Agenda Item 3	Conference Room Document 61 English only

second fao/who global forum of food safety regulators

Bangkok, Thailand, 12-14 October 2004

Building a Food Safety System in Uganda

(Prepared by Uganda)

1. SITUATION ANALYSIS:

• The Ministry of Health takes food safety issues seriously because food safety related epidemics e.g. cholera and other cases of food poisoning are still occurring in our communities.
• According to the 1995 Burden of Disease study in Uganda, 75% of life years lost to premature death are due to ten (10) preventable diseases. Food hygiene and safety related diseases fall in this category.
• In addition, because of lack of an effective food safety system local and international food trade opportunities are reduced.

Table 3: Food Hygiene & Safety related disease burden in Uganda: Outpatient Diagnoses in Uganda: 1997– 2001

Diagnosis (All Ages)	Year
	1997	1998	1999	2000	2001
Cholera	1172	17636	2614	2637	632
Diarrhoeal Dysentery	82022	70192	54852	59915	77,606
Acute Diarrhoea (Not bloody)	378457	369391	388570	403122	504,365
Persistent Diarrhoea (Not bloody)	112471	116974	121633	117213	114,213
Intestinal worms	733818	744917	784708	778463	1,235,399
Typhoid & para typhoid fevers	8975	7053	6336	11301	12,194
Total	1,316,915	1,326,163	1,358,713	1,372,651	1,944,409
Total OPD	8,132,519	8,833,713	9,806,395	10,502,186	14,527,249
% of Total OPD	16.2	15.0	13.9	13.1	13.4

Source: HMIS District Monthly Reports, MOH

** Numbers increasing annually due to improved reporting (timeliness and completeness) from Health facilities/Districts**

• Much of the burden of illness results from basic sanitation failures that occur in food production, processing, storage, transportation, retailing, and handling in the home.
• Achieving basic food hygiene is made difficult by the lack of necessary sanitation infrastructure in many areas of the country and in food processing industries.

2. FOOD SAFETY CONTROL STRATEGIES BY MINISTRY OF HEALTH

The Ministry has accordingly developed the following implementation strategies in order to address the food safety concerns:

2.1.1 National Health Policy

The Cabinet approved the National Health Policy and Health Sector Strategic Plan in 2000. The policy seeks, among others, to review and develop laws that govern health services and health related activities in accordance with the policy principles and policy objectives. The policy:

• Highlights the need to update and enforce Food Hygiene and Safety Laws.
• Places Environmental Health on the priority list of the “Minimum Health Care Package” and food hygiene safety is one of the aspects of environmental health.

2.1.2 Health Sector Strategic Plan (2001 – 2004/5):

• HSSP I (2001–05)
  The Ministry of Health developed a 5–year Health Sector Strategic Plan to guide the implementation of the Health Policy. The environmental health component in this strategic plan emphasizes promotion of proper food hygiene and safety, safe water supply and improved Sanitation.
• HSSP II (2005–2010)
  Uganda is in the final stages of completing HSSP II (2005–2010) and issues of food hygiene and safety have been highlighted.

2.1.3 The Food and Drug Act (1964)

This law is still in force; however, the National Drugs Authority transformed the component on Drugs into the Drugs Act (1993).

• Revision of the law:
  The Ministry has initiated an exercise to develop a modern and unified National Food Safety Law. A draft Food Safety Bill has been developed through dialogue and consultations with key stakeholders in the food industry.
• Food Hygiene Advisory Committee
  The Food and Drugs Act empowers the Minister of Health to constitute a Food Hygiene Advisory Committee. The Committee is composed of technical experts drawn from key stakeholders in the Food Industry. Its mandate is to advise the Minister to regulate on any matters of food hygiene and safety in Uganda. This Committee is in place and DHS (myself) is the Chairperson and the Director National Bureau of Standards is Vice Chairperson. The Committee is active.

2.1.4 National Codex Committee

Uganda has established a multi–sectoral National Codex Committee in June 2000. This Committee is chaired by DHS (myself). A colleague from the National Agricultural Research Organization is Vice Chair. The Uganda National Bureau of Standards is the National Codex Contact Point. Codex Contact Points and National Codex Committee are responsible for implementing the objectives and activities of Codex Alimentarius Commission in Uganda

2.1.5 National Food Safety Strategic Plan

The Ministry of Health in consultation with key stakeholders in the food industry has undertaken an exercise to develop a National Food Safety Strategic Plan. The strategic plan is to:

• Guide the implementation of the Food Safety Laws, programmes, activities and other Food Safety Control Systems in the country.
• Gives the food laws a sense of direction and translates law it into a tool for an effective food safety control system through creation of consumer awareness.
• Clearly spell out the roles and responsibilities of the key stakeholders, address issues of institutional linkages, collaboration and harmonization of activities aimed at promoting and improving the status of food hygiene and safety in Uganda.
• The document is being finalized and will be launched soon.

2.1.6 The Public Health Act (1964)

This is the law in force that empowers health workers to carry out inspections of public eating-houses to ensure health, hygiene and safety of the workers and clients. The inspections focus on the hygienic and safety standards of the premises, sanitary fittings, utensils, workers (protective war and medical fitness) in order to minimize disease transmission. This Act is still in force and is an important regulatory tool for ensuring public health including food safety.

2.2. INTER-SECTORAL COLLABORATION IN FORMULATION OF FOOD SAFETY STANDARDS & GUIDELINES

2.2.1 Ministry of Agriculture, Animal Industry & Fisheries (MAAIF)

Collaboration between Ministry of Health and MAAIF is through the following government policy initiatives:

• Plan for Modernization of Agriculture (PMA)
• The Food & Nutrition Policy.

These are some of the Government’s Sector Wide Approaches (SWAPs) intended to provide a more coordinated approach to sector challenges. Both the HSSP and PMA provide sector frameworks of food security, nutrition and poverty eradication, among others.

A national Food and Nutrition Council composed of key stakeholders including MOH, coordinates these initiatives.

2.2.2 Uganda National Bureau of Standards (UNBS)

The Ministry has so far participated in development of the following standards:

• Milk & Milk Products (US 164: 2000)
• Fortified Food Products (US 500: 2003)
• Drinking (potable) water (US 502:2003)

2.2.3 Uganda National Council of Science & Technology (UNCST)

The Ministry of Health collaborates with UNCST especially on food safety issues related to Biotechnology and Bio–safety e.g. Genetically Modified Organisms or foods produced through biotechnology. The issues of GMOs, should not be limited to only GMOs but to all Foods with artificially modified materials or foods resulting from other technologies.

2.2.4 Ministry of Trade and Industry

On World Trade Organization (WTO) Agreements related to Sanitary, Phytosanitary and Public Health issues that apply to international trade in food.

2.2.5 National Environment Management Authority (NEMA)

The Ministry of Health collaborates with NEMA in various food safety related activities e.g. to compile a National Profile on Management of Chemicals for Uganda and on Development of Environmental Standards.

2.2.6 Directorate of Water Development (DWD)

This department is responsible for the development and improvement of water sources for communities. These sources have to be accessible, affordable and safe for the user communities. Though the mandate of the water suppliers is to ensure safety of water through “water quality control”, the Ministry of Health plays the role of an independent monitor through “water quality surveillance”. The surveillance helps the health workers to identify key areas in the water chain for tailored water and hygiene education to communities. Since water is a major component of food, water safety is paramount in the food safety control systems.

3. WAY FORWARD

3.1 Human Resource Development

Training of Food Inspectors (Junior and Senior Staff) in Legislation, Policy, Modern Inspection Systems and Quality Management Systems

Target groups:

• Health Inspectors
• Fisheries Inspectors
• Veterinary Inspectors
• Agricultural Inspectors
• Others

3.2 IEC and Community/Consumer awareness programmes

Food related diseases and incidents should be taken as a priority and addressed at all levels. Public awareness is an effective tool that should be applied for the implementation of laws and regulations to sustain food safety activities and programmes.

Complimentary efforts require a multi-sectoral approach to address the documented and undocumented incidences of food borne diseases through public awareness and training in order to:

• Increase awareness on the effects of unhygienic food to human health and to the national socio – economic status
• To advocate for strict controls
• To advocate for legislation on food
• To enhance public participation through dialogue

3.3 Support to Districts and Urban Authorities Information Management system

Although food borne illness is recognized to be a significant public health problem in Uganda, quantitative data is incomplete and inadequate.

A centralized management information system is to be put in place. Districts and urban authorities should be supported to generate, use and disseminate the data.

3.4 Implementation of other related Health Programmes

• Nutrition
• Water & Sanitation (Environmental Health)
• Health Promotion & education
• Integrated management of Childhood Illnesses (IMCI)

3.5 Research & development

This component is still not well developed. The main constraint is financial and logistical support.