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NEM/REP 1

FOOD AND AGRICULTURE ORGANIZATION


OF THE UNITED NATIONS

WORLD HEALTH
ORGANIZATION

FAO/WHO Regional Meeting on Food Safety


for the Near East
5-6 March 2005
Amman, Jordan

Practical Actions to Promote Food Safety

FINAL REPORT

FOOD AND AGRICULTURE ORGANIZATION OF THE UNITED NATIONS


Rome, 2005

For further information on the activities of the FAO/WHO Regional Meeting


on Food Safety for the Near East, please contact:

The Joint Secretariat of the Regional Meeting on Food Safety for the Near East
c/o Food Quality and Standards Service
Food and Agriculture Organization of the United Nations
Viale delle Terme di Caracalla
00100 Rome - Italy
Fax. No.: + 39 06 57054593
E-mail Address: Food-Quality@fao.org

or

The Joint Secretariat of the Regional Meeting on Food Safety for the Near East
c/o Food Safety Department
World Health Organization
20, Avenue Appia
CH-1211 Geneva 27 - Switzerland
Fax. No.: + 41 22 7914807
E-mail Address: foodsafety@who.int
Web site: www.fao.org/es/ESN/food/meetings_neareast_en.stm

Issued by the Secretariat of the FAO/WHO Regional Meeting on Food Safety for the Near
East, FAO, Rome

NEM/REP 1

FAO/WHO Regional Meeting on Food Safety


for the Near East
5-6 March 2005
Amman, Jordan

Practical Actions to Promote Food Safety

The designations employed and the presentation of material in this


information product do not imply the expression of any opinion
whatsoever on the part of the Food and Agriculture Organization of
the United Nations concerning the legal or development status of any
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delimitation of its frontiers or boundaries.

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FAO 2005

FAO/WHO Regional Meeting on Food Safety for the Near East

iii

FOREWORD
Ensuring safe and healthy food is essential for improving human life in all countries, whether
developed or developing. Rather than being a luxury of the rich, all people should have the right
to an adequate supply of safe and nutritious food. The importance of safe food, whether
domestically produced and consumed, imported or exported, is well known by the countries of the
Near East region, as the region relies on imports for over 60 percent of its food supply, while in
some countries this level can be as high as 90 percent. In some countries of the region, food
exports are an important source of foreign exhange earnings, so compliance with international
market requirements and quality and safety standards is essential. These standards have become
increasingly complex, and at times, stringent, demanding greater vigilance and investment.
The countries of the region recognize the importance of developing practical actions and
recommendations for capacity building to promote food safety in the region. Accordingly, at the
request of the delegates of the region in an informal meeting at the 27th Session of the Codex
Alimentarius Commission (Geneva, July 2004), following the guidance of the FAO/WHO
governing bodies, in line with the suggestions made by the participants at the first and second
Joint FAO/WHO Global Fora of Food Safety Regulators (GF1- Morocco, January 2002 and GF2Thailand, October 2004), and at the kind invitation of the Government of the Hashemite Kingdom
of Jordan, FAO and WHO jointly convened a Regional Meeting on Food Safety for the Near East
in Amman, Jordan from 5 to 6 March 2005.
The Meeting was held as part of a series of regional events that FAO and WHO are jointly
organizing to meet the needs of member countries for policy guidance and capacity building in
food safety, the first of which was held in Budapest in February 2002 for the European region and
the second of which was held in Seremban, Malaysia in May 2004 for the Asia and Pacific
Region. Over 90 delegates from 11 member countries of the Near East Region and observers
from 5 international governmental and non-governmental organizations participated in this
Meeting, under the general theme of Practical Actions to Promote Food Safety.
The participants at the Meeting affirmed that the countries of the region recognize the need for
institutional reforms toward unified national food safety agencies, broader data collection and
surveillance of food borne diseases, increased investment in food inspection services and
laboratories and increased regional cooperation in the harmonization of food safety standards and
regulations and in the equivalency of food safety systems. Within this context, the Meeting made
numerous recommendations of practical actions to strengthen food safety systems in the region. It
was generally recognized by the participants that although the convening of the Meeting itself was
successful, its true success can only be measured by the degree of implementation of the
recommendations of the Meeting and the improved safety of foods produced and consumed in the
region.

iv

FAO/WHO Regional Meeting on Food Safety for the Near East

ACKNOWLEDGEMENTS
The Joint Secretariat of the FAO/WHO Regional Meeting on Food Safety for the Near East
wishes to express its sincere thanks to all those that contributed towards the success of this
Meeting, in particular to the Jordanian authorities for their efficient organization of the Meeting
and their warm hospitality. The Joint Secretariat also expressed its thanks to the Chair, ViceChairs, and Rapporteur of the Meeting for their dedicated hard work and the exceptional manner
in which they conducted the meeting; all those who prepared Conference Room Documents and
those who made interventions during the Meeting; and last, but not least, to the members of the
press for their excellent coverage of the event.

FAO/WHO Regional Meeting on Food Safety for the Near East

CONTENTS

I.
II
III.
IV.
V.
VI.

EXECUTIVE SUMMARY ...............................................................................................1


INTRODUCTION ...........................................................................................................2
OPENING CEREMONY (AGENDA ITEM 1).....................................................................2
DESIGNATION OF MEETING CHAIRS AND RAPPORTEUR (AGENDA ITEM 2) ................3
ADOPTION OF THE AGENDA (AGENDA ITEM 3)...........................................................3
FOOD SAFETY AND TRADE: THE IMPACT OF FOOD SAFETY STANDARDS ON FOOD
AND AGRICULTURAL TRADE IN THE NEAR EAST (AGENDA ITEM 4) ............................3
VII. FOOD SAFETY AND HEALTH: THE IMPACT OF CURRENT FOOD SAFETY SYSTEMS
IN THE NEAR EAST ON HUMAN HEALTH (AGENDA ITEM 5).........................................4
VIII. NATIONAL FOOD SAFETY SYSTEMS IN THE NEAR EAST: A SITUATION ANALYSIS
(AGENDA ITEM 6) ........................................................................................................5
IX. REGIONAL, SUB-REGIONAL AND NATIONAL COOPERATION IN FOOD SAFETY
IN THE NEAR EAST (AGENDA ITEM 7) .........................................................................7
X.
RECOMMENDATIONS OF THE MEETING.......................................................................7
XI. ADOPTION OF THE REPORT .......................................................................................10
XII. CLOSING OF THE MEETING .......................................................................................10

ANNEX 1: LIST OF PARTICIPANTS ........................................................................................11


ANNEX 2: PROVISIONAL AGENDA (NEM 05/1) ...................................................................20
ANNEX 3: OPENING SPEECH OF DR HUSSEIN A. GEZAIRY, WHO ......................................21
ANNEX 4: OPENING SPEECH OF MR HARTWIG DE HAEN, FAO ..........................................23
ANNEX 5: OPENING SPEECH OF H.E. DR AHMAD AL-HINDAWI, MINISTER OF TRADE,
JORDAN ..............................................................................................................26
ANNEX 6: MEETING DISCUSSION PAPERS ............................................................................28
ANNEX 7: CONFERENCE ROOM DOCUMENTS .....................................................................59

FAO/WHO Regional Meeting on Food Safety for the Near East

Report of the FAO/WHO Regional Meeting on Food Safety


for the Near East
Amman, Jordan, 5-6 March 2005
I.

EXECUTIVE SUMMARY

A Regional Meeting on Food Safety for the Near East, jointly convened by the Food
and Agriculture Organization of the United Nations (FAO) and the World Health
Organization (WHO), took place from 5 to 6 March 2005 in Amman, Jordan, at the kind
invitation of the Government of the Hashemite Kingdom of Jordan. Over 90 delegates from
11 member countries of the Near East Region and observers from 5 international
governmental and non-governmental organizations participated in the meeting, which was
designed to i) exchange information on food safety programmes and food control systems in
the countries of the Near East region; ii) Identify practical actions to strengthen national food
control systems in the countries of the region; iii) Promote the strengthening and/or the
establishment of regional and sub-regional networks for the exchange of food safety related
information and experiences among all stakeholders; and iv) Identify opportunities for
improving regional cooperation in promoting food safety.
Countries have recognized the need for increased national attention and international,
regional and national cooperation to strengthen food safety systems in the countries of the
Region. Within this context, the Meeting made numerous practical recommendations to
strