Agenda Items 4 and 6.1 Conference Room Document 23
English only

second fao/who global forum of food safety regulators

Bangkok, Thailand, 12-14 October 2004

Building Consensus on Food Safety Programs among Consumer and Public Health Organizations

(Prepared by Safe Food International)


The Center for Science in the Public Interest (CSPI),1 a non-profit consumer advocacy group in Washington, D.C. with nearly 900,000 members in both the United States and Canada, is collaborating with the World Health Organization (WHO) and the Food and Agriculture Organization (FAO) to organize an international meeting of consumer and public health groups from around the world to develop a common vision of food safety. This project is called Safe Food International (SFI), and it is staffed by an international team of experts in food safety, law, and communications.


With the globalization of the world's food supply, food contamination knows no borders. Due to innovations in transportation and refrigeration, food is rapidly moved across countries and between continents. While consumers benefit from having access to fresh affordable food from all parts of the world, the risks are growing. Food contamination that originates in one area is distributed widely and can cause illness in large numbers of people in distant places. Globalization of the world's food supply also increases the risks of intentional contamination.2

In both developing and developed countries, increasing consumers' protections from both intentional and unintentional contamination of the food supply will require improvements in many existing systems. It makes little difference whether those changes come about in response to terrorist concerns or as a general effort to modernize food safety control services. Improvements in such areas as outbreak response and investigation will result in many immediate benefits for consumers. Strong inspection systems also serve to prevent and deter many food safety problems.


In detailed analysis of food-borne illness outbreaks in the United States, CSPI has identified a number of trends. First, many outbreaks are occurring from foods, such as meat, seafood, produce, eggs and poultry, that are widely traded on the world markets. While meat and poultry are the most commonly suspected cause of outbreaks, CSPI's analysis of 3,500 outbreaks in the U.S. reveals that a majority of outbreaks are caused by non-meat items, such as seafood, fruits, vegetables, and eggs.3

Second, a single contamination point in a production chain can cause hundreds or even thousands of people to become ill. For example, in 1994, Schwann's Ice Cream contaminated with Salmonella sickened more than 200,000 people in the United States; the contamination point was a single tanker truck.4 An unusual outbreak traced to breakfast cereal in 1998 was linked to over 200 confirmed cases in twenty-three states in the U.S.; the contamination point was a single room in a production plant where vitamins were sprayed onto the cooked cereal.5 And numerous outbreaks involving fresh produce, including an outbreak of Hepatitis A last fall traced to raw green onions from Mexico, demonstrate that a single farm can be a contamination point. This green onion outbreak was one of the largest outbreaks traced to vegetables ever recorded in the United States, with over 500 illnesses and 3 deaths.

Worldwide, outbreaks of this magnitude are not uncommon. In 1988, a Hepatitis A epidemic in China associated with the consumption of clams affected 292,000 people, killing nine of them.6 In a 1996 Japanese outbreak, at least 9,578 individuals (mainly schoolchildren) suffered from severe E. coli infections linked to white radish sprouts.7 In 2000, an outbreak from milk in Japan resulted in almost 6,000 illnesses; the contamination point was a production line valve that became contaminated.8

Finally, examples of outbreaks caused by intentional contamination illustrate the ease with which food could be used for terrorist purposes. In a 1984 outbreak in the United States, members of the Rajneeshee cult contaminated a salad bar in Oregon with Salmonella, causing 751 illnesses.9 In 1996, a disgruntled employee at a Texas hospital intentionally contaminated pastries, causing twelve cases of Shigella dysenteria.10 In Japan, curry laced with arsenic and sold at a community fair resulted in 60 illnesses and four deaths.11 More recently, in 2002, a baker in Nanjing, China spiked the flour of a competitor with rat poison, killing thirty-eight people.12 In a 2003 episode in the U.S., 200 pounds of meat at a Michigan grocery store were poisoned intentionally with an insecticide, sickening over 100 people.13 On a larger scale, events like these could be devastating to national and even world markets.

Food is also an obvious target for food scares. During the 2003 America's Cup race in New Zealand, a group calling itself "September 11" threatened to contaminate the food supply with cyanide. In letters addressed to the British and Australian High Commissions and the U.S. Embassy in Wellington, the group said it was "fighting for the rights of free Islamic people" and warned that 25 kilograms of cyanide had been stockpiled and would be put in the food supply if Iraq was invaded. A national security alert, including a warning to consumers to "Watch what you eat," set off a flurry of discussions about the effects of such a threat― the economic damage it might do to the multimillion-dollar America's Cup restaurant and hotel business, deterioration of relations with Arab countries, and the number of deaths it could cause.14

The globalization of the food industry makes New Zealand's problem emblematic of what every nation faces. The extent to which New Zealand authorities― or authorities in any country ― are prepared to detect and prevent such threats has an effect on all nations.

If disaster strikes, quick, efficient, and comprehensive action is an absolute necessity, on both governmental and non-governmental levels. Furthermore, such action must be coordinated and standardized so that appropriate authorities in each region can apply compatible methods to contain the risk and prevent the spread of disease to large numbers of consumers. Without a unified approach, we increase the risk for serious food-related outbreaks in the event of intentional or unintentional contamination of our food supply.


As crucial stakeholders, consumer organizations can play an important and constructive role in building strong food safety control systems. Historically, consumer organizations have educated the public about food safety risks, and influenced government policies and corporate practices on many public health issues. The principal objective of Safe Food International is to involve consumer and public health organizations in developing guidelines for non-governmental organizations (NGOs) to evaluate and help strengthen their national food safety programs. Those guidelines would aid consumer organizations in promoting changes to help ensure that national governments have the tools and the resources to manage food safety problems in a comprehensive and effective manner and to respond promptly to contamination events.

In brief, Safe Food International aims to unify and focus the efforts of consumer organizations worldwide in a collaborative effort to ensure that national food safety programs: a) address common food safety problems; b) approve both foods that are consumed domestically and those imported or exported for consumption; and c) provide deterrence for those who might consider using food as a target of intentional contamination.

SFI will present its "Guidelines for Consumer Organizations to Promote Food Safety in their National Governments" at an international meeting in Geneva, Switzerland during the spring of 2005.15 Consumer and public health organizations from developed and developing countries will be invited to attend the meeting and contribute to the Guidelines which will be finalized at the conference. Participants will include representatives of consumer and public health organizations from around the world. The final Guidelines will be distributed after the conference to NGOs and governments worldwide.

In collaboration with the WHO, FAO and the NTI Foundation, CSPI is undertaking this effort for the purpose of establishing dialogue and consensus among consumer groups internationally in order to establish a more unified approach to food safety advocacy.

CSPI has provided more than 200 NGOs worldwide with information on the project.16 Nearly fifty groups have already shown strong interest in attending the international conference and participating in the discussions which will shape a final, consensus-based document. Once the conference is formerly announced, interest among NGO will likely escalate further.

To better inform the conference, SFI has researched food safety problems in different regions of the world, in consultation with the consumer organizations in the various regions. In a set of regional reports, we have documented the wide variety of concerns consumer organizations on every continent share, including street food in India, clean water in many African countries, genetically modified foods in Europe, and common food-borne bacteria in North America.17 This type of information is extremely helpful in developing a more complete overview of food safety concerns in different parts of the world. Comments and suggestions on these regional reports are invited.

The regional reports and the Guidelines in English, Spanish and French are posted on our website, In the future, the website will also feature news and links to food safety educational materials from consumer organizations in various parts of the world.


SFI, in collaboration with the WHO, FAO, and the NTI Foundation, is taking the growing concern among consumer organizations worldwide about the safety of the food supply and channeling that concern into a consensus document for monitoring and improving national food safety systems. The landmark conference in Geneva, Switzerland will be the first formal discussion among consumer organizations about universal standards for strengthening national food safety control services and the beginning of improved international cooperation among advocates who wish to protect both the food and consumer confidence.

1 CSPI is also one of the founding members of the International Association of Consumer Food Organizations (IACFO), an international association of non-governmental organizations that represent consumer interests in the areas of food safety, nutrition, and related matters. IACFO has been granted observer status before the Codex Alimentarius Commission. For more information on IACFO, please see

2 World Health Organization, Terrorist Threats for Food: Guidance for Establishing and Strengthening Prevention and Response Systems, FOOD SAFETY ISSUES 10, 2002.

3 C. Smith DeWaal & K. Barlow, OUTBREAK ALERT! CLOSING THE GAPS IN OUR FEDERAL FOOD-SAFETY NET (S. Watkins ed., CSPI 6th ed. 2004), available at

4 T.W. Hennesy, C.W. Hedberg, L. Slutsker et al., A National Outbreak of Salmonella Enteritidis Infections From Ice Cream, 334 NEW ENG. J. MED. 1281-86 (1996).

5 Personal conversation between Caroline Smith DeWaal, CSPI, and CDC personnel during the outbreak investigation (1998).

6 M. L. Halliday, L. Y. Kang, T. K. Zhou, et al., "An epidemic of hepatitis A attributable to the ingestion of raw clams in Shanghai, China", JOURNAL OF INFECTIOUS DISEASE, November 1991; 164(5), pp. 852-859.

7 WHO Weekly Epidemiological Record, Vol. 71, No 35, 1996.

8 ASSOCIATED PRESS, Bad Milk Sickens Japanese, July 1, 2000.

9 J. McDade & D. Franz, Bioterrorism as a Public Health Threat, EMERGING INFECTIOUS DISEASES, July-Sept. 1998, at 493-494, available at (last visited Aug. 24, 2004).

10 Maryland Dep't of Health & Hygiene, Chemical and Biological Terrorism Events: Historical, BIOTERRORISM NEWSLETTER, June 2001, at page 2, available at

11 ASSOCIATED PRESS, Bad Milk Sickens Japanese, July 1, 2000.

12 ASSOCIATED PRESS, China Food Poisoning Investigated, Sept. 16, 2002.

13 M. Boulton et al., Nicotine Poisoning After Ingestion of Contaminated Ground Beef—Michigan, 2003, MORBIDITY MORTALITY WEEKLY REP., May 9, 2003, at 413-16.

14 P. Gower, P. Oliver & A. Perrott, Cyanide Letter Threat to Cup, NEW ZEALAND HERALD, Feb. 26, 2003, at A1.

15 The Guidelines were developed by Caroline Smith DeWaal, J.D., Food Safety Director at CSPI.

16 Dr. Lilly Papaioannou, a psychologist from Greece with a specialty in linguistics, is responsible for project-related communications with NGOs internationally.

17 The regional reports were prepared by Nadine Robert, a lawyer trained in France.