensure food safety - Development of indicators 1200 - 1330 1330 - 1515 1515 - 1530 1530 - 1700 Lunch Draft reports of group discussions Break Presentation and discussion of group reports and formulation of recommendations 21 20(c)

.... ,

....

Friday, 21 August 1987: 0900 - 1030 1030 - 1045 1045 - 1200 1200 - 1330 1330 - 1515 1515 - 1530 1530 - 1630 Field visit to 11alaysian Agricultural Research and Development Institute (MARDI) Break Final discussions and review of draft report Lunch Adoption of recommendations Break Closing remarks 23 22

....

-27ANNEX 4 LIST OF WORKING PAPERS. BACKGROUND DOCUMENTS. AND ADDITIONAL REFERENCE MATERIALS List of working papers Agenda Item No. Title of paper WHO Food Safety Programme - an overview An overview of the WHO food safety activities in the Western Pacific Region International cooperation in food safety Role of food safety in health and development Country reports: Australia China Fiji Guam Hong Kong Japan Malaysia New Zealand Papua New Guinea Philippines Samoa Singapore V:'.et Nam 10 Strateg~es tcr ~he prevention and control of food borne diseases by improvement of food safety

Paper no. WP-001 WP-002 WP-003 WP-004

5 6 7

....

CR-001 CR-002 CR-003 CR-004 CR-005 CR-006 CR-007 CR-008 CR-009 CR-OlO CR-Oll CR-012 CR-013 WP-005

...

Public awareness and health education in the promotion of food safety WHO consultation on health education in food safety. Geneva. 27 April - 1 May 1987 (summary of conclusions and recommendations) Monitoring and evaluation of national food safety programmes Rationalizing food inspection systems - the New Zealand experience Role of food irradiation in food safety Safety and wholesomeness of irradiated food

WP-OOb WP-007

12 13

WP-008 WP-009 WP-OlO WP-Oll

...

14 14

-28Agenda Item No. 15 16 17 18 19 Title of paper Regional food safety information sharing Joint FAO/WHO Food Contamination Monitoring Programme Radionuclide contamination of foods Codex Alimentarius Commission WHO Medium-Term Programmes on Food Safety (1990-1995 ) Global Regional List of background documents Agenda Item No. 6 6

Paper no. WP-012 WP-013 WP-014 WP-015

WP-016 WP-017

Seventh General Programme of Work covering the period 1984-1989. WHO Western Pacific Regional Medium-Term Programme (1984-1989); Sub-programme 11.4 - Food Safety. Food safety services in the WHO Western PacifiC Region, (in press). The role of food safety in health and development. WHO Technical Report Series No. 705, 1984. WHO Feature No.109 - Food safety and health education, June 1987. Guiding principles on evaluation of programmes to ensure food safety. (Provisional edition) Doc. No. WHO/EHE/FOS/86.1 Use of irradiation to ensure hygienic quality of food. Report of Task Force Meeting, Vienna, July 1986. Doc. No. WHO/EHE/FOS/87.2. Wholesomeness of irradiated food. WHO Technical Report Series No. 659, 1980.

8 11

-29/30-

Additional reference materials Final Report WHO Western Pacific Regional Working Group on Food Hygiene and Food Safety, Kuala Lumpur, Malaysia, 1-5 October 1979 Doc. No. (WP) DDR/ICP/ERE/001-E. Food Safety, A World-wide Problem. WHO, Geneva 1985. Food Safety. In point of fact, No. 28,

World Health Magazine, March 1987.

Food Safety - An International Source List of Audio Visual Materials. Doc. WHO/ERE/FOS/87.1. Food Irradiation. In point of fact, No. 40, WHO, Geneva, 1987.

List of Documents and Publications on Food Safety and Control. Doc. WHO/EHE/FOS/8616/Rev.2, 1987. WHO Publications - Listing of New Books and Standard Reference Works on Food Safety, 1987.

-31ANNEX 5

SUMMARIES OF COUNTRY REPORTS 1.

Australia

Because no formal coordinated food safety programme exists at the national level, state health authorities are responsible to ensure a safe food supply. Food laws and their enforcement are the responsibilities of each of the eight Australian states and territories. Because there is no Federal food legislation for the whole country, uniformity among these independent laws ia easential to promote interstate trade. All states have been involved in prolonged consultative processes, primarily through the food committees of the National Health and Medical Research Council (NHMRC). At the request of the Australian Health Ministers Conference, all states, excepting New South Wales, have adopted the Model Food Act. New South Wales has amended its Pure Food Act to conform to the main features of the Model Food Act. Uniformity of food regulations has been functionally achieved by the developments of the NHMRC's Food Standards Code. A major advance has been the recent agreement by all states and territories to adopt the NHMRC Food Standards Code for implementation later this year. On the other hand, states have yet to agree to model food hygiene regulations, which have been considered for several years within the framework of the NHMRC system. Salmonella, Campylobacter and Shigella infections are the only notifiable food borne diseases. While physicians are required to advise state health authorities, reporting is incomplete. State health authorities investigate reported cases to determine origin of infection. They also have the power to enforce medical examination of food handlers and the inspection of premises and products. The NHMRC has funded the establishment of a National Salmonella Surveillance Scheme which will greatly facilitate epidemiological studies. Formal surveillance systems include the NHMRC Market Basket Survey of Noxious Substances in Foods, focusing on toxic substances, including pesticides, heavy metals and aflatoxins. Results are also provided to the Joint FAO/WHO Food Contamination Monitoring Programme. The National Residue Survey conducted by the Department of Primary Industry tests cereals, dairy products, honey, eggs, fruits and vegetables for residues of pestiCides, fumigants, antibiotics, growth hormones and heavy metals. The NHMRC Survey of the Microbiological Status of Foods provides microbiological data on foods. Concerning training in food safety, there is now a trend to upgrade the requirements for food inspectors to the bacherlor's degree level. There has been an increasing number of courses available for food processors and handlers, as well as greater availability of educational material for consumers, especially in foreign languages.

....

One priority area requiring attention is the need for a nationally coordinated inspection service for imported foods at the point of entry • Increased resources are also needed by state and territorial food inspection services for surveillance. Improved coordination is needed to

-32secure uniformity of interpretation of regulations. Improved reporting of food borne diseases is required to facilitate accurate assessment of their incidence and prevalence. Coordinated and comprehensive public education programmes, including those for food processors, food handlers and the consumer, are also required. 2. China

The current food safety law in China was adoped in 1982 and includes provisions for basic hygienic requirements as well as promulgation of food regulations. Up to the end of 1986, China had established 761 regulations or "standards" covering the composition and specifications of certain foods (91), food additives (54), flavouring agents (496), food containers, packaging materials and equipment (17), and laboratory methodology for microbiological (28) and physical and chemical analysis of food (74). In addition, another 34 regulations were promulgated in broad areas of concern, e.g., Provisional Regulation for the Safety Control of Imported Foods (1980) and Regulation for the Safety Control of Reconstituted Milk (1983). A proposal to amend the law is awaiting approval by the Government. Food safety in China is the primary responsibility of the Ministry of Public Health. Other ministries, such as the Ministries of Light Industry, Commerce, Foreign Trade, and Agriculture, maintain a self-management system, but are periodically inspected by health officers. At the national level, the Institute of Food Safety Control and Inspection within the Chinese Academy of Preventive Medicine provides overall guidance, conducts research and provides training in advanced food safety techniques. At the provincial, prefecture and county levels, Epidemic Prevention Stations or, where they exist, counterpart Institutes of Food Safety Control and Inspection are responsible for implementing the law and regulations. About 13,000 professionals are engaged at these levels in various aspects of food safety control and inspection. Most of the 26,000 food safety officers in China carry out education and inspectiona1 work at the district and village levels. Laboratory support varies markedly with the level of the institution. At the county level, only basic microbiological and simple chemical analyses can be performed. At the provincial level, some instrumentation is available with the better equipped laboratories being in the bigger cities, such as Beijing, Tianjin, Shanghai, Guangzhou and Shenyang. More than 20 food safety control and inspection agencies and medical colleges in different parts of China have participated in collecting data under the Joint FAO/WHO Food Contaminated Monitoring Programme. Portable kits for rapid field testing of over 50 chemicals have been developed which can detect a variety of toxic agents and commonly used adulterants. In addition to annual physical examinations, including chest X-rays, food handlers are required to attend training courses and to pass examinations to assure that such personnel are familiar with the laws and regulations and proper methods for handling food. Managers of food establishments are also required to successfully complete at least one course in food safety each year. Since 1983, the Ministry of Public Health has conducted about 110,000 training courses for some 7,000,000 people in food safety.

.....

.....,

-.,

-33-

In 1981, the Ministry of Public Health promulgated a special regulation which requires the reporting and investigation of all food borne diseases and intoxications. Provincial reports of outbreaks involving more than 300 people or more than 5 deaths or serious illnesses must be submitted to the Ministry of Public Health every quarter. One of the major constraints in implementing food safety regulations is the shortage of qualified food safety officers. Most officers have received only high school or technical school training. Another difficulty is the need to strengthen laboratory services. Equipment and staff training are currently inadequate. A nationwide quality assurance programme is also needed to validate the results of laboratories scattered throughout the country. Another difficulty is posed by the proliferation of free markets and itinerant street vendors, especially in regard-to assuring that food is wholesome and presented honestly. 3. Fiji

The current Pure Food Act and its regulations, while quite outdated in its particulars, does contain general provisions for the safety and quality of food (including raw materials) during its preparation, packaging, storage and distribution. The law establishes a Central Board of Health made up of a Chairman (the Permanent Secretary for Health), a Secretary (the Chief Health Inspector) and 6 members from government departments and health professions. The Central Board of Health oversees all the public health activities of local authorities, including matters of food safety. New food regulations have been developed in consultation with industry and other interested parties and are in the process of enactment. Food control activities are carried out primarily by officers of local authorities, e.g., city and town councils and rural authorities, who are appointed by the Central Board of Health as Pure Food Inspectors or Food Control Officers. Only such officers may take food samples, inspect foods and require compliance with food standards regulations. Physical improvements and compliance of the food premise is the responsibility of the local authority. Food Control Officers individually organize their programme of inspection within their district under the supervision of their divisional heads. Officers have to perform other public health functions in addition to food safety activities. The bulk of surveillance and inspection is carried out in Suva and Lautoka which are the main ports of entry, as well as the sites of most of the local food factories and warehouses. Training of Food Control Officers is part of the Health Inspectors course curriculum which will be upgraded in 1988 to a Diploma in Environmental Health. Microbiological laboratory services are provided by the main hospital of the Ministry of Health. Chemical analyses are performed by the research laboratory of the Ministry of Primary Industry. In addition, local industry is encouraged to establish their own laboratories or to contract outside laboratory services to monitor product quality.

-34.... I

Dissemination of food safety information is carried out by local authorities in cooperation with the Ministry of Health •. Other .. organizations which may assist in education p~o~rammes ~nclude ~h~ F1Ji Consumers Council, the National Food and Nutr1t10n Comm1ttee, M1n1stry of Primary Industry and the Ministry of Education. Reporting and investigation of food borne diseases is conducted by Health Inspectors or Medical Officers, but most cases are not reported. Generally, those cases that are reported fall into the following categories: (a) (b) (c) (d) patients admitted to hospitals; large outbreaks involving many people; fish poisoning; and foodborne intoxication involving suspected cooked food or canned food, particularly canned fish.

....

"'"

While the food safety programme in Fiji is facing constraints of human and financial resources, the lack of adequate laboratory services is the major difficulty. 4. Guam

The principal responsibility for food safety and control lies with the Division of Environmental Health within the Department of Public Health and Social Services (DPHSS). A 1956 law established the DPHSS with the authority to establish necessary regulations to assure a safe, wholesome and fairly presented food supply. The law is modelled on the United States Federal Food, Drug and Cosmetic Act. The Division of Environmental Health, staffed with environmental health specialists and technicians, is responsible for providing training for people employed in food-related occupations, as well as for training its own enforcement personnel. The division's food hygiene programme concentrates mainly on regulations relating to eating and drinking establishments and retail food establishments. Periodically, inspectors from the U.S. Food and Drug Administration (USFDA) will provide technical cooperation in such areas as milk processing. In addition, the Guam Department of Agriculture regulates importation of agricultural commodities. The U.S. Department of Agriculture (USDA) has a full-time representative assigned to Guam to inspect meat and poultry imports, meat wholesalers/distributors and meat product manufacturers. Surveillance of imported food focuses mainly on commodity labelling and shellfish. Because of a high incidence of food borne diseases related to shellfish, Guam has limited the importation of shellfish to only those countries which are participants in the U.S. National Shellfish Sanitation Programme.

, -35-

There is no food contamination monitoring programme within DPHSS because of the lack of personnel and facilities to conduct analytical services. If required, samples may be sent to the USFDA for analysis. Facilities for microbiological analysis are, however, available at the Guam Public Health Laboratory. Food safety inspection and enforcement programmes, as well as training of food handlers, are conducted by 14 environmental health specialists and technicians of the Division of Environmental Health. The former are degree holders, while the latter have high school diplomas. Under Public Law (1956), food handlers, depending on their occupations and the type of food, are required to have health certificates issued by the DPHSS. The requirements for health certificates vary but may include a physical examination, a written and oral examination, and completion of training courses deemed necessary by the Director of DPHSS to prevent the spread of communicable diseases. Operators of food establishements must not permit any person having a communicable disease to work, lodge or remain in the food establishment. Physicians and medical institutions are required to report all known cases of food poisoning to the DPHSS. The territorial epidemiologist for the DPHSS has general responsibility for the investigation of epidemics, including foodborne disease outbreaks, occurring in Guam. All morbidity reports are channelled through his office. National food borne disease statistics are compiled yearly. Currently, Salmonella, Shigella and Vibrio parahaemo1yticus are the most commonly isolated organisms in Guam but it is suspected that only a small portion of salmonellosis cases are related to food. In spite of the level of development achieved in Guam, diarrhoeal diseases remain a problem. Practices in the home need further investigation and education programmes are too often limited to reacting to crisis situations. Training of food safety officers, especially environmental health technicians, is needed as well as training for managers of food establishments. 5. Hong Kong

•

As the food control authority, the Municipal Services Branch operates through its Hygiene Division. The executive arm of the Hygiene Division is the Food Section which implements the Food Safety Surveillance Programmes through its Food Surveillance Offices and Food (Import/Export) Offices. The Agriculture and Fisheries Department, which advises on all agricultural and veterinary matters, regulates the importation and quarantine of live animals and poultry for food and ensures the safe use of pesticides in agriculture. Hong Kong has an effective body of food laws comparable with those of larger advanced countries. These laws have been updated over the years to reflect international developments. Since 1979, important enactments include:

-36-

the Harmful Substances in Food Regulations (1983) which restrict the levels of aflatoxin and erucic acid, and prohibit the presence of certain harmful synthetic hormones in food; the Food and Drugs (Composition and Labelling) (Amendment) Regulations (1985) which impose detailed requirements for the marking and labelling of prepackaged foods; and the Public Health and Municipal Services (Amendment) Ordinance (1987) which expands the definition of 'food' to include bottled water. Health inspectors are required to undergo a two-year training course and examination leading to the Diploma in Public Health Inspection by the Royal SOCiety for the Promotion of Health (England). The entry requirement for food inspectors is one year of field experience after having obtained the above-mentioned diploma, followed by a six-month training course and examination leading to the Diploma for Inspectors of Meat and Other Foods of the Royal Society. The public health bacteriology laboratories of the Institute of Pathology of the Medical and Health Department provide laboratory services for bacteriological examination of food, while the Government Laboratory carries out chemical analyses. Routine analyses of food samples are carried out for common contaminants and additives on a broad distribution· of foods. A health education unit organizes food hygiene education courses throughout the year for the different sectors of the community, particularly for food handlers and students. An annual food hygiene seminar is held for managers of food establishments. The Medical and Health Department with the assistance and cooperation of the staff of the Urban Services Department, undertakes the investigation of food borne diseases. Since 1974 medical practitioners have been required to report occurrences of dysentery, enteric fever, viral hepatitis and food poisoning. Statistics of foodborne diseases are compiled annually. To ensure the maintenance of effective food safety measures, the Food Control Authority has set priorities for the main areas of actiVities, namely: (8)

to expand the health inspectorate and develop a scientific advisory arm; to up-date food laws in line with international developments; to examine the feasibility of simplifying sampling procedures to better utilize resources; to improve inter-departmental mechanisms so that joint effort can be made in tackling a number of problem areas, notably:

(b) (c) (d)

-37-

(i) (ii)

(iii) (iv) (e) (f) (g)

shellfish hygiene, including red tide outbreaks; import of live poultry and amphibians; control of pesticide residue levels; and quality and transport of raw milk.

to improve surveillance of imported packaging materials; to increase work on consumer education; to examine the feasibility of introducing a systematic general surveillance of the diet; this could help, among other things, with the identification of critical pathways in monitoring for radioactivity; and to plan for future expansion of chemical and microbiological services. Japan

(h)

Both central and local governments are empowered to enact food safety legislation. The legislation presently in force includes the Food Sanitation Law (1947), Slaughter-House Law (1953) and ordinances based on these national laws. The Food Sanitation Law is intended to prevent or minimize all occurrences of disease and intoxication caused by chemical, microbiological and physical agents introduced through the oral route. It includes the regulation of not only all food and drinks but also additives and contaminants, packaging and containers, tableware, and even children's toys which might come into oral contact. Food safety activities are administered at both the central and local government levels. The Environmental Health Bureau of the Ministry of Health and Welfare prepares and enforces regulations, standards, specifications and modifications related to food sanitation; studies food hygiene problems; supervises food safety administration at the local level; and inspects imported foods at 19 ports and airports. The Food Sanitation Division is responsible for the sanitary inspection of food. The Veterinary Sanitation Division is primarily engaged in the inspection of dairy and meat products, while the Food Chemistry Division is primarily concerned with food additives and pesticide residues. The Office of Port Health Administration under the Food Sanitation Division is responsible for the sanitary inspection of imported foods. There are IS food inspection divisions and 4 branches or detached offices of the port quarantine stations. The Food Sanitation Investigation Council, provided for under the Food Sanitation Law, is an advisory committee to the Minister of Health and Welfare and is composed of experts on food sanitation which review food safety problems and cases of food poisoning. At the local government level, health authorities exist at 47 prefectures, 31 cities and about 850 health centres. Each health authority has assigned food sanitation inspectors who inspect establishments which manufacture, process, sell or serve food. Local governments are also

