Uppsala, Sweden
14 March 2001

Food Chain 2001 - "Food Safety - a World-wide Challenge"

Minister Winberg,

Chairman Dalin,

Ladies and Gentlemen,

Ten years ago, food safety was not on many people’s mind in Europe. We all expected our food to be safe, not only because it generally was safe, but also because incidences of chemical or microbiological contamination were local in nature. So was the reporting about them. A conference like this one would not generate much interest beyond the people present.

What a contrast with the present. Today, food safety is one of the highest priority issues for consumers, producers and governments alike, all over Europe.

What has caused this change? The occurrence of BSE, of course, which brought with it the link to the terrible and fatal Variant Creutzfeldt-Jacob disease, created a widespread and deep-set unease about meat products. Yet, for a long time, continental Europeans left the worrying to the unfortunate British, safe in their conviction that the danger was contained by the Channel.

No longer. The consequences of BSE are felt across Europe and beyond. And the recent occurrence of foot-and-mouth disease spread alarm across Europe in a matter of days, even though it has no direct relation to human health. Through such and other incidents, European consumers have woken up to the reality that the trade in food and farm products is truly international – not least because countries of origin are clearly marked on supermarket produce. They are starting to discover the intricate network of international trade that underlies the food industry and brings products to supermarket shelves.

Still, based on evidence, it is clear that the main food safety problems are not the spectacular outbreaks which make their way into the media. In fact, the problem is a vast number of sporadic cases, many of which not only fail to reach the headlines; they don’t even make it into our reporting system.

As I look at the vast area of food safety from the vantage point of the World Health Organization, I see three major challenges to protect the health of the consumer:

• We need to accept that the systems we use in Europe to ensure food safety are not as good as we have come to believe. To improve these systems and re-establish consumer confidence, we must reassess them all the way from the farm to the table;

• We need to ensure reasonable food safety standards that apply throughout the world and assist all countries to reach these standards. In the long run, it is in our own self interest to do so. Secondly, unless we do so, developing countries cannot participate in global trading systems; and

• We must develop global standards for pre-market approval systems of genetically modified food to ensure that these new products not only are safe, but also beneficial for consumers and more efficient than existing products.

I will address these three challenges one by one. Let me begin with European food safety systems.

Between the 1950s and 1980s, we saw tremendous improvements in the safety of the food we eat in Europe. What we can call the "first wave" of food safety measures came with the pasteurization of milk and milk products and the introduction of rigid and effective hygiene systems in the production chain, mainly from the dairy and the abattoir to the supermarket.

The "second wave" of food safety measures came with the widespread introduction of HACCP; the hazard control system for the production chain.

Yet, since the early 1980s, we have seen a marked increase in the reports of food-borne diseases, resulting from chemical or pathogenic contamination.

The number of confirmed cases of human disease caused by Salmonella has increased significantly since 1985 – as much as five-fold in some European countries. For Campylobacter the increase has in some countries been even higher. Even though some of this could reflect better reporting, I believe everybody would agree that these problems are of a size that warrants action.

This situation, and associated loss of public confidence, suggest that something has gone wrong. We need a "third wave" of food safety measures.

This third wave must be a focus on the direct risk to humans. We need to begin with the epidemiology of food-borne diseases and track them back through the food chain, all the way to the farm. This represents a tremendous challenge for the governments of Europe.

It means building up the capacity – and making effective use of expertise in assessing risks to human health.

It means building up capacity for epidemiological tracking and mapping of food-related diseases, something that until now has held a rather low priority among most health authorities.

It means improving our data collection efforts for both the pathogens in the food and human disease, so that the data are comparable both along the whole food chain and between regions and countries. We always have to remember that food chains are international.

And it will mean that officials concerned with agricultural productivity, and officials responsible for the health of populations, work together. Not only must they communicate. They must collaborate closely so that they can quickly trace back each incident of suspected food-borne disease to its source, analyse the size and geography of the problem and suggest both short and long term remedial measures.

