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| Agenda Item 6.1 | Conference Room Document 32 English only |
second fao/who global forum of food safety regulators
Bangkok, Thailand, 12-14 October 2004
(Prepared by WHO Regional Office for Africa)
Reports on outbreaks of food borne illness are indications of the magnitude of the problem associated with food as a vehicle for disease transmission. At the macro level, a number of factors impact negatively on the situation and these include: Poverty coupled with poor environmental hygiene and sanitation; Rapid and unplanned proliferation of street food vending sites in countries; Poor public health funding coupled with inadequate human resources and expertise; Civil strife, boarder conflicts, droughts, and floods with associated population displacement and humanitarian disasters. Food handling, preparation and storage are the major problems at the micro level.
Many of the countries in the Region do not have adequate food security so having effective food control systems appear not to be a priority, resulting in little or no attention to food legislation, its administration and enforcement. This has often resulted in the importation of substandard food items as well as trade rejections of food exports. In a Region where many are malnourished or suffering from deficiency diseases, food quality and safety deserves special attention. This paper reviews the health and economic impacts of foodborne diseases, the current status of food control systems in the Region, the lessons learnt and the prospects for improvements.
There is a high incidence of diarrhoeal diseases in African children, estimated as 3.3 to 4.1 episodes per child per year. Approximately 800,000 children also die each year from diarrhoea and dehydration1. Microbial pathogens, chemical contaminants and biotoxins present serious threats to health and trade in the Region. The Region suffers from campylobacteriosis, salmonellosis, shigellosis, brucellosis, hepatitis; food poisoning due to Staphylococcus aureus and Bacillus cereus; infections due to Escherichia coli and rotavirus. Cholera traditionally associated with water has been shown to be also foodborne and is endemic in the Region (Figure 1).
In addition to death and ill-health, foodborne diseases have negative economic consequences within the region. A cholera outbreak in Tanzania in 1998 cost US$36 million2. In Nigeria, the Food and Drug Administration destroyed aflatoxin-contaminated food worth more than US$ 200,0003. In 1997 a ban was imposed on Ugandan fish exports to the European Union (EU) because the country's fish processors and exporters failed to meet the new EU Hygiene and Processing quality standards. The country lost 36.9 million dollars in terms of reduced returns during the ban which ended in July 1999. The fishing community also lost a total income of about US$ 720,000 per month4.
Table 1 Contraventions Cited by United States Food and Drug Administration Import Detentions for July 1996-June 1997
Reason for contravention |
Rejections from Africa |
Total Global Rejections |
Food additives |
2(0.7%) |
554(5.0%) |
Pesticide residues |
0(0.0%) |
864(7.7%) |
Heavy metals |
1(0.3%) |
537(4.8%) |
Mould |
19(6.3%) |
570(5.1%) |
Microbiological contamination |
125(41.3%) |
1425(12.8%) |
Decomposition |
9(3.0%) |
890(8.0%) |
Filth |
54(17.8%) |
3519(31.5%) |
Low Acid Canned food |
4(1.3%) |
1400(12.5%) |
Labeling |
38(12.5%) |
1098(9.8%) |
Other |
51(16.8%) |
309(2.8%) |
Despite the attention given to the safety of food exports vis-à-vis food for domestic consumption, several trade contraventions were reported on exports from the African Region (Table 1). Losses from export rejection not only rob countries of critical revenues but also of credibility as reliable trading partners. Over 50% of the rejections from African countries are attributed to lack of basic food hygiene, and failure to meet labelling requirements. Dealing with these is possible if countries could introduce basic Sanitary and Phytosanitary (SPS) measures in order to meet international requirements.
Common problems associated with food legislation, regulations, laboratory services, inspection services, monitoring services, administration of food control, manpower development and funding of food safety programmes have been identified from studies by a number of international organisations including WHO/AFRO. Constraints from local problems further compound these problems.
An effective food control system must be based on adequate food law from which it derives its powers (FAO 1976). This appears not to be the case in most countries in the Region as most existing food laws have been based on conditions in developing countries. The principles for developing food laws; protecting the consumer and promoting fair trade, may be universal but must be applied in relation to individual national needs and resources. Basic food laws may either be lacking or the existing ones may be outdated, inadequate, fragmented and could be found in different statutes and codes. This confuses the enforcement agents, producers and distributors. The regional survey of 2002 showed that out of 28 responding countries 22 had Acts or Ordinances for food safety standards and regulations. Only 12 however found existing laws satisfactory. Twelve countries had regulations on food additives and pesticide residues, 16 had microbiological standards, codes of practice for specific applications such as street foods, safe food packaging and storage (Figure 2).