.-38-

respo nsible for ordin ances under the Food Sanit ation Law and f~r the establishm~nt of stand ards for busin ess facil ities , food handl licen sing. Admi nistra tive guida nce is given by the centr al ~ng and for the obser vance of guide lines to promote unifo rmity . Prefe government ctura l gover nment s provi de food sanit ation traini ng cours es for food handl ers. In addit ion, a food sanit ation week is obser ved snnua lly. Adequate management of abatt oir facil ities and slaug hter o~ anima ls is contr olled by the Slaug hter-H ouse Law. Natio nal codes of pract~ce have been estab lished for the handl ing, stora ge, trans port and sale of meat, poult ry, fish and crust acea; safety of food in natio nal and intern ation al trade ; and, food servi ce hygie ne in trave l cater ing. A Shell fish Agreement exist s between the Unite d State s Food and Drug Admi nistra tion and the Japan ese Government on the accep tabili ty of such foods •. Natio nal food conta minat ion monit oring is routin ely perfor 80,00 0 food sampl es comp rising rice, fruit s, veget ables , meat, med. About poult ry, milk, eggs, fish, etc., are analy zed each year. Large food proce ssing plant s maint ain their own labor atorie s to ensur e the safety and quali ty of their produ cts. Other plant s may make use of labor atorie s desig nated by the Minis try of Healt h and Welfa re. At the local level , labor atorie s of healt h centr es and publi c healt h labor atorie s coope rate to perfor m food analy ses with the forme r carry ing out simpl e bacte riolo gical and chemi cal exam inatio ns, and the latte r perfor ming more comp licate d analy ses. Tests on impor ted foods are carrie d out at the Natio nal Insti tute of Hygie nic Scien ces in coope ration with the labor atorie s of the food inspe ction divis ions of the Port Quara ntine Statio n at ports and airpo rts. There are about 80 food sanit ation inspe ctors at the 6700 at the local level . Some 2500 veter inary inspe ctors centr al level and of the local government inspe ct and examine anima ls in 470 publi c and priva Food sanit ation inspe ctors are gradu ates of medic ine, pharm te abatt oirs. scien ce, anima l husba ndry, agric ultur al/fis hery scien ce, or acy, veter inary more than two years exper ience in food sanit ation admi nistranutri tion, with gradu ates of train ing insti tutes for food sanit ation inspe tive work, or ctors autho rized by the Minis try of Healt h and Welfa re. The Food Sanit ation Law requi res notif icatio n of food and intox icatio ns withi n 24 hours of diagn osis. Exten sive borne infec tions outbr eaks must be imme diatel y repor ted to the Minis try of or serio us Healt h and W.lfa re. A natio nal comp ilatio n of food poiso ning stati stics annua lly. When a food poiso ning outbr eak occur s, food sanit is made ation inspe ctors in the healt h centr es initia te epide miolo gical inves tigati ons and take neces sary admi nistra tive measu res. Most cases of food poiso ning in Japan are due to Vibri o parah aemo lyticu s infec tions from raw fish and shell fish and Staph yloco ccus. 7. MalaYSia

_II

The Food Act of 1983 is the basic enabl ing food safet Malay sia. While the Act has not been fully imple mente d, y legis lation in food regul ation s issue d in 1985 speci fy requir emen ts for food addit ives, nutri suppl ement s, packa ging and label ling, pesti cide resid ues and tiona l other topic s.

-39-

The food safety activities in the Federal Territory of Kuala Lumpur are regulated by its own by-laws, which in their main points, are similar to the codes of practice and regulations of the Ministry of Health. Among the most useful of these by-laws is the Hawkers' (Federal Territory) By-Law 1978. The By-Law, which is enforced by the Hawkers Division of the Health Department of City Hall, provides a very useful instrument for controlling food stalls through licensing and inspection. Within the Ministry of Health, the Food Quality Control Unit, which was established in 1974, is responsible for the overall technical supervision of food safety activities; formulation of legislation, codes of practice and gUidelines; policy and strategy development; and coordination, especially through the Main Food and Drugs Committee of the Ministry of Health. At the state level, sampling plans and inspection programmes are formulated in liaison and coordination with local authorities within the state. District level personnel are responsible for the enforcement of food safety requirements and carry out the actual inspectional work. Various guidelines and circulars are issued to food safety officers to ensure effectiveness and uniformity in food safety administration activities. Laboratories under the Ministries of Health and Science as well as branches of the Department of Chemistry provide analytical support for food monitoring and compliance activities. The Atomic Energy Unit is also providing services in monitoring imported food for traces of radionuclide contamination. An excess of 30,000 samples were analyzed in 1986. Medical personnel are required to notify the Ministry of Health (either at the district, state or central levels) in cases of foodborne disease. Most of the reported incidences of food poisoning were due to Staphylococcus or Salmonella. Over the ten-year period ending in 1986, the incidence of food borne diseases and intoxications has risen from 9 to 12 cases per 100,000 population. While better reporting may be responsible for some of the increase, poor food handling practices is still a major factor in the growing occurrence of such diseases. In addition, the prevalence of new pathogens such as Camphylobacter, Vibrio parahaemolyticus, Bacillis subtilis and Listeria monocytogenes has complicated food control strategies. One of the more difficult problems contributing to the incidence of food borne disease is the large number of illegal food operations which occur at all stages of the food trade, including backyard food processing, food establishments and street vendors. In Kuala Lumpur alone, there are an estimated 10,000 operations which generally share the same characteristics - poor sanitation, poor quality or prohibited food ingredients and poor food handling practices. Even among licensed establishments, the knowledge and practice of safe food handling procedures by food handlers points to a need for greater efforts in education and training of such personnel. One difficulty has

-40-

been the rapid growth of small food establishments which complicates the normally high turnover rate of food service personnel. Currently, there are not enough food safety officers to provide adequate frequency of inspection or to conduct necessary training and educational programmes. In addition, Malaysia, like many rapidly industrializing countries in the Region, is faced with an increasing number of food imports which pose special inspectional and analytical problems. Imported high technology also challenges the technical and scientific capabilities of food control agencies. Under a United Nations Development Programme project being implemented by the Food and Agriculture Organization of the United Nations in cooperation with WHO, the Ministry of Health expects to better cope with the increasingly complex and diverse problems associated with assuring safe food. 8. New Zealand

The Department of Health of the Ministry of Agriculture and Fisheries and local authorities are responsible for the control of food for sale. The Department of Health of the Ministry of Health has overall responsibility for the safety of food offered for sale. The relevant basic food laws are the Health Act 1956 and the Food Act 1981. Under the latter Act, the Food Regulations 1984 and the Dietary Supplement Regulations 1985 have been promulgated. Attempts are being made to harmonize New Zealand Food Legislation with those of Australia and Codex Standards. A Food Standards Committee provides technical expertise on matters relating to food legislation. The Food Regulations 1984 contain specific requirements for: labelling, including date marking; maximum permitted levels of food additives, including preservatives; colours and incidental constituents, such as pestiCides, lead and mercury; imported foods; control of food workers; irradiated foods; low acid canned foods; and safety standards for food containers and appliances. Some 218 territorial local authorities have primary responsibility for the inspection and licensing of food premises for the enforcement of the food regulations and education of the public on food safety matters. The Ministry of Agriculture and Fisheries is responsible for supervising processing facilities for meat, poultry, fish and dairy products.

-41-

Adequate laboratory support services are available through the National Health Institute (microbiology) and the Department of Scientific and Industrial Research (chemistry). Animal health analytical services are provided by the Ministry of Agriculture and Fisheries. In addition, registered private laboratories are available for both microbiological and chemical analyses. Foodborne illness outbreaks are notifiable and the Department of Health conducts appropriate epidemiological studies. The Department of Health has established the following food safety priorities: providing information and advice to the Minister of Health, Protection Officers, food industry and the public; providing adequate training to food safety offices in the health districts and area health boards; upgrading of the shellfish sanitation programme to current United States Food and Drug Administration standards; coordinating a total diet survey to ascertain contaminant levels in the New Zealand diet; coordinating routine monitoring of foods by districts and area health boards; coordinating a survey to determine the presence of Listeria in soft cheeses; coordinating surveys of breast milk, vegetables and dairy products for dioxin and organochloride pesticide residues; coordinating a survey on synthetic colours used in foods; coordinating a survey of mercury levels in fish; coordinating surveys of polynuclear aromatic hydrocarbons and polychlorinated biphenyls in food; implementing Codex recommendations; and up-dating legislation and procedures. 9. Papua New Guinea

In Papua New Guinea the food industry is diverse, consisting of roadside and street vendors, foodstalls in markets, fast food bars, grocery stores, supermarkets, dairies, manufacturers of carbonated drinks and ice blocks, meat canneries and small food processing plants. In addition, about 20% of Papua New Guinea imports are food and food products.

-42-

Much ready-to-eat food is prepared in the home and brought to markets or roadside stalls for sale. With increasing wealth and development, such foods are becoming widespread. However, most self-employed food handlers or those employed by the food industry receive little or no training in the safe handling of food. Food legislation, adopted before independence, has not been modified sufficiently to meet the present situation. Consequently, difficulties in interpretation and enforcement have been experienced. A shortage of health inspectors with specific responsibility for food inspection has compounded the ineffectiveness of enforcing the legislation. No statistics on outbreaks of food poisoning are available because there is no reporting system. Similarly, no examinations of imported food at ports of entry are being undertaken because there is no system to notify the National Health Department or Provincial Authorities of the arrival of food consignments, although Food and Quarantine Officers are stationed at the six main seaports (Port Moresby, Lae, Madang, Rabaul, Wewak and Heta) • Development of a widespread and effective food safety programme has encountered the following constraints: (a) (b) (c) (d) (e) (f) (g) insufficient legal basis for food inspection in rural areas; absence of procedures for the medical examination of commercial food handlers; little public awareness of the importance of hygienic handling of food; no laboratory facilities to carry out food analyses; poor coordination with other agenciea. particularly with those involved in food importation: no up-dated food standards and regulations, including those for food additives; and no specific training for food inspectors and analysts.

-, ....,

The objective of the food safety programme is to ensure that all food sold for consumption is wholesome. The strategies to achieve this will involve health education and inspection of all food retail outlets. Because of limited resources, the programme concentrates on education of food handlers on their responsibilities and ways in which they can ensure the wholesomeness of food they prepare and sell. As resources become available a wider programme of registration of established food premises will be introduced. The following targets have been Bet at the national level: (a) by 1987, to have developed guidelines for provincial governments with respect to the handling of food;

-.,

-43-

(b)

by 1988, to have introduced a nationwide provincial reporting system to provide dsts on the incidence of food borne diseases and intoxications; by 1988" to have established national standards for food premises; by 1990, all provinces to have established the position of Provincial Food Inspector; and by 1990, to have an equipped and stsffed food analysis laboratory.

In order to reduce the incidence of sickness ariSing from poor food preparationa, programmes of education of food handlers and managers who are involved in food industries, will be regularly mounted at the provincial level through the planned period. While the programme of food safety education will be carried out by provinces, the Department of Health will provide technical advice and assistance, establish national standards and policies and coordinate the programme. 10. Philippines

The Bureau of Food and Drugs under the Ministry of Health and the National Meat Inspection Colllllission under the Ministry of Agriculture are the two agencies most responsible for ensuring the safety of the country's food supply. Supportive activities are rendered by the Environmentsl Sanitstion Division of the Bureau of Health and Medical Services. The Food, Drug and Cosmetic Act (R.A. 3720) generally provides for the adoption of qeasures to ensure a pure and safe food supply and for the promulgation of food standards. The Bureau of Food and Drugs is the implementing agency. Presidential Decree No. 7 authorizes the National Meat Inspection Colllllission to develop policies and procedures governing livestock, marketing of animal products and animal feed, and meat hygiene inspection. Presidential Decree No. 704 gives the Bureau of Fisheries and Aqustic Resources the administrative responsibility to control fish and other marine products. Presidential Decree No. 930 authorizes the Ministry of Agriculture to exerCise inspection and certification and/or treatment activities on imported and exported plant products, such as fruits, vegetables and spices. Presidential Decree No. 856 (Code on Sanitation) covers the sanitation of food service establishments. All food establishments are required to obtain a licence to operate, which is renewable annually. To monitor the health of food handlers, such persons are required to obtain a health certificate before they are employed.

-44-

The Bureau of Food and Drugs oversees the manufacture and sale of processed foods, where the major concerns are adulteration and mislabelling of food products. It is responsible for the surveillance of imported food products at legal ports of entry. The National Meat Inspection Commission supervises the operations of abattoirs and meat establishments and conducts ante- and post-mortem inspections of meat. Sanitary operation of establishments engaged in the sale and preparation of food in public markets, restaurants and other food premises is the responsibility of the Environmental Sanitation Division. The food control programme of the Bureau is aimed at ameliorating food sanitation conditions through inspection and licensing of food establishments, registration and evaluation of processed food products, laboratory analysis of food samples, investigation of consumer complaints, and voluntary certification of processed foods for export. Training programmes for food handlers are conducted at the national, provinCial and municipal levels. Health education of the public, including the basic concepts of food sanitation and nutrition, has been incorporated into the programme. Food control laboratories at the national level are well-equipped and staffed to carry out necessary analytical procedures. However, regional laboratories have only basic capabilities and frequently require support from the central laboratories. The Bureau of Food and Drugs recently opened its new office and laboratory facility which was completed with cooperation from the Japan International Cooperation Agency. The laboratory is equipped with sophisticated analytical instruments for chemical and microbiological analysis of food and drugs. An animal breeding and testing unit is also part of the facility. The food industry in the Philippines consists largely of small and medium size firms and a few big companies. Many of the smaller companies lack the capital to improve marginsl facilities or to establish adequate quality control programmes. Food safety hazards encountered during processing and storage are aggravated by the high cost of energy and sporadic power failures. Lack of proper storage facilities leads to growth of pathogenic microorganisms and mycotoxin-producing moulds. Pests like rodents and insects affect the quality and safety of raw food and pose hazards for processed foods as well. The adverse effect on public health of these food safety problems are difficult to document from the limited available information. Despite the Health Information Service's established procedures for disease notification, including food borne diseases, lack of sensitive epidemiological surveillance precludes any accurate assessment of the magnitude of foodborne illness. In addition, the little information that is currently gathered from food borne disease" outbreaks is not transmitted to food inspection personnel. Foodborne diseases due to chemical agents are also becoming an increasing cause of concern. Such episodes are particularly insidious because symptoms are much more obscure and detection of the responsible contaminant requires sophisticated analytical procedures which may not be performed during routine analysis of food samples. In this regard,

-45-

... research, especially by universities and institutions, into potential food safety problems can contribute substantially in determining national priorities and in directing food safety resources towards more meaningful and productive areas • Among problems recently identified within the past five years, two episodes of "red tide" have occurred in the Philippines and a number of fatalities were reported in communities where proper precautions were not observed. Recently, bogus alcoholic beverages were implicated in 31 cases of alcohol-related deaths. However, the causative agent has not been identified and further studies are underway to determine the actual cause of death in these cases. Because of the slow economic recovery, the problem of itinerant street vendors has been aggravated. Not only has their numbers increased because of unemployment, but also a sizeable portion of the population has come to depend on such vendors for their daily meals • Overall, there is a great need to promote food safety as part of the primary health care approach. Food safety practices should be incorporated into the educational programmes for families and communities, including basic concepts of personal hygiene, waste disposal and food and water sanitation. Just as inspection and monitoring programmes strive to protect the consumer from health hazards and economic fraud in the marketplace, community health education programmes must be designed to protect·consumers from sanitation problems that are rooted in poverty and ignorance. 11. Samoa

. ... ...

...

... ...

The existing legislation for food safety control is the Food and Drugs Act of 1967. No new food regulations have been formulated since the Act was enacted resulting in difficulties in enforcement. Under the Act, the responsibility for food safety administration in the country is delegated by the Director-General of Health to the Chief of the Division of Public Health who has under his supervision a Chief Health Inspector, two Senior Heath Inspectors, and other Health Inspectors and Assistant Health Inspectors, who, in addition to other public health inspection functions, conduct inspection of food premises. Health Inspectors hold diplomas from the Royal Society of Public Health. Ongoing training of all Assistant Health Inspectors is underway and all inspectional staff receive in-service training, including food safety control. Health education courses for food handlers are organized from time to time to promote an awareness of food safety. Medical practitioners are required to notify the Director-General of Health of cases of food borne disease and intoxication. Notifiable diseases include dysentery, typhoid, diarrhoea and undulant fever. The nationwide reporting system is currently being modified to include "lay" reporting in order to obtain a more accurate account of the incidence of food borne diseases. The major constraints to the food safety programme include lack of trained personnel to conduct regular inspections of all food establishments and to educate food handlers and the public in proper food safety practices. Legislation is also in need of updating.

-4612. Singapore The general administrative responsibility for the implementation of food control lies with the Food Control Department of the Ministry of the Environment, which ensures thst food manufactured imported is wholesome and safe. Importation of fish, meat and animal-der~ved ~roducts is . controlled by the Primary Production Department of the Ministry of Nat~onal Development at the wholesale level or at the processing plant.

The Sale of Food Act (1973) is the basic legislation to ensure the wholesomeness and purity of food. It prohibits the sale of foods which are contaminated or unfit for human consumption and the use of articles which are dangerous or injurious to health. The Food Regulations (1974) enacted under this act contain definitions and standards for various food items, stipulate the permitted food additives and their permissible limits and list the tolerable levels of chemical residues. Generally, food control inspections are conducted at manufacturing facilities, warehouses, and points of sale. Certain imported food items are checked at points of entry. Frequency of inspection is dependent upon the cleanliness standard and the results of previous inspections. The Hazard Analysis Critical Control Point system is being promoted by food safety officers working closely with industry. Licensing and inspection of food premises is carried out to ensure compliance with the Environmental ' Public Health Act and the Environmental Public Health Regulations. Export plant approval based on veterinary public health requirements govern the acceptability of meat imported into Singapore. Control efforts are supported by food sampling and analysis to ensure compliance with the Sale of Food Act and its regulations. The routine monitoring schedule for food samples is based on the potential health risk posed by the food and its safety record. In 1986, about 22,000 samples were taken, of which about 14,500 were for monitoring of radionuclide contaminants in imported food. Where food is found to be unsafe, it is traced to the source, seized and destroyed. Counselling of food manufacturers and food handlers may also be undertaken. In 1986, 1,200 metric tonnes of unsatisfactory food were destroyed. The Training and Education Department of the Ministry of the Environment and the Primary Production Department of the Ministry of National Development periodically hold seminars, talks, film shows, and exhibitions to advise the public on food safety. Pamphlets on personal hygiene and food safety are also distributed to food handlers. Food handlers involved in "high risk" food production and those implicated during epidemiological investigations of typhoid, cholera and bacterial food poisoning incidents are required to undergo medical examinations. About 20 food inspectors are involved in the sampling of food, inspection of food factories and investigation of food complaints. These inspectors have undergone a 36-week full-time course, conducted by the Training and Education Department, in conjunction with the Royal Society of Health, covering various aspects of public health, including food hygiene

--,

~II

,"" -47-

and food legislation. Health inspectors having similar qualifications inspect hawker centres and food service establishments. About 25 veterinary officers and meat inspectors supported by the Veterinary Public H:alth Laboratory are responsible for veterinary inspection and plant v1sits. Food analytical services are carried out by a staff of about 25 chemists, bacteriologists and techniCians. Training courses on general food safety and technology are available. The former is provided by the Training and Education Department of the Ministry of the Environment, while the latter is a diploma course offer.ed by the Singapore Polytechnic. Final year students at the the Singapore Polytechnic either major in food technology or polymedical technology for the Diploma in Chemical Process Technology.

...