This all calls for political action. People – both as consumers and producers – expect their government officials to work together for the common good. They demand this of those who represent them in government. Not only do they expect their politicians to make sure that government works in the primary interests of those who consume food: they also expect politicians to take action based on expert evidence. This calls for political courage, and for openness in government processes, so that risk assessment and analysis are transparent and available for public scrutiny. Only then can public health be maintained, and – at the same time – consumer confidence be restored.

This will mean a restructuring of agricultural ministries so that they move beyond a primary focus on economic issues. They need to represent the interests of the whole community – producers, processors and consumers. This kind of transformation will make for a healthier base for the future of the industry: this is already taking place in several European countries.

The current efforts of the European Commission to strengthen and focus the scientific advice for food safety is an important contribution to the reforms already taking place in several countries.

It will also mean that ministries of health have to take interest in, and give priority to, action to monitor and prevent food-borne illness. They would need to strengthen their food safety resources and improve collaboration with other ministries. An incident of suspected food poisoning should no longer just be seen by doctors as a temporary health problem. It should be considered as a possible symptom of break-down in the food-safety system, and those who see patients need more help to decide what kind of event to report to public health authorities.

Food safety law has traditionally focused on enforcement tools for removing unsafe food from commerce and punishing responsible parties after the fact, in stead of providing a mandate to prevent food safety problems. The result has been food safety programs that are reactive and enforcement oriented rather than preventive and holistic in their approach to reducing the risk of food-borne illness. When developed as well as developing countries try to develop new systems they should integrate strategies for reducing the most significant risks throughout the food system.

I am optimistic that such changes will be possible – even speedy. Ironically, the BSE calamity has moved thinking forward. Twenty years on, I am certain we will look back at the BSE outbreaks as a watershed. It has thoroughly changed the way we look at food safety.

One of the consequences is the focus it has put on the first link in the food chain: the farm.

During the middle 20^th century, as attention was given to the abattoirs, the factories and the supermarkets, the farm was for decades thoroughly neglected as a battlefield against microbial and chemical contamination. Yet, it is so obvious, really; if one can ensure contamination free animals and poultry, it is so much easier to keep the products contamination free through the rest of the food chain.

Take salmonella, one of the major factors of food-borne disease in Europe. Until recently, market forces created by high volume purchases of food by small numbers of companies led to an extreme pressure on producers to lower prices of meat and other perishables. Food producers found that it was un-competitive to invest in ensuring that all herds or flocks were salmonella free. Resources were instead invested in treating contaminated products so that they should be safe by the time they reached the consumer.

Sweden, however, didn’t accept this dictum, and over the past decade, this country has managed to practically eradicate salmonella from its poultry stock. This is a truly impressive feat, and interestingly, it has not led to any substantial increase in the price of poultry.

Salmonella, together with Campylobacter as well as the new pathogens, such as BSE, are microbiological contaminations that form a key threat to our food safety.

But we should also pay close attention to chemical and radiological contamination of food. Let me just list a few serious incidents the past few years:

• Dioxins that was found in poultry in Belgium 1999 lead to widespread trade disruption and losses of hundreds of millions of Euros.

• An incident of toxic mustard seed oil in India in 1998 led to a number of reported deaths.

• We all remember the contamination by radio-nuclides in food after the Chernobyl accident in 1986 which led to a subsequent contamination of wide areas of Western Europe, and

• The case of toxic cooking oil in Spain in 1981 with a toll of 800 dead and 20,000 injured.

As with microbiological contamination, periodic outbreaks for chemical poisonings appear in the global media. But the more serious health hazards posed by chemicals in food are chronic and they often build up over time without immediate symptoms.

While many microbiological contaminants of raw food can be eliminated through proper heat treatment in the kitchen, the consumer will in most cases have no way of avoiding chemical contamination in food. The protection of consumers from chemical hazards can therefore only be assured by government intervention.

Consumer confidence in the government has fallen parallel with their confidence in the safety of the food supply. As a minimum, governments urgently need to assure that:

• all chemicals that are intentionally added to food are assessed for risk before they are introduced into the food supply.

