Experts stress need to act on foodborne infection data

Experts have identified four key areas that make the case for investing in foodborne disease data and turning information into action.

The four imperatives were revealed in a Health Talks series webinar as part of World Food Safety Day. They are health, economic, environmental, and governance.

Dr. Luz María De Regil, director of the Department of Nutrition and Food Safety in the World Health Organization (WHO), said: “We know the burden of unsafe food on health continues to be high and the more we measure we realize it is probably heavier than we anticipated before. The reality reminds us that there is urgent work still ahead. Many of the over 200 diseases that can be carried by food are preventable and sometimes eradicable. We will soon have new estimates on foodborne disease but the question is once we have them what can we do?”

Dr. Karen Keddy, co-chair for the country support task force in FERG for 2021-2025, gave an overview of previously published figures from WHO’s Foodborne Disease Burden Epidemiology Reference Group (FERG).

“There are regional differences and this makes it important for countries to understand their own burden of diseases. So, for instance, Africa may have the highest burden but Salmonellosis is found everywhere,” said Keddy.

“The largest burden from the intestinal flukes is in South East Asia. The largest aflatoxin burden is in Western Africa with a high burden in China and India. There are global considerations for foodborne diseases, it is not just about the acute episode but the long-term sequelae. Forty percent of the burden of foodborne diseases is in children under 5 years of age.”

The economic view
Dr. Steve Jaffee, from the University of Maryland, compared making the economic case to a courtroom scene where the judge is the Ministry of Finance and the jury are a group who don’t have food safety as a day job.

“For most policymakers the image of food safety is of highly trained professionals, some of whom are speaking Latin regarding the hazards and in acronyms in terms of the solutions. In early stages of capacity development, things appear to be getting worse as we are now shining light on areas where we didn’t have so much insight,” Jaffee said.

“Ultimately we need to go from data to storylines, to investment, to impact, to having stories about that impact which then yields more investment and longer-term impact. When making the economic case we can be thinking in three realms: export competitiveness, domestic market growth and human cost and loss avoidance.”  

Jaffee said communication has to be tied to where commitments are evident.

“Messages have to be tailored, we can’t just say all these people are sick, you need to reprioritize public spending. It should be a more positive message like around how investment in safer food yields outcomes in other areas. It is a challenge to translate better evidence on the burden of disease that communicates with policymakers who are thinking in terms of infrastructure and targeted support. It is finding how do you leverage your evidence to build on where there is already momentum.”

Dr. Vittorio Fattori, from the agrifood systems and food safety division in the UN Food and Agriculture Organization (FAO), spoke about how climate change is having an impact on food safety with hazards including mycotoxins and heavy metals.

“Changing agrifood systems are inviting more complexities in food safety and this is due to a multitude of differentdrivers and trends including technological innovation in food safety management and urbanization,” Fattori said.

“Climate change is having a direct influence on different type of food safety hazards. Some examples relate to food pathogens and parasites. There is evidence linking increasing temperatures and higher incidences of infection by Salmonella and Campylobacter.”

Fattori touched on issues such as collaboration among different stakeholders, sharing data, early warning systems and surveillance.

“It is critical to be proactive instead of reactive, and so gathering intelligence through foresight, understanding what some of the new drivers and trends may mean in terms of food safety implications is important. Sharing intelligence with different stakeholders is fundamental to make sure we can support policymaking that is more future oriented.”

New Zealand’s Campylobacter approach
Dr. Roger Cook, principle adviser for science and risk assessment at New Zealand Food Safety, shared how the country was tackling foodborne Campylobacter after being known as the “Campylobacter capital of the world”.

“How did we get this reputation? Well, we don’t eat raw chicken but we have an excellent infectious disease notification system called EpiSurv, that gave us some powerful information so we could baseline our level of Campylobacterosis. We also have annual reports that give us information about the level of foodborne disease throughout New Zealand,” Cook said.

“The next question was how can we use the data to find a solution? We put in place a Campylobacter strategy several years ago and more recently a Campylobacter action plan, which is led from the top. The most important thing is we implemented food safety culture. We have this whole governance structure from the minister for food safety to the consumer.  

“[In 2004] the rates of campylobacteriosis were way out of hand, the cost and burden on the health industry was high and we said enough is enough.”

Cook said data was presented to industry at a meeting in 2006 and a plan was created which led to a decline in rates even before regulation was in place. Another target of 70.2 cases per 100,000 was achieved in 2024.    

“We wouldn’t have been able to do that if we couldn’t see how all these mitigation measures were going,” Cook said. “We certainly wouldn’t have been able to do it without the Minister, industry, research organizations, retailers, consumer groups and consumers being on board. We still have 70 cases per 100,000 and our next job is to work out what we can do to get more improvement.”

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