The investigations of food borne diseases are carried out by the Quarantine and Epidemiology Department of the Ministry of the Environment. There are two epidemiologists and four public health inspectors for this purpose. Cholera, enteric fever and infectious hepatitis are food borne infections notifiable by law to the Quarantine and Epidemiology Department. Notifications come from various sources, such as government and private hospitals, outpatient clinics and general practitioners. Statistics on foodborne diseases and intoxications are compiled annually. Generally, the food safety programme in Singapore has effectively addressed most problems encountered. 13. Viet Nam

Food safety activities are accorded high importance as part of the country's overall public health strategy. These actiVities aim at minimizing harmful factors affecting food quality at all stages of production, processing, storage, transportation, marketing and handling. Outbreaks and incidents of food borne illness are, in the main, of microbiological origin, and rarely due to chemicals, although pesticide residues are detected in fruits and vegetables. As part of the national nutrition programme, food safety falls under the jurisdiction of the Ministry of Health. The National Institute of Nutrition has responsibility for technical aspects, while the Hygiene and Epidemiological Department has the overall responsibility for the main direction of activities as follows: (a) (b) control of quality and wholesomeness of all food produced and consumed locally; inspection, on a regular baSis, of all enterprises where food is handled; monitoring of the health status of food handlers; implementation of epidemiological investigation of food borne diseases; and training and education in food safety.

...

(e)

-48-

.. While food safety regulations have been revised for consideration by the government, other approaches towards strengthening the food control system include: (a) (b) (c) (d) better coordination between related institutions, such as agriculture, domestic trade, food industry and public health services; improved training of food control technical staff; provision of equipment to facilitate food analysis; and education and information of the public on food safety;

The National Institute of Nutrition together with the Hygiene and Epidemiological Department recently organized a food hygiene workshop. The current status of the programme was reviewed and future activities were planned, including: (a) (b) (c) improving food safety regulations and standards; strengthening existing food control measures, with particular attention to hygienic aspects of foods commonly consumed; and strengthening existing health education programmes including the compulsory education of food handlers both in the public and private sectors.

-49ANNEX 6

SUMMARIES OF WORKING PAPERS 1. Overview of WHO Food Safety Programme

While few precise figures are known due to inadequate or non-existent reporting systems in many countries, WHO estimates that only a small proportion of global food borne disease is currently recognized, and an even smaller fraction reported. In developing countries, the ratio between real and reported cases may be as high as 100:1, while in industrialized countries that ratio is probably no better than 10:1. It is not surprising, therefore, that the impact on health of food borne disease due to contamination of the food supply has not been well recognized by governments. In developing countries, diarrhoeal diseases are of paramount importance. In 1980 it was estimated that more than 1,000 million cases of acute diarrhoea occur annually in children under the age of five in developing countries of Africa, Asia (excluding China) and Latin America, and that about five million of those children die. While there are several avenues of transmission of diarrhoea causing sgents, until recently water had been thought to be the main vehicle involved; however, the scientific community now recognizes thst contaminated food is slso an important source of enteric pathogens and a significant cause of diarrhoea. Hence, it is vital that public health authorities give wider recognition to the negative impact of food borne disease on the health of their people. A Joint FAO/WHO Expert Committee on Food Safety, in its report, "The role of food safety in health and development", drew attention to the fact that the Alma-Ata Declaration only implicitly covered food safety as an essential component Df primary health care. The Expert CDmmittee emphasized that fODd safety and adequate nutrition are basic tD the reduction and preventiDn Df disease and tD the promotiDn Df health. It recDmmended that, "fDDd safety shDuld be cDnsidered an integral part Df the primary health care delivery system" since the access tD safe and whDlesDme fDod is vital fDr health. Based on the views and recDmmendatiDns Df the Expert Committee Dn FDDd Safety, WHO will, in the future, CDncentrate much more Dn the prDmDtiDn Df community participatiDn thrDugh public informatiDn and health educatiDn. For this reason, the Organization is in the prDcess of develDping primary health care strategies for food safety. WHO Headquarters is also involved in a number of food safety activities having broad implications. One of the oldest is the Joint FAO/WHO Food Standards Programme which provides food safety recommendations cDncerning levels of food additives, pesticide residues and other contaminants in food as well as codes of practice, food standards and other guidance documents for governments and the food industry. Through the Codex Alimentarius Commission, these efforts to protect consumers and promote trade have been strengthened by international agreement. More recently, a 'new' class of residues in food - those caused by the application of drugs and other chemicals used in veterinary medicine and

-50-

animal husbandry - has gained prominence and WHO, again jointly with FAD, is furnishing scientific advice and judgements to be used as the basis for recommendations on the safe use of such products. To promote the recognition, evaluation and control of environmental conditions and hazards that may affect human health, WHO participates actively in the health-related monitoring activities of the Global Environmental Monitoring Systems (GEMS). The Joint FAO/WHO Food Contamination Monitoring Programme, initiated in 1976, is one of the major health-related activities of GEMS. As early as 1961, WHO, jointly with IAEA and FAD, has been collaborating with scientists working in the field of food irradiation. In 1986, a Task Force on the Use of Irradiation to Ensure Hygienic Quality of Food concluded that irradiation must be seriously considered in all those countries where certain foods, such as poultry and pork, contaminated with certain pathogenic microorganisms and parasites, like Salmonella, Campylobacter, Toxoplasma and Trichinella, play an important role in the epidemiology of food borne diseases. WHO Headquarters collaborates with the WHO Regional Office for Europe in a surveillance programme for the control of food borne infections and intoxications in Europe. Although this is essentially a programme tailored to the needs and conditions of European countries, it can be seen as a model for other regions of the world where epidemiological studies and, in particular, surveillance of foodborne diseases are overdue. In the area of strengthening national food control activities, WHO again jointly with FAD, has been providing guidance material for developing effective national food control systems and food contamination monitoring programmes. Responsibility for technical cooperation with individual Member States to strengthen their national food control capabilities, to train manpower, etc., lies, as a rule, with the six regional offices of the Organization. The WHO Regional Office for the Western Pacific has a long-standing record in this area and a separate report on their activities in the Region follows. 2. An overview of WHO food safety activities in the Western Pacific Region

The main thrust of WHO cooperation in the Region has been directed towards the basic strengthening of national food safety programmes. For many years, WHO resources available through the WHO regular budget have provided limited, but sustained, support for food safety programme development in Member States. As a measure of this commitment, a Food Safety Adviser has been attached to PEPAS for the past several years. Considerable progress has been made in the review of national policies and strategies and in the revision of existing food safety legislation. Cooperation in the development of food safety policies and programmes was extended to China, Laos, Macao, Papua New Guinea, Philippines, Republic of Korea, the Trust Territory of the Pacific Islands, and Viet Nam. In cooperation with WHO, basic food safety legislation was drafted in Papua

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New Guinea and the Trust Territory of the Pacific Islands. WHO also collaborated in the review of existing food legislation, regulations, and standards in Guam, Macao, Philippines, and Viet Nam. In China, support was provided for a national workshop aimed at evaluating provisional food safety legislation and identifying and resolving potential problems in its enactment. WHO collaborated in the review of food safety contingency plans being formulated by the Republic of Korea in preparation for the Olympic Games to be held in Seoul in 1988. Training programmes for food inspectors have also been given priority with programmes being supported in China, Papua New Guinea, and Viet Nam. Pilot training courses for food handlers were held in Papua New Guines and the Trust Territory of the PaCific Islands with a view to improving food safety practices in the food industry. Additional training programmes were supported in China, Guam, Papua New Guinea, and Viet Nam.

...

A series of national workshops on development of a food inspection manual were supported in China. Collsboration was extended to Papua New Guinea and the Trust Territory of the PaCific Islands in drafting of protocols for inspections. In Malaysia, a food inspectors manual was developed based on new food safety legislation enacted in 1983. In the Philippines, PEPAS collaborated in the preparation of a project proposal to construct and equip a modern food and drug laboratory,'which was recently completed in cooperation with the Government of Japan. In Malaysia, a food analytical manual was developed to standardize analytical methodologies and facilitate training. WHO collaborated in the procurement of limited equipment and supplies to upgrade the capabilities of food safety laboratories in China and several other countries. In Laos, WHO carried out UNDP-funded project to develop health laboratory services, including the establishment of a bacteriological laboratory for diagnosis of diarrhoeal diseases, as well as for testing of selected foods and water.

...

Numerous food control personnel hsve been trained under the WHO Fellowship Programme in cooperation with the world's leading food safety institutions. These personnel included all levels of food control staff who studied in a variety of areas, such as policy and management, compliance procedures, inspection techniques and analytical methodologies. An approach to promoting regional information exchange was undertaken through a regional survey of food safety services in the Region, which was recently issued as a PEPAS document. A planning document has been prepared by PEPAS to establish a regional information eXChange system in the food safety area. In 1986 PEPAS convened a regional workshop on chemical safety to exchange, among other things, information and data on the use and control of chemicals in countries of the Region, including toxicological and exposure assessment procedures of relevance to food. Five countries in the Region - Australia, China, Japan, New Zealand and the Republic of Korea - continue to participate in the ongoing Joint FAO/WHO Food Contamination Monitoring Programme which has provided basic information on potential food safety hazards. Because fish poisoning is a significant health hazard in the Region, particularly in the South Pacific, WHO has for several years supported

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research into cigustoxin. However, research has been hampered by difficulties in collecting sufficient quantities of pure toxin necessary to develop simple, rapid analytical procedures and antitoxins. Other programmes of WHO in the Western Pacific which directly relate to the food safety area include programmes to control diarrhoeal diseases and zoonoses, nutrition, community water supply and sanitation, control of environmental health hazards, parasitic diseases, maternal and child health , health laboratory services, public .information and education for health, health manpower development and pr1mary health care. In spite of the efforts of national governments and WHO, food safety remains a major health problem in both developing and newly industrializing countries in the Region. While the extent and complexity of food safety problems in the Region has grown, the available resources for food safety programmes, for the most part, have declined or remained the same. While many national governments have established the necessary legislative framework for ensuring food safety and have allocated basic resources to formulate national programmes, implementation has not met initial expectations. In view of the continued budgetary constraints, WHO together with Member States will need to evaluate their current activities and consider other sources of possible support.

International cooperation in food safety

WHO international collaborative efforts are. primarily but not exclusively, undertaken with FAO, examples of which are:

3.1

Food standards

Almost 200 international standards have been developed and adopted for individual food commodities. These have been compiled in volumes of the Codex Alimentarius. A number of general standards, as distinct from the commodity standards, have been developed, such as those for the labelling of prepackaged foods and the labelling of food additives when sold as such. These are also published as volumes of the Codex Alimentarius. 3.2 Pesticide residues

-' ""I

The evaluations and recommendations of the Joint FAO/WHO Meetings on Pesticide Residues (JMPR) provide much of the technical basis for the work of the Codex Alimentarius Commission. Maximum limits for pesticide residues in foods, known as "maximum residue limits" (MRLs), are developed for a wide range of chemical compounds in many food commodities. These limits are published as a volume of the Codex Alimentarius. Like the standards. they are submitted to governments for acceptance after adoption by the Commission. 3.3 Food additives and contaminants

The evaluations and recommendations of the Joint FAO/WHO Expert Committee on Food Additives (JECFA) continues to provide much of the technical basis for the work of the Codex Committee on Food Additives.

... -53-

....

Maximum levels for food additives and contaminants appear in many of the standards and have been published separately as a volume of the Codex Alimentarius. This list is not exhaustive and will be supplemented in the light of future work. In addition to maximum levels for food additives and contaminants, the Commission has developed other general principles and gUidelinea in this area, which form part of the same volume. 3.4 Residues of veterinary drugs

The latest Codex general subject committee on residues of veterinary drugs in foods, established in 1985, has just begun its extensive task. A speCial meeting of the JECFA took place in Rome in June 1987 to discuss principles for evaluation and to begin the evaluation of selected residues with hormones having the first priority. 3.5 International Consultative Group on Food Irradiation

....

Sponsored by IAEA, FAO and WHO, the International Consultstive Group on Food Irradiation (ICGFI) came into being in May 1984. ICGFI, through its member countries, has the following functions: (a) to evaluate global developments in the field of food irradiation: to provide a focal point of advice on the application of food . irradiation to Member States and the Organizations; and to furnish information, through the Organizations, to the Joint FAO/IAEA/WHO Expert Committee on the Wholesomeness of Irradiated Food and to the Codex Alimentarius Commission •

....

(b) (c)

....

3.6 Joint FAO/WHO Food Contamination Monitoring Programme Initiated in 1976, the Programme is one of the major health-related activities of Global Environmental Monitoring System (GEMS) supported by

....

UNEP:

(a) (b)

to collect and evaluate data on levels of certain chemicals in individual foods; to obtain estimates of the intake via food of specific chemicals: to provide technical cooperation to the governments of countries wishing to strengthen food contamination programmes; and to provide the relevant committees of the Codex Alimentarius Commission with information on levels of contaminants in connection with the establishment of Codex Standards. Joint FAO/WHO Expert Consultation on Food Protection for Urban Consumers, Rome, 1-5 December 1986

....

3.7

The main issues addressed by the Consultation concerned the lack of infrastructure at the local level needed to provide an adequate and safe food supply in rapidly expanding urbari situations.

.... -54-

.... 3.8 Second FAO/UNEP/WHO International Conference on Mycotoxins In order to provide a sound scientific basis for decision-making in respect of the control of mycotoxins in foods. a second FAO/UNEP/WHO Conference on Mycotoxins is scheduled to be held in Bangkok. Thailand. from 28 September to 3 October 1987. The Conference will concentrate ?n the impact of mycotoxin contamination on trade in foodstuffs in the l1ght of growing health and environmental considerations. 3.9 Publications

....

WHO. frequently in collaboration with FAO. issues publications on food safety and control topics. Jointly prepared by FAO and WHO. the publication "Guidelines for can manufacturers and food canners" has been issued to assist food processors in developing countries to meet the requirements of Codex standards for levels of tin in canned foods. It has been published as FAO Food and Nutrition Paper No. 36. Together with FAO, WHO has developed "Guiding principles for the evaluation of programmes to ensure food safety". These guiding principles are intended to provide Member States with suggested indicators for monitoring the programmes. The gUiding principles have been published as a provisional edition in 1986 to allow the incorporation of comments/ suggestions prior to finalization early in 1988. A bibliography of WHO and joint FAO/WHO publications and documents on food safety and control issued since the 1979 meeting of the Western Pacific Region Working Group on Food Hygiene and Food Safety is given in Appendix A. 3.10 International Programme on Chemical Safety

....

Memoranda of Understanding have been signed with 19 countries which are actively participating in the International Programme on Chemical Safety (IPCS) , a collaborating activity between UNEP, 110 and WHO. There is now a network of 41 IPCS partiCipating institutions in these countries. Development of methodology for risk assessment and other activities related to chemical safety are continuing. Recent publications include principles for evaluating health risks from chemicals during pregnancy and childhood and monographs on subjects such as toxicokinetics and on neurobehavioural toxicology. A collaborative study is in progress on application of shortterm tests for genotoxicity and carcinogenicity assessment. Methods for assessing and testing chemicals in food are also being evaluated. 4. The Role of Food Safety in Health and Development

The above titled report of the Joint FAO/WHO Expert Committee on Food Safety, TRS. No. 705 (1984) focuses on the importance of food safety as an integral part of primary health care. It also draws attention to the enormous health and economic costs of food borne diseases. Issues covered include the nature and extent of the food safety problem; factors affecting the safety of food; and, strategies for the prevention and control of food borne diseases by improvement of food safety. The above report was endorsed by the WHO Executive Board in January 1985.

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Strategies for the prevention and control of food borne diseases by improvement of food safety

Annexed to the report of the Joint FAO/WHO Expert Committee on Food Safety were strategies proposed for consideration by Member States in the planning, implementation and evaluation of a food safety programme for the prevention and control of the food borne diseases of microbiological origin. Strategies propoaed involved the following basic components:

(a) (b)

problem recognition, which includes the application of epidemiological skills; target group identification, which proposes focusing on protection of the most vulnerable population groups, such as preschool children, or possibly, certain socioeconomic levels within both urban and rural populations; and interventions, which outline priority approaches, through direct and indirect means. Public awareness and health education in the promotion of food safety

Dr R.A. Perry elaborated on the health education approaches b~ing undertaken by Hong long to reach all segments of the population and especially mothers and schoolchildren. The paper presented was supplemented with a video presentation of recent food safety promotions. Health education, at its best, could result in improved attitudes and behaviour with far-reaching benefits not only to food safety but also to other public health problems. The recent WHO Consultation on Health Education in Food Safety came to the conclusion that food safety is a worldwide public health and economic problem which is not appreciated at various levels, including consumers. Because the report was in preparation, a summary of conclusions and recommendations was provided to the participants. 7. Monitoring and evaluation of national food safety programmes

The paper emphasized the need for continuous re-examination and evaluation to ensure that activities undertaken are those that bring substantial improvements. Such evaluations should examine issues such as: (a) (b) (c) the relevance of existing food safety policy to essential human needs, i.e., health, social and economic well being; the adequacy of ongoing food control activities; and the relative effectiveness of various interventions.

Only through such a process can programme and activity performance be improved.

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Rationalizing food inspection systems - the New Zealand experience

Mr P. Busby informed the Working Group that, as part of an overall government policy to encourage self-financing, approaches were being undertaken in New Zealand to rationalize the existing national food inspection service. The relationship of various government departments involved in food administration in relation to objectives, accountabilities, clients and resources was being reviewed. Special mention was made of the compatibility of the trade, consumer and health aspects of food protection. 9. Food Irradiation

Two papers were presented: The first paper, "Safety and wholesomeness of irradiated foods" elaborated on actions that have been taken internationally to ensure that food irradiation at established levels present no health hazards. The role of WHO was to provide support in reassuring Member States that food irradiation is a process that has potential to promote a safe food supply and thus contribute to primary health care. The second paper, "Role of food irradiation in food safety", while emphasizing the potential that food irradiation has for promoting a safe food supply through destruction of food borne pathogens and extending shelflife, also cautioned that food irradiation by itself should not be seen as a panacea for all food safety problems. 10. Regional food safety information sharing

A paper was presented for consideration by the Working Group on the development of a Focalized Network Information Service for food safety. Initially, such a service would collect basic documentation and referred information on food safety presently available from various sources around the world, including guidelines, expert reports, proceedings of meetings, safety reviews of food and colour additives, toxicity assessments of food contaminants, sampling and analytical methodology, regulatory requirements and standards, and training and education opportunities within and outside the Region, as well. as a compilation of curricula vitae of potential food safety consultants. This portion of programme development will be mostly the responsibility of PEPAS, but the network members will also be required to contribute information to the system. Following the initial stage, the system would perform more interactive functions for the Region, including the collection and dissemination of information on: (a) (b) (c) food borne diseases; information on emerging food safety problems; and food safety policies and regulatory decisions/actions by countries in the Region and major traders in food.

"'"

.."

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11.