• effective monitoring and enforcement programmes for such chemicals as well as for contaminants must be in place to protect the public.

As most chemicals cannot be removed from food or otherwise be detoxified once they enter food, it is essential that all persons working at all stages of the food chain understand the importance of the safe use of chemicals.

There should also be a concerted effort to reduce the use of antibiotics in food. WHO has strongly warned against the dangers of growing resistance to antibiotics, and one important source of such resistance is overuse in food products.

Caution, whether applied as an approach or as a principle, must in any case be at the base of any food safety policy of any country.

Let me now turn to the second challenge: the globalization of food safety standards.

But first let me remind all those instinctively worried about agricultural imports from the developing world of a simple fact: All the major food scares in Europe over the past decade or two have originated here at home. In fact, many developing countries – with good reason – are worried about agricultural imports from Europe. Europeans should be careful to lecture others about food safety.

That said, there is a lot we can contribute towards global food safety. We have resources, we have experience and we have learned many lessons. There is no reason why other countries shouldn’t be able to leap-frog past the past fifty years of development up to modern, globally acceptable standards.

Why is this so important?

Firstly, because of the devastating cost of food scares. As the trade in food and farm products goes global, the costs involved in each food scare are rising sharply. We are talking about sums so large that they could be devastating to the budgets of the European Union. The United Kingdom has alone spent more than $6 billion in sorting out its own BSE crisis, and that does not include job-losses. Its beef product exports are still down 99% from 1995 and the economic effects can still stretch on another 15 years. Continental Europe has seen a painful drop in meat sales.

There is a close and important link between health and economic development. Not only can the economic consequences of contaminated food be staggering. The economic opportunities for developing countries that can ensure satisfactory food safety standards are substantial.

It is of crucial economic interest to developing countries to achieve quality and safety for their products at international levels. And it is in the interest of the industrialized countries to help them achieving this.

Fear of competition from cheap imports should not be an argument for delaying such assistance. In order to ensure the safety of foods consumed, we need to develop global food safety. The technical and financial assistance from the developed world to the developing world is the cornerstone to achieve this.

Secondly, because in a globalized world, we all swim in a single microbial sea. As the movement of people and trade of foods – including ingredients and food animal feeding stuffs – becomes more and more global, it turns out to be more and more difficult to solve food safety problems by one country without international collaboration and a consolidated strategy to combat problems.

There is no Maginot Line for food safety. Confiscating sausages and seeds at the airport makes little difference when one imports tons of fish or animal feed. The only real way of ensuring that what is on ones own plate is safe is to make certain that what is produced at a farm on the other side of the globe is also safe.

Thirdly, because food-borne diseases amount to an enormous global health problem.

The true incidence of food-borne diseases is often difficult to evaluate. In many instances, only a small proportion of cases comes to the notice of health authorities, and even fewer are investigated. It is believed that in industrialized countries less than 10% of the cases are reported, while in developing countries reported cases probably account for less than 1% of the total.

WHO estimates that world-wide almost 2 million children die every year from diarrhoea, most of this caused by microbiologically contaminated food and water. Even in industrialized countries it is estimated that one third of the population suffers from food-borne disease every year, and out of these maybe up to 20 per million die. When you consider that this basically only relates to microbiological problems and you add to these figures the potential of chemical contamination of food, the situation becomes even more serious.

To ensure global food safety, the voice of developing countries should be well-heard and developing countries should be a key player. Thus, participation of developing countries in the process of international rule setting, such as the Codex Alimentarius Commission is important. Industrialized countries will find it is in their interests to ensure that this happens in the near future.

WHO and its Member States is recognizing food safety as a world-wide challenge. For the first time in many years the World Health Assembly passed a food safety resolution in May 2000 with reference to food safety as an essential public health issue. The resolution focuses on the need to develop sustainable, integrated food safety systems for the reduction of health risk along the entire food chain. WHO is doing this in collaboration with FAO, and notably within the FAO/WHO Codex Alimentarius Commission, and we have over the past year substantially increased our resources in this area.

