English only
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| Agenda Items 5-9 | Conference Room Document 19 English only |
FAO/WHO Regional Conference on Food Safety for Asia and the Pacific
Seremban, Malaysia, 24-27 May, 2004
Cambodia Country Report on Food Safety
Cambodia is an agricultural country located in South East Asia with a total landmass of 181,035 square kilometers. It has a tropical climate with two distinct monsoon seasons (dry and rain seasons). The latest population census in 1998 recorded a total of 11.5 million people with an annual growth rate of 2.5 %. In Cambodia 84% of the population lives in rural areas. In 2002 the GDP was US$360. However, thirty six percent (36%) of the total population live below the poverty line, but in rural areas the percentage of the population that live below the poverty line rises to 79%.
Agriculture, mainly rice production, accounts for 40% of the GDP employing more than 70% of the workforce. The growth rate in agricultural employment is, however, slowing down. National disasters (annual flooding and drought) result in year-to-year fluctuations in the agricultural sector
Agro-based food production is one of the main characteristics of the Cambodia food production. The middle and small industrial sector play a crucial role in the nation's economic framework. Besides raw agricultural products (rice, maize, soy bean, green bean, fresh meat, fish, sea products, fruits, fresh water), milk, flour, soy sauce, fruit juices, beverages, bottled drinking water and etc. are locally processed. Food safety remains a major public health concern. Food-borne disease outbreaks are common and caused by mishandling of perishable food and unhygienic preparation, especially ready to eat food (in restaurants, street food, and hawkers).
Life expectancy at birth among females is 58.3 and male 54.5. Cambodia Demographic and Health Survey (CDHS) 2000 revealed high level of mortality among children and women: infant mortality rate 95 deaths per 1,000 live births, under five mortality rate 124 deaths per 1,000 live births, and maternal mortality rate 437 deaths per 100,000 live births. These mortality rates are highest in the region. Diarrheoal diseases, acute respiratory infection and vaccine preventable diseases cause about half of all deaths in the under-five age group.
1) In Patients for Cholera, Diarrhea, and Dysentery (source: MoH report)
Diarrhea syndromes |
1997 |
1998 |
1999 |
2000 |
2001 |
2002 |
Cholera |
146 |
212 |
- |
244 |
- |
- |
Diarrhea |
5,293 |
6,243 |
8,701 |
8,709 |
10,847 |
10,178 |
Dysentery |
2,078 |
2,071 |
2,266 |
1,976 |
3,470 |
2,632 |
Total (%) |
7,517(5.0) |
8,526(5.4) |
10,967(5.60) |
10,929(3.8) |
14,317(5.1) |
12,810(5.1) |
Total in patients reported |
150,433 |
156,945 |
195,790 |
291,248 |
283,140 |
250,301 |
2) Cases and Fatality Rate of Diarrhea, and Dysentery among In Patients
Fatality rate (%) |
1997 |
1998 |
1999 |
2000 |
2001 |
2002 |
Diarrhea |
35(0.66) |
41(0.66) |
103(1.18) |
70(0.80) |
54(0.5) |
54(0.5) |
Dysentery |
14(0.67) |
12(0.58) |
7(0.31) |
13(0.66) |
63(1.8) |
63(2.4) |
In 2002, fatality rates by dysentery were increased 3 times higher comparing with cases fatality rates in 1997.
3) Out Patients for Diarrhea
Cases |
1997 |
1998 |
1999 |
2000 |
2001 |
2002 |
Diarrhea |
382,604 (11.4%) |
354,743 (11.4%) |
266,410 (9.2%) |
301,224 (8.7%) |
304,834 (7.5%) |
333,612 (7.3%) |
Total out patients |
3,347,367 |
3,108,329 |
2,909,986 |
3,477,485 |
4,078,688 |
4,595,939 |
4) Food Safety Outbreak in Cambodia 1996 – 2004
Year |
Outbreak/Problem |
Effect |
1996 |
Drinking rice wine that mixed with some pesticide (to make it strong) |
40 deaths |
1998 |
Drinking rice wine that mixed with Methanol (to make it strong) in rice wine |
30 deaths |
2000 |
Eating puffer fish that had poison |
7 deaths |
2001 |
School children eating contaminated rice |
212 children/hospital |
2002 |
Eating meat from a dead marine turtle |
3 deaths/100 affected |
2003 |
Drinking contaminated well-water |
1 death/112 affected |
2004 |
Bird flu in farms near Phnom Penh and other two provinces |
3 outbreaks in provinces |
In 1993 a new system of developing legislation was introduced in Cambodia. Subsequently, there has been only one framework law that has been enacted and is related to products such as food. The Law on The Management of Quality and Safety of Products and Services (N0 0600/001) was approved on June 21, 2000. The law addresses "Production and Commercialization”; consumers' rights and economic operators' obligations; labelling; commercial fraud repression; action against products or services, which are likely to induce grave or imminent dangers; Inspection procedures for quality and safety of products, goods and services; and offences.