Joint FAO/WHO Food Contamination Monitoring Programme

Under the Joint FAO(WHO Food Contamination Monitoring Programme, a total of 35 countries, including 5 from this Region, provide data on the concentrations of about 20 contaminants in individual foods and in total diets. Contaminants which are monitored include pesticides, industrial contaminants and naturally occurring toxins. 12. Radionuclide contamination of foods

The paper summarized the events and policy developments in the aftermath of the nuclear accident at Chernobyl in 1986. In particular it addressed the variability in national responses to the problem of food contamination by radionuclides both in the affected countries and in the Member States represented at the meeting. Problems arose as a consequence of the lack of international harmonization, restricting internstional trsde in food commodities in certain countries. The paper concluded with a summary of the ongoing WHO, FAO and IAEA initiatives in development of harmonized control strategies. Following the accident at the Chernobyl nuclear power station, WHO undertook to produce derived intervention levels (DIL) for radionuclide contamination of environmental media. WHO convened an inter-agency meeting in November 1986 to inform the other international agencies of its activities in this field and to discuss the integration of all agencies' plans. A consultation of experts was held in Geneva from 6 to 9 April 1987 to discuss the approach to be used in cslculating DIL. When issued later this year, the WHO guideline values will cover the radionuclides most likely to be encountered following a nuclear accident in the contamination of groups of foods and drinking water. These gUideline values will be finalized by a wider task group meeting in September 1987. 13. Codex Alimentarius Commission

The work of the Joint FAO(WHO Food Standards Programme is implemented through the Codex Alimentarius Commission (CAC). The objectives of the CAC are the protection of the consumet and the facilitation of international trade in foods. The CAC, through its many internationally-agreed commodity standards and guidelines for the labelling of foods and food additives, maximum limits for pesticide residues in foods and its many codes of hygienic and technological practice, has provided, and is still in the process of providing, food regulatory authorities and food industry with a wealth of valuable advice, gUidance and background information. No evidence has been found of harm to humans when foods have complied with Codex standards and limits. A report on the nature and activities of the CAC was presented to the Seventy-ninth Session of the WHO Executive Board in 1987 which endorsed the report and the work of the CAC. The Fortieth World Health Assembly adopted a resolution supporting the CAC and calling for greater involvement by Member States, especially in utilizing Codex recommendations.

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14.

WHO Global and Regional Medium-Term Programmes on Food Safety (1990-1995)

The participants were informed that the Eighth General Programme of Work (covering the period 1990-1995 inclusive) had been approved by the World Health Assembly. Currently, this is being translated into Global and Regional Medium Term Programmes covering the same period. The draft approaches proposed are that: (1)

At the country level WHO will continue to collaborate with Member States in identifying national food safety problems and will cooperate in the formulation of national food safety policies and strategies involving all those with a role to play in ensuring food safety, including the food industry, trade and consumers. WHO will support governments in the review and updating of legislation and in strengthening its implementation; it will advocate intersect oral coordination and cooperation, particularly between ministries of health, education, agriculture, industry and trade, and tourism. WHO will collaborate in the establishment or strengthening of food borne disease surveillance and food contamination monitoring. Governments will be assisted, where appropriate, in enlisting the support of nongovernmental organizations, the food industry, and the consumer in a concerted effort to improve food safety, using culture-specific information on food and nutrition practices. The Organization will support governments in related training and in developing and updating health education programmes on food safety appropriate to sociocultural and economic conditions. At the regional level, national action will be stimulated through, inter-alia, intercountry training activities on food safety. WHO will continue to support the work of regional Codex Coordinating Committees, promote training courses for food safety personnel, and develop gUidelines for training personnel in primary health care aspects of food safety in the home. It will foster technical cooperation activities among countries and cooperate with regional United Nations bodies and selected regional non-governmental organizations, such as consumer associations. At the global level WHO will advocate the development of national policies on food safety and will disseminate relevant information to this end. It will collaborate with FAO: (a) (b) (c) in evaluating the public health risks associated with food additives; in the Joint FAO/WHO Food StandardS Programme and, together with UNEP, in the monitoring of certain contaminants in foods; and in advocating the need for intersectoral cooperation in food safety and for' the generation and transfer of information and methods relating to the planning, implementation, monitoring and evaluation of programmes ensuring safe food.

(2)

(3)

It will also collaborate with IAEA in assessing food irradiation processes and sponsoring the International Consultative Group on Food Irradiation.

. -59-

APPENDIX A BIBLIOGRAPHY OF FOOD SAFETY PUBLICATIONS 1979-1987*

, 1. Food Safety (General) Final Report. WHO Western Pacific Regional Working Group on Food Hygiene and Food Safety, Kuala Lumpur, Malaysia, 1-5 October 1979. Doc. (WP) DDR/ICP/EHE/001-E. The role of food safety in health and development. Report of a Joint FAO/WHO Expert Committee on Food Safety. WHO Technical Report Series No. 70S, ISBN 92 4 120705 1, 1984. Guiding principles on evaluation of programmes to ensure food safety. Doc. (provisional edition) Doc. WHO/EHE/FOS/86.1. World Health Magazine, March 1987, "Food Safety". Food Safety Services in the WHO Western Pacific Region (In Press). 2. Food Microbiology Microbiological criteria for foods - Summary of recommendations of FAO/WHO Expert Consultations and Working Groups 1975-1981. Doc. VPH/83.54, 1983. Manual on food virology. Doc. VPH/83.46, 1983.

Microbiological safety of irradiated food. Report of a meeting of the Board of the International Committee on Food Microbiology & Hygiene, with participation of WHO, FAO and IAEA, Copenhagen, 1982. Doc. CX/FH/83/9. Histamine poisoning associated with fish, cheese, and other foods. Prepared for WHO by S.L. Taylor. Doc. VPH/FOS/85.1. Report of the WHO Consultation on Veterinary Public Health Aspects of Prevention and Control of Camp lobacter Infections, Moscow, 20-22 February 1984. Doc. VPH CDD/FOS/84.1

Use of irradiation to ensure hygienic quality of food. Report of a Task Force Meeting, Vienna, July 1986. Doc. WHO/EHE/FOS/87.2, 1987.

*This bibliography supplements the bibliography contained in the Final Report of the WHO Western Pacific Regional Working Group on Food Hygiene and Food Safety, Kuala Lumpur, Malaysia, 1-5 October 1979.

-603. Salmonellosis Present status of the salmonella problem (prevention and control). Report of a WHO/WAVFH Round Table Conference, Bilthoven, 6-10 October 1980. Doc. VPH/81.27, 1982. Guidelines on prevention and control of salmonellosis. Doc. VPH/83.42, 1983. Prevention and control of food borne salmonellosis through the application of the Hazard Analysis Critical Control Point System. Report of an ICMSF ad hoc committee. Doc. WHO/CDS/VPH/86.65. 4. Parasitic infections Prevention and control of intestinal parasitic infections. Report of the WHO Expert Committee on Intestinal Parasitic Infections, WHO Technical Report Series No. 749, ISBN 92 4 120749 3, 1987. 5. Chemical contamination of food Joint FAO/WHO Food and Animal Feed Contamination Monitoring Programme. Summary of data received from Collaborating Centres, 1977-1980. Part A - Countries. Geneva, 1981. Doc. EFP/81/19A. Joint FAO/WHO Food and Animal Feed Contamination Monitoring Programme, Summary and data received from Collaborating Centres, 1977-1980. Part B - Contaminants. Doc. EFP/81/19B. Joint FAO/WHO Food Contamination Monitoring Programme. Summary and assessment of data received from the Collaborating Centres. Uppsala, Sweden, 1982. Joint FAO/WHO Food Contamination Monitoring Programme. Programme Report, 1984-85. Doc. FOS/85.7. Toxic oil syndrome (Mass food poisoning in Spain). Report on a WHO meeting, Madrid, 21-25 March 1983; 92p (E S) ISBN 92 890 1021 5, 1984. Guidelines for the study of dietary intakes of chemical contaminants. WHO Offset Publication No. 87, Geneva, ISBN 92 4 170087 4, 1985. Analytical quality assurance III. Doc. WHO/EHE/FOS 85.20, Geneva. 1985. Summary of 1980/83 monitoring data. Document FOS/86.2, Geneva, 1986. Report of the Fourth Session of the Technical Advisory Committee, Geneva, 9-13 September 1985. Doc. FOS/86.4 Safe use of lead glazes for foodware. International Lead Zinc Research Organization Inc., January 1980. Chemical contaminants in foods 1980-1983. Doc. FOS/86.5, Geneva, 1986.

•

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6. 6.1

Individual Food CODDDodities Meat hygiene Guidelines on the hygienic disposal and 'rendering of dead animals and animal wastes to protect human and animal health. Doc. WHO/VPH/85.5. Report of Round Table Conference on Meat Hygiene in Developing Countries - meeting convened jointly by the Instituto Superiore di Sanits and WHO, Rome, 4-8 November 1985. Doc. VPH/85.60.

6.2

Fish and shellfish hygiene Paralytic shellfish poisoning. Prepared by B. Halstead. Publication No. 79, ISBN 92 4 170079 3, 1984. WHO Offset

Surveillance of foodborne disease and epidemiology Surveillance programme of control of food borne infections and intoxications in Europe. Report of a WHO Meeting, Geneva, 18-20 April 1979. Doc. VPH/79.16, 1979. WHO surveillance programme for control of food borne infections and intoxications in Europe. Third report, 1984, Berlin (West) •. Guidelines for organization and management of surveillance of foodborne diseases. Doc. VPH/82.39. 19~3. f 'To:;' ~

The role of food in the epidemiology of acute enteric infections and intoxications. Prepared by by D'. Barua and F. K. Kaferstein. Doc. EFP/FOS/83.48. Global review of information on the extent of ill-health associated with chemically contaminated foods. Prepared by J. Haworth. Doc. EFP/FOS/EC/WP/83.4. 8. Food Technology Wholesomeness of irradiated food. Report of a Joint FAO/IAEA/WHO Expert CoDDDittee. WHO Technical Report Series No. 659, ISBN 92 4 120659 4, 1980. Summaries of data referred to in TRS 659. Doc. EHE/81/24.

Guidelines for can manufacturers and food canners: Prevention of metal contamination of canned foods. FAO Food and Nutrition Paper No. 36, FAO, Rome 1986. Use of irradiation to ensure hygienic quality of food. Report of a Task Force meeting, Vienna, July 1986. Doc. WHO/EHE/FOS/87/2, 1986. Food Irradiation. In point of fact, no. 40, WHO, Geneva, 1987,.

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Food Control/Legislation Hazard Analysis Critical Control Points System in food hygiene. Report of WHO/ICMSF Meeting, Geneva, 9-10 June 1980. Doc. VPH/82.37, 1982. Sanitary control of food. Technical Discussions of the XXVIII Meeting of the Directing Council of PAHO, Washington D. C., Scientific Publication No. 421, 1982. Food control laboratories. Doc. ICP/FSP/003, 1979. Report on a conference, Copenhagen 1977.