A number of attempts have been made by Member States to revise outdated food laws but these have not always been successful. For example, a new Food Act was passed in June 1998 to replace the former act of 1940 and became operational in January 2000 in Mauritius. The act was criticised by the food industry as being too modern; did not allow enough time for compliance, did not allow the involvement of industry in the drafting process; had specific requirements which differed from international norms and thus made it difficult to import certain products. A joint committee therefore had to be established to review and draft amendments to this act to ensure effective food control.
There are at least two ministries and departments involved in food safety regulation activities, however there is no collaboration and coordination resulting in conflict and duplication of efforts. This would not allow the efficient use of human, material and financial resources. It is therefore sometimes impossible to determine which department can represent Member States on food control policy. In Ghana production and sale of food is governed by food standards established and promulgated by the Ghana Standards Board for manufactured foods. There are regulations and bye-laws to control food hygiene and the Metropolitan Medical Officer has the vested authority for enforcement. The Ghana Food and Drugs Board, which assures food safety is under the Ministry of Health and therefore has several collaborating agencies. In Mauritius the Health Inspectorate Division of the Ministry of Health is responsible for the enforcement of 1998 Food Act but many other Ministries are involved in the enforcement of various aspects of food control, causing overlap, duplication of efforts and gaps in enforcement.
In Mozambique, the Food Safety Unit is under the Department of Environmental Health within the Ministry of Health and is responsible for regulation, standards etc. The main partners of the Ministry of Health in the area of food control are the Ministries of Agriculture, Commerce, Fisheries and the National Institute of Normalization and Quality. In Malawi, the Ministry of Health and Population, Ministry of Local Government, Bureau of Standards, Consumer Association are responsible for the implementation of Food Laws. In Botswana, the Food Control Unit is under Community Health Services Division in the Ministry of Health while in the Comoros, the Ministry of Environment and Ministry of Agriculture are responsible for the implementation of food policy. The ineffectiveness of food regulation systems may also be due to the adoption of food laws dating as far back as colonial times. Most of these were introduced on ad hoc basis to deal with problems of particular interest to the colonial administrators and have not been updated over a very long time.
An effective service is achieved when there is proper coordination between surveillance, food laboratory and inspection services. Food inspectors and surveillance systems are the ‘eyes and ears' of a food control system while the laboratory services act as the analytical brain. This is often not the case, thus leading to disorganised sampling. Furthermore, the emphasis is on sampling for penal action rather than advice and assistance. There are no activities for monitoring food contaminants for government to take action. Lack of cooperation between the inspectorate, surveillance and laboratory services results in the hampering of record-keeping and constant monitoring. This creates a vicious cycle which results in the absence of information on which to base local decision-making, regulations and food standards.
Surveillance and Laboratory Services
WHO in collaboration with Pasteur Institute has been organising courses on foodborne disease surveillance and microbiological monitoring of foods for the francophone countries in the Region. Training courses for the Anglophone and Lusophone countries are yet to begin. A regional strategy for foodborne disease surveillance is currently in preparation so available data is patchy and unreliable. Indeed very few countries had surveillance systems which identify most of the known etiological agents of foodborne diseases. Table 2 provides data on the notifiable foodborne diseases in the responding countries. Cholera, salmonellosis and shigellosis are among the most prevalent food-borne diseases.
Table 2 Notifiable foodborne diseases in the African Region
(WHO/AFRO Regional Survey)
Country |
Notification of foodborne diseases |
Incidence of the diseases |
Botswana Congo Ethiopia Guinea Mauritius Mozambique Nigeria Senegal Togo |
Cholera, diseases caused by Salmonella Cholera Diseases caused by St. aureus, Salmonella, Shigella & Bacillus cereus Cholera, diseases caused by St. Aureus, Salmonella, Shigella & Bacillus cereus Food poisoning (bacteria etc) Cholera & Diarrhea Cholera, Diarrhea due to Salmonella Diseases caused by Shigella, Rotavirus Diseases caused by Salmonella, Botulism, Shigella, Listeria, Pesticide, Natural toxins. |
ND ND ND ND 38 notified cases for 2001 Cholera:44%; Diarrhoea:21% ND ND |
ND = No Data
Food safety control laboratories are the weakest in the Region and may be due to lack of financial resources for the development and maintenance of equipment and manpower. Majority, of public health laboratories do not have the capacity to test for chemical contaminants and naturally occurring toxins. Nineteen countries had laboratory facilities capable of conducting microbiological studies. In Nigeria for example, there is a standard laboratory involved in the certification of seafood. The agents tested for included Salmonella, Vibiro cholerae, Vibrio parahaemolyticus, Listeria monocytogenes and Staphylococcus aureus. The current outbreak of acute aflatoxicosis in Kenya which has so far affected 285 people with 115(40%) deaths showed huge weaknesses in laboratory infrastructure as well as microbiological monitoring and surveillance systems.
