Role of Food Safety in Ensuring Food Security

1. Role of Food Safety in Ensuring Food Security Isabel Walls, Ph.D. National Program Leader, Epidemiology of Food Safety USDA National Institute of Food and Agriculture

2. National Institute of Food and Agriculture • Mission: • To advance knowledge for agriculture, the environment, human health and well-being, and communities • Support research, education and extension programs in Land Grant universities and other organizations • Fund competitive grants programs • Provide leadership in food safety

3. Overview • Link between food and water safety and food security • Food/ water safety is an essential public health issue • Severe economic impact of foodborne disease • Increase poverty • Food and water safety should be integrated into food security initiatives • Reduce post harvest losses • Improve market access for foods • Capacity building along the value chain

4. Public health issues • Global burden of foodborne diseases unknown • Poor surveillance data – global food supply • Impacts amount spent to control foodborne diseases given other priorities • WHO estimates 2.2 million deaths each year from diarrheal diseases • US: 48 million foodborne illnesses; 3,000 deaths/ year • Most illnesses- viruses; most deaths – Salmonella • Second biggest killer of children globally (WHO) • Most illnesses: Dysentery (Shigella) • Mostdeaths: E. coli, cholera

5. Cholera: Kansas City outbreak 1849 • In 2009, 45 countries from all continents reported cholera cases to WHO • Total number of cases: 221,226 • Deaths due to cholera: 4,946 • Cholera in Haiti – ongoing outbreak • Outbreak first reported October 20, 2010 • January 27, 2011 Ministry of Health of Haiti report • Cumulative number of cholera cases: 209,034 • Deaths due to cholera: 4,030 • Since 29 May 2011, MSF has treated almost 2000 patients in the capital

6. Cholera • Cholera is caused by the bacterium Vibrio cholerae • From eating food or drinking water contaminated by feces of infected persons • Prevented by safe water and sanitation systems • Prevented by washing hands with soap after using bathroom/ changing diapers • Raw/ undercooked seafood (crabs, oysters, shrimp) or vegetables/ fruit may be source of infection • If water contaminated • Need to fully cook or heat process food • Point of use water treatment

7. Global burden of foodborne diseases(Paul Torgeson, U of Zurich; Christine Budke & Hélène Carabin, Texas A & M and U. Oklahoma) • Pork tapeworm • Causes brain seizures/ epilepsy • Highly stigmatized, cannot marry, work, prone to injury • 100% preventable • Brucellosis – from raw milk • Causes fever – mimics malaria

8. Mold can result in aflatoxin contamination which causes various diseases. Contaminated food is rarely discarded in famine situations. • Hemorrhagic necrosis • Liver and lung cancer • Stunting of growth in infants • Immune suppression • Nutrition interference

9. Foodborne disease in USA • Certain pathogens cause serious, long term illnesses • STEC E. coli – kidney failure, stroke, death • Salmonella – reactive arthritis • Campylobacter – Guillain-Barré syndrome • Listeriamonocytogenes – meningitis, spontaneous abortion (20-30% mortality rate)

10. Economic impact of foodborne diseases • 2010 US report estimates costs at $152 billion/year • Healthcare costs very high for people with chronic illnesses • Economic losses due to sick adults/ caregivers who may need to take time off work • Sick kids not in school • Can impact travel/ tourism, e.g., cruise ship outbreaks

11. Economic impact of foodborne diseases • Loss of sales associated with 2006 spinach outbreak estimated at $1 million/ day • Loss of export markets • 2008: US exports of peanut butter products were halted, due to findings of Salmonella • 529 confirmed cases, 116 hospitalized, 8 deaths • Estimated cost $66 million • Processing plant closed

12. Link between food safety and food security: public health impact • Malnourished individuals more likely to have severe outcome from diarrheal diseases (Black, Pediatrics, 1984; Bhandari, Acta Pædiatrica 1992) • Vulnerable populations (infants; immunocompromized) more likely to have severe outcome • Cryptosporidium outbreak in Milwaukee, USA • (Mac Kenzie et al, NEJM, 1994) • Salmonella outbreaks among individuals with HIV • (Levine, J. Infect Dis 1991)