WHO’s European Region has also adopted a Food and Nutrition Action Plan, endorsed by all 51 Member States. Progress towards implementing the plan will be measured at a Ministerial Conference in 2005.

Now to my third theme – biotechnology and food.

Modern technologies such as biotechnology must be thoroughly evaluated if they are to become a true improvement in our way of producing food.

Public health can benefit enormously from biotechnology’s potential to increase the nutrient content of foods, decrease their allergenicity, and improve the efficiency of food production. On the other hand, the potential negative effects on human health of the consumption of food produced through genetic modification must be carefully examined.

There is no way to escape from the fact that the new foods derived from genetic modification are another major area of concern of many consumers.

A number of statements from regulators, producers and scientists involved in the area of biotechnology seem to suggest that they feel the problems originate in the consumers incapacity to understand and scientifically compare the risk of biotechnology foods to the risk of traditional food.

To base future deliberations upon this view could be a very serious second mistake. The first mistake has been not to involve consumers – and other interested parties – in the risk analysis process. The process of a scientific assessment and the following management decisions was considered by many regulators to be too complicated for the common consumer.

We should instead acknowledge the consumers right to be concerned as well as to be informed. In realizing the increased need for communication of risk, the goal for the regulators should not only be to gain the trust of the consumers. The main communication challenge is to adequately address all potential effects of genetically modified food, and in doing so acknowledging the input from all interested parties participating in the overall risk analysis process.

So far, we have not succeeded. Many consumers have not been able to see any benefit from biotechnology food and they do not feel informed of the process of assessing such foods.

By effectively performing and communicating this process, the evaluation system will earn the trust of the consumers. WHO has together with FAO and through the Codex system initiated a process to get international agreement and standardization in this area.

Safety is a key issue, but it is not the only one. We must also answer questions about whether genetically modified food is beneficial, and for whom. European consumers have not been impressed by arguments that they should eat modified maize and beans because these new varieties are cheaper to produce and therefore increase profits for the farmers. They may have been more willing to listen to arguments that, since they are more resistant to insects, the new varieties need less use of insecticides and therefore are more environmentally friendly. But these arguments have been largely countered by those claiming we know too little about the ecological consequences of the gene manipulations.

When new products with specific benefits for the consumer will hit the market in a not too distant future, this debate may take a different turn. We all know of the so called ‘Golden Rice’, which could be a powerful tool to combat Vitamin A deficiency – a major cause of blindness amongst children in Africa and South-East Asia.

Yet, such claims from the inventors of such varieties will not be taken at face value. The efficiency of such foods to combat Vitamin A deficiency and other deficiencies need to be compared to other existing methods to promote health.

There are many questions to answer: Do we know that golden rice will be more effective in preventing Vitamin A deficiency than current methods of giving Vitamin A in connection with vaccinations? Will the rice be more expensive than ordinary rice, and would this mean that the poorest will be excluded from access to it? Should golden rice replace ordinary rice, or only supplement it? Is it acceptable in all or only in some cultures?

And, of course, possible adverse health and environmental effects need to be addressed. The scope should include both safety, nutritional and environmental aspects, as well as efficiency and socio-economic considerations. We must agree on standardized methodology at the international level also in this area. A regulatory framework should be in place to form pre-market evaluations – not ad-hoc tests after the products have come on the market.

Monsanto and other companies have learned these lessons at a great cost.

Chair,

With the EU Presidency bringing together key figures from the producer, processor, consumer advocacy and regulator communities, I hope that, from a public health perspective, this meeting will confirm the commitment of all concerned with food continuing to ask five key questions:

• How safe is the food we produce - and sell - for people to eat?

• What can we do to reduce the risks of harm?

• How can we establish systems that minimize this risk of harm, both now and in the long term?

• How can these systems be set within the context of global food safety standards?

• How can we ensure a broad evaluation of risks as well as benefits of new food technologies?

This approach will, I am sure, increase the long term prospects for the world’s food industries and ensure real improvements in food-borne disease prevention as well as in consumer confidence.

Thank you.