Manuals of food quality control. Vol. 5: Food inspection, FAO Food and Nutrition Paper No. 14/5, FAO, Rome, 1984. 10. Food Catering Mass catering. Prepared by R.H.G. Charles. WHO European Series No. IS, ISBN 92 890 1106 8, 1983 (E F G). Institutional catering. Report on WHO Working Group (1984) published in EURO Environmental Health Series No.7, Copenhagen, 1986. 11. Information/Education/Training Food Safety - An International Source List of Audiovisual materials. Prepared for WHO by the British Life Assurance Trust for Health and Medical Education. Doc. WHO/ERE/FOS/87.1 1987. The environmental health officer. Industrial Society report on a WHO Consultation, BURO Reports and Studies No. 29, Copenhagen, 1979. 12. Socio-cu1tura1 aspects of food safety Socio-cu1tura1 aspects of food safety. consultation, Bangkok, 1982. Health education in food safety. Geneva, April 1987 (in press). 13. Food Additives Food additives have been evaluated yearly by the Joint FAO/WHO/ Expert Committee on Food Additives (JECFA) since 1956. Each report contains an annex listing all previous reports in this series. Only the name and number of the most recent report is therefore shown on this list. Evaluation of certain food additives and contaminants - 30th Report of the JECFA, 1985. WHO Technical Report Series No. 751, ISBN 92 4 120751 5, 1987. 14. Pesticide Residues Pesticide Residues in Food - 1985, FAO Plant Production and Protection Paper No. 68, Rome, 1986. Proceedings of an informal

Report on a WHO Consultation,

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15.

Veterinary Drug Residues Health aspects of residues of anabolics in meat. Report on a WHO working group, Bilthoven, Netherlands, 1981. EURO Reports and Studies, No. 59, ISBN 92 890 1225 0, 1982. Residues of veterinary drugs in food. Report of a Joint FAO/WHO Expert Consultation, Rome 1984. FAO Food and Nutrition Paper No. 32, FAO, Rome, 1985. (out of print).

16.

Zoonoses Control Parasitic zoonoses. Report of a WHO Expert Committee with the participation of FAO, WHO Technical Report Series No. 637, ISBN 92 4 120637 3, 1979. Bacterial and viral zoonoses. Report of a WHO Expert Committee with the participation of FAO, 1982, WHO Technical Report Series No. 682, ISBN 92 4 120682 9. Joint FAO/WHO Expert Committee on Brucellosis - Sixth Report, WHO Technical Report Series No. 740, 1986.

17.

Codex Alimentarius The Codex Alimentarius is a collection of internationally adopted food standards, codes of hygienic and technological practice and other advisory texts authorized by the Codex Alimentarius Commission and presented in a uniform manner and published by the Secretariat of the Joint FAO/WHO Food Standards Programme.

Food Standards Volume I Volume II Volume III Volume IV Volume V Volume VI Volume VII Volume VIII Volume IX - General information - Codex standards for processed fruits and vegetables and edible fungi - Codex standards for sugars (including honey) - Codex standards for processed meat & poultry products and soups and broths - Codex standards for fish and fishery products - Codex standards and guidelines for the labelling of foods and food additives - Codex standards for cocoa products and chocolate - Codex standards for quick frozen fruits and vegetables - Codex standards for foods for special dietary uses. Uses include foods for infants and children and related code of hygienic practice

... -64Volume X Volume XI Volume XII - Codex standards for fruit juices, concentrated fruit juices and fruit nectars - Codex standards for edible fats and oils - Codex standards for natural mineral waters (European Regional Standard), and Codex.standard for edible ices and ice mixes - Codex maximum limits for pest~cides

... ... ...

Volume XIII Volume XIV Volume XV Volume XVI Volume XVII

in food

Food additives (evaluated for their safety in use in food) - Codex standard for the irradiation of food - Codex standard for milk products - Food contaminations

Volume XVIII - Codex standards for cereals, pulses, legumes and derived products Recommended International Codes of Hygienic and/or Technological Practice Volume A - General principles of food hygiene Volume B - Recommended international codes of practice for fish and fishery products Volume C - Recommended international codes of pr.actices for meat and poultry products Volume D - Recommended international codes of practice for processed fruits and vegetables Volume E - Recommended international codes of practice for quick frozen fruits and vegetables Volume F - Recommended international code of practice for egg products Volume G - Recommended international code of practice for low-acid and acidified low-acid canned foods Volume H - Recommended international code of practice for dried milk Volume J - Code of ethics for international trade in food 18. No.1 No.2 No.3 Environmental Health Criteria Documents of Relevance to Food Safety Mercury (out of print) Polychlorinated biphenyls and terphenyls Lead (out of print) 1976 ISBN 92 4 154062 1

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-65/66No.5 No.9 No.ll No.15 No.18 Nitrates, nitrites and N-nitroso compounds DDT and its derivatives Mycotoxins Tin and organotin compounds Arsenic Selenium Principles for the safety assessment of food additives and contaminants in food 1979 1979 1979 1980 1981 1986 1987 ISBN 92 4 154069 9 ISBN 92 4 154071 0 ISBN 92 4 154075 3 ISBN 92 4 154078 8 ISBN 92 4 154158 6 ISBN 92 4 154270 5

No.58 No.70

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ANNEX 7

PUBLIC INFORMATION AND EDUCATION

, Target group

SPECIFIC TYPES OF INFORMATION REQUIRED BY VARIOUS TARGET GROUPS Informatlon type Scientifically sound data on the health and economic c.onsequences of food borne diseases

Policy/decision-makers Primary producers

Safe and effective use of pesticides and other agricultural chemicals; proper methods of food handling and storage Proper food handling, processing, storage, and transport practices; proper use of food additives and other good manufacturing practices Culturally specific information on safe handling of food, personal hygiene practices requirements and the health consequences of contaminated food; appropriate information to permit informed and discriminating food choices, including the demand for food safety Nutrition and basic food safety practices incorporated in home economics or health science

Food processors

Homemakers

Schoolchildren

• -69/70ANNEX 8

AWARENFSS PROMOTION PROPOSED FUNCTIONS OF A NATIONAL FOOD SAFETY CONSULTATIVE COUNCIL* The functions may include the following: (a) (b) (c) (d) (e) (f) (g) to promulgate distinct and explicit policies on food safety; to promote food safety awareness; to identify the role of each participating group in food ssfety education and promotion; to initiate and coordinate programmes and activities by the participating groups; to monitor and evaluate programmes and activities of participating groups; to facilitate communication between food safety officials and,target groups; and to meet at regular intervals but not less than twice a year.

*Should include representatives of all sectors and groups involved in food safety (both formal and informal).

-71ANNEX 9

INDICATORS FOR MONITORING AND EVALUATION OF PROGRAMMES TO ENSURE FOOD SAFETY It is appreciated that many governments do not have an evaluation process built into their food safety programmes and therefore lack experienced evaluators. The following selected indicators are intended to allow evaluation by non-specialist personnel of the progress towards achieving food safety goals. The indicators listed are considered to represent the minimum necessary information to conduct an evaluation and should be expanded where additional appropriate information is available. Selection of indicators should be based on their feasibility, objectivity and relevance*. Their use will enable governments to monitor the impact of their food safety activities and result in more effective food safety programmes. The list is: Food Legislation Is there enabling food legislation which empowers the making of food regulations? Are existing laws and regulations considered satisfatory by the authorities responsible for ensuring food safety? Are there laws or regulations which effectively cover food safety issues, particularly in areas effecting the incidence of foodborne infections and intoxications, including: (a) (b) (c) (d) microbiological standards for high risk foods food additives and contaminants technical processes such as, pasteurization, irradiation, etc. licensing and registration requirements for food premises.

...

Are there Codes of Practice to supplement the food regulations? Is there an effective coordinating committee of relevant government departments or a similar mechanism to ensure cooperation and coordination of activities related to food safety? Food Control Implementation How many food safety officers conduct food inspections? How many food safety officers conduct meat inspections? How many health and sanitation officers perform food safety functions?

*See "Guiding Principles on Evaluation of Programmes to Ensure Food Safety," Provisional Edition; WHO/EHE/FOS/86.l

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Is the number and distribution of the above personnel adequate for the efficient performance of the food safety programme? Is there adequate scientific support by qualified professionals in such fields as medicine, food science and technology, nutrition, toxicology and veterinary science? Are there specific procedures/guidelines/manuals to allow for the effective enforcement of food safety regulations? Supporting Laboratory Services Are there laboratory facilities and services adequate to provide support for the food safety programme in: microbiology chemistry including radionuclides biotoxins and naturally occurring toxins Do these laboratories participate in national food monitoring and research programmes? Are laboratories adequately staffed with appropriate personnel? Do these laboratories have an adequate analytical quality assurance programme? Epidemiological Data What food borne diseases are legally required to be notified? What is the incidence of these diseases? What is the rate of child mortality due to gastrointestinal diseases? Manpower Development What categories of personnel are involved in food safety and control and is their training adequate? Public Education and Information Are there appropriate education programmes in food safety available for the different sectors of the community including: (a) (b) (c) (d) (e) policy/decision-makers food industry consumers professional groups others, e.g., opinion leaders

....

Is there an effective consumer advocacy organization involved in food safety issues?

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International Harmonization Is the country a member of the Codex Alimentarius Commission? Has the country adopted Codex Standards/Codes of Practice? If yes, specify. Does the country participate in the Joint FAO!WHO Food Contamination Monitoring Programme?

Informations clés

Organisation Organisation mondiale de la santé (OMS)

Type de document Technical Documents

Date d'adoption 31 décembre 1987

Source Organisation mondiale de la santé