Since the Law has been approved, several actions have been taken to disseminate information about the law by using media, meetings at schools, and consumer education. In addition, the law has been applied in legal actions against any violators of the law's provisions. In addition, a number of sub-decrees have been endorsed since 1997. These include the following:
a) Sub- Decree N0 54 (22/09/97) – Sub-Decree on the Organization and Functioning of the Ministry of Commerce. Under this sub- decree the Ministry of Commerce assigns duty to the Department of Cambodia Import and Export Inspection and Fraud Repression (CAMCONTROL ) as follows:
b) Sub-Decree N0 64 (29/ 07/ 2001) relating to the designation and management of border control at the border gates, airport and the seaports of the Kingdom of Cambodia.
c) Sub-Decree N0 69 (October 20, 2003, Ministry of Planning) concerning the Management of Exploitation of Iodized Salt in the Kingdom of Cambodia. The purpose of this sub-decree is to eradicate iodine deficiency disorder by supplying properly iodized salt. The responsible agency in charge of quality and safety control is the quality control agency of the Ministry of Commerce, in cooperation with relevant ministries.
d) Sub-Decree No 67 (October 22, 1997) Identified that the Ministry of Health (MoH) is responsible for controlling the safety and the management of food. As a result, the MoH added 'Food and Cosmetics' to its existing Department of Drugs and Medical Devices. At present, the Department of Drugs and Food is responsible for food safety for the MoH. This sub-decree No 67 clearly and unambiguously defines the duty of the Ministry of Health to control the safety (and wholesomeness) of the food supply.
e) Sub-Decree No. 12 (February 2002) established the Department of Industrial Standards of Cambodia which is in charge of national standards development in order to improve the quality of local products, including food.
The system of food control in Cambodia is complex. To enhance coordination of the inspection of quality safety of products and services, an inter-ministries committee was established under sub-decree No 5: Establishment of an Inter-Ministerial Committee Coordinating Inspection of Quality and Safety of Products and Services. Another step to enhance coordination was the formation of the Cambodia national Codex committee (CNCC) in 2001. It is the same committee as the Inter-ministerial Committee Coordinating Inspection of Quality and Safety of Products and Services. Eight Members have been appointed to the CNCC. The CNCC is to consider matters related to policy on safety and quality of products and services, consumer protection and fair trade and to ensure coordinated action by relevant ministries. The Codex Contact Point is located within Camcontrol (Cambodia Import Export Inspection and Fraud Repression Department) of the Ministry of Commerce.
Significant control is exercised by the Ministry of Commerce and the Ministry of Industry, Mines and Energy (MIME). Camcontrol's officers inspect imported foods at the point of entry as well as foods for export. The inspectors also perform market monitoring throughout the country. The major focus of Camcontrol's activities is on preventing the distribution of unsafe, poor quality, adulterated, misbranded or contaminated products, including food.
The MIME is responsible for quality control in manufacturing industries. Under the sub-decree No. 4 (February 1992) on the Management and Quality Control of Industrial Products of Factories and Handicrafts and its related law, every three months, inspectors sample processed foods and undertake microbiological and/or chemical analyses in their laboratories on a diversity of products e.g. bottled water, rice wine, fish sauce and vinegar. Before issuing production licenses, the results of analytical testing should be satisfactory. Where there are no Cambodian food standards against which to interpret the results, Codex standards are applied. A limited number of national standards have been approved by the Industrial Standards Technical Committee.
The Ministry of Agriculture, Forestry and Fisheries has a key role in managing the safety and quality of agricultural products as they enter the food chain. Concerns exist that some meat entering the Phnom Penh market has not been inspected and may have been processed at illegal slaughtering operations. There are also concerns about movement of animals through Cambodian border checkpoints. The Ministry has nine checkpoints to control this issue.
The Ministry of Health has responsibility for all matters of public health, including assuring the safety and wholesomeness of food offered for sale in Cambodia. The Department of Drugs and Food has been requested to provide the Ministry with guidance in the creation of a fully integrated food control structure, involving all stakeholders in the food supply and food control chain. Implementation of the objectives of this program will help achieve the Ministry of Health's goals of safe food for all Cambodians. Ministry of Health is the focal point of the Asian Expert on Food Safety.