13. Link between food safety and food security: post harvest losses • Post harvest losses may be large (FAO, 2010) • Erroneous packing and transport practices • Contamination by micro-organisms • Physical damage • Process food/ improve packaging/ storage conditions – along the supply chain • Infrastructure – roads/ trucks/warehouses • Cold chain – keep food refrigerated/ frozen

14. Link between food safety and food security: Impact on trade (Buzby, 2003) • Increased market access needed for food surpluses • Cannot legally trade in contaminated food • Lack of knowledge of food safety standards and strategies to ensure safe food • Requires capacity building • Lack of market access can have devastating economic impacts • Contamination can result in loss of export markets • 2008 US closed market to Mexican tomatoes/ peppers after Salmonella outbreak – estimated cost $200 million

15. World Food Summit, 2009 • Food security exists when all people, at all times, have physical, social and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life

16. Four of the Millennium Development Goals are impacted by food safety: • Eradicating extreme poverty and hunger • Child mortality • Improving maternal health • Combat HIV/ AIDS, malaria and other diseases UN Millennium Development Goals (MDGs)

17. Integrating food safety into food security: Food safety capacity building • Foodborne disease surveillance systems • Enforceable regulatory framework throughout the food chain • Food safety standards • Provide education/ training for growers/ processors and food handlers throughout the food chain • Risk analysis • Supply chain management • Laboratory testing • Incident management

18. Risk analysis • Risk communication • Outbreak of E. coli O104 in Germany – cucumbers or bean sprouts? Not sure? • Risk assessment • What is the risk associated with the food? • What hazards are there? (Salmonella, E. coli) • What is the likelihood someone will get sick? • Risk management • Have you addressed the hazards? • Prevention/ control strategy • Verify control strategy is being used

19. CDC advice: 5 messageshttp://www.cdc.gov/haiticholera/five_messages.htm • Drink and use safe water • Wash your hands often with soap and safe water • Use latrines or bury your feces (poop); do not defecate in any body of water • Cook food well, keep it covered, eat it hot, and peel fruits and vegetables • Clean up safely—in the kitchen and in places where the family bathes and washes clothes • Wash yourself, your children, diapers, and clothes, 30 meters away from drinking water sources

20. Supply chain risk management – from production through consumption • Good agricultural practices • Water safety/ manure/fertilizer • Good manufacturing practices • Cooking temperatures/ times • Safe food handling, storage, transportation • Sanitation • Requires safe water • HACCP • System to prevent contamination of food • Consumer education

21. US Feed the Future Initiative Address root causes of hunger that limit potential of millions of people Will include food and water safety $12M to support the Africa-led Partnership for Aflatoxin Control in Africa Mitigate adverse effects of aflatoxin contamination on health and economic growth Support from a broad array of organizations and foundations

22. USDA food safety capacity building activities • Cochran/ Borlaug programs bring scientists to USA to learn agricultural/ food science • Workshops: Codex guidelines on setting food safety standards, Nicaragua, 2008 • Laboratory training – Central America • GAP to improve safety of melons • April 2008: US found Salmonella in Honduran melons – trade halted • August 2008: FDA / USDA joint training on GAP • December 2008: Trade re-established • 2009 imports to US from Honduras worth $33 million

23. USDA NIFA Research funding • NIFA Food Safety RFA • Applicants may include international partnerships in proposed projects that may contribute to the Feed the Future initiative • http://nifa.usda.gov/fo/foodsafetyafri.cfm • Letters of intent due July 5th 2011

24. Conclusion • Food safety is an integral element of achieving food security • Integrate food safety into food aid, food security and nutrition interventions, food crises and hunger emergencies (World Health Assembly, 2010) • In situations of food shortages and hunger, it is not enough to provide food, it is essential to provide safe food (FAO, 2004)

25. Contact Information Isabel Walls, Ph.D. National Program Leader, Epidemiology of Food Safety US Department of Agriculture National Institute of Food and Agriculture (202) 401-6357 iwalls@nifa.usda.gov