Food Inspection Services
Food inspectors must have a comprehensive idea of food safety and related subjects but this appeared not to be the case in the Region. Only 7 of the 28 countries that participated in the regional survey had distinct mechanisms for the collection and dissemination of information on food exports rejected by foreign buyers. Lack of skilled inspectors and coordination among the relevant organizations were the main problems affecting oversight of exported and imported foods. Inspection systems for food imports were available in 23 countries. The major setbacks to effective control of imported food were: insufficient means of ensuring control; inadequate capacity to monitor food imports; inadequate resources in terms of human and laboratory facilities. The number of and distribution of inspectors was unsatisfactory in 24 countries. The Comoros and Mauritania had two food inspectors; South Africa had 2,500 health inspectors and Nigeria 4,000 meat inspectors.
An ideal food control system should include effective enforcement of mandatory requirements, along with training and education, community outreach programmes and promotion of voluntary compliance. Food safety education for industry and consumers is limited in Member States. Only 12 of the 28 countries which participated in the AFRO survey had educational programmes for industry, 13 had programmes for housewives and school children and 15 had included food safety in national curricula for primary and secondary schools. African women could play a major role in all food safety control programmes as they are involved in a wide variety of food processing activities. They are also charged with the responsibility of providing food for entire households and whatever they place on the table gets eaten. This makes their role unique because they will put whatever comes from high-level actions into practice. They could be reached through functional literacy programmes, women's groups and through school children.
Food safety and control requires a wide variety of expertise and these include health inspectors, veterinarians, sanitary engineers, public health officers and microbiologists. The survey showed an overall shortage of trained personnel to support laboratory services. Only 12 countries were adequately equipped for capacity building locally. The Region needs to take advantage of these limited facilities in order to solve this human resource problem.
One key factor affecting food control systems is the lack of financial support. Funds are needed to improve infrastructure, purchase equipment, train personnel and monitor food contamination. Food safety programmes are often not a priority to many governments and hence have reduced budgets. This is because they do not fully appreciate the importance and health impact of food safety control.
FAO/WHO and other international organisations have been providing varying degrees of assistance to the African Region to establish or strengthen their food control programmes. Studies by these organisations have identified a number of constraints which limit the establishment of effective food control systems. Lack of financial support appears to be the underlying factor, but lack of awareness could limit the efforts being directed at these programmes.
The public in particular consumer organisations could have key roles in the food control system. They could bring attention to deficiencies and at the same time constructively assist the functioning of national food quality systems. Wherever consumer pressure exists, there is greater awareness of food problems and governments as well as food industries are forced to make improvements. The role of women in this process cannot be overemphasised.
Countries may differ in their requirements for food control systems and there is no set of existing guidelines that could provide the needs of any one country. All countries would require the development of special food control system although they may learn from other countries. Member States should therefore conduct an honest and detailed evaluation of their food control systems in order to identify gaps and mechanisms for improvement. These mechanisms and approaches must be targeted to specific country needs and must include an evaluation protocol.
In order to overcome the problem associated with fragmentation of food control systems and the lack of collaboration, all food control functions could be transferred to a single government department or a National Food Control Body with inter-ministerial and interdepartmental representation. These bodies may require oversight from the highest authority.
Countries could take advantage of upcoming WHO training courses to strengthen foodborne disease surveillance and microbiological monitoring in order to obtain data for sensitising policy-makers on the importance of planning and implementation of effective food control strategy. Capacity building through training of inspectors, laboratory technicians and experts in risk analysis, Hazard Analysis and Critical Control Points, development and implementation of guidelines as well as communication systems could be achieved using similar mechanisms. Member States could however consider local mobilisation for graduate and postgraduate training. They could also take advantage of online training programmes.
In order to avert the problems associated with international trade rejections countries should strive to upgrade food laws and legislation and implement standards from the Codex Alimentarius with support of partners. WHO is seeking financial support in this regard in order to provide assistance to Member States.
1 Fact Sheet No. 109: Childhood Diseases in Africa. WHO. 1996.
2 FAO/WHO Global Forum of Food Safety Regulators. Marrakesh, Morocco. Improving Efficiency and Transparency in Food Safety Systems - Proceedings of the Forum, 28-30 January 2002.
3 Anyanwu RC, Jukes DJ. Food Safety Control Systems for Developing Countries. Food Control 1990;1:1726- 1736.
4 The Importance of Food Safety and Quality for Developing Countries: Committee on World Food Security: Food and Agricultural Organization (FAO). CFS 99/3