There are several sections with a laboratory in each of the key ministries including the National Institute of Public Health and the Department of Drugs and Food in MOH; fisheries, agronomy and animal health in MAFF; and laboratories in MIME, MOC and the Ministry of the Environment. In addition there are private laboratories such as the Pasteur Institute. There is however no coordinated programme of food surveillance and little analytical data regarding microbiological or chemical contamination of food.
Ministry of Health, Department of Drugs and Food, conducts monitoring of microbial and chemical hazards in foods. In relation to chemical hazards, analyses are limited but the Department is capable of the basic assessment of food colours. Ministry of Commerce, Camcontrol, also conducts assessment of microbial and chemical hazards in foods. Ministry of Industry, Mine, and Energy also conducts assessment of microbial hazards in foods. Ministry of Agriculture, Forestry, and Fisheries also conducts assessment of microbial hazards in foods. The Department of Agronomy and Agricultural Land Improvement laboratories conducts assessment of pesticide formulation and is planning to develop pesticide residue capability. Animal health authorities have recently set up a veterinary public health laboratory and are receiving support from Japan and Norway for training in analytical procedures of relevance. Upcoming training will focus on veterinary drug residues in imported meats and milk and in meat slaughtered in slaughterhouses in Cambodia. The Pasteur Institute can also determine antibiotic residues and evaluate the antimicrobial resistances of isolated cultures.
Cambodia does not have an active programme of food borne disease surveillance and outbreak response is often limited by the lack of available expertise.
Information, education, training and advice to producers, industry, consumers and regulators are quite variable across the different sectors of the food chain.
Cambodian legislation does not stipulate training requirements for food inspectors. Inspectors do not have degree level qualifications and have minimal training in risk-based approaches to food safety. However, key Camcontrol inspectors have received some training on quality control of food with the assistance of FAO. The purpose of this training was to ensure Camcontrol could effectively implement its responsibilities in relation to inspection of imported food.
The Ministry of Health plays a leading role in relation to food safety education for consumers. Within the Ministry of Health is the National Centre for Health Promotion. It is actively involved in health education and food safety for the public and for school children. Even though active the National Centre for Health Promotion has developed and uses only limited information, education and communication materials.
Agriculture authorities have conducted an extensive integrated pest management (IPM) programme in 15 provinces between 1998 and 2004. This programme (supported by DANIDA and WB) has trained 80,000 (less than 1-2% of the total farming population) farmers in IPM rice farmer communities. Village animal health workers conduct training as part of their regular duties.
The Ministry of Commerce has conducted several seminars and workshops at a national level on topics related to food safety including on how Codex works. In addition, the Ministry has a staff exchange program with other Asian countries.
However, because of the limitation of such efforts most farmers, fishermen, food processors, food handlers and consumers are still in need of education and training in relation to food safety. In order for food safety education and training to have a significant impact on the safety of food there is a great need for any programme to both be better focused and better resourced.
Still food control activities are weak and many examples of failure to control unsafe, fraudulent and improperly labeled food can be observed. Consequently Cambodia's food control authorities really need to ask how safe is the food in Cambodia, what the burden of food borne disease is both in terms of health and the economy of Cambodia, whether they want to better protect the population and facilitate economic development through enhanced trade in safe food and what they can do to improve on what is currently being done. This report looks at current concerns in Cambodia's food control system and identifies corrective actions to be taken.
Globalisation opens a window of opportunity that should allow Cambodia to learn from the mistakes of the developed countries that have spent significant time and resources trying to get their own food control strategies right. The country is at a point in the path to safer food where authorities can choose to either better coordinate food control activities using a risk-based farm-to-table approach or to make the mistakes already identified in developed countries. These mistakes have included:
Accession to the World Trade Organization and the signing of key agreements could very well provide the same momentum for a view of what is being done and what to do better as it has in other countries of the region, such as China and Viet Nam. Grasping this opportunity could provide an important catalyst for not only improving health but also improving the economy of the community.
In looking at how to implement an effective food control strategy focusing on risk reduction a number of guiding principles need to be applied. The principles include:
Cambodia needs to grasp these guiding principles and employ the building blocks as laid out by FAO and WHO from farm-to-table in a sector-wide approach to strengthen its food safety efforts, to better protect the health of consumers and to enable it to find an appropriate niche in the international trading market in food and food products.
A five-year action plan has been proposed by a Joint FAO/WHO mission to develop the food control system in Cambodia. The action plan emphasizes the importance of a coordinated and risk-based farm-to table approach. It provides for strengthening all key building blocks of a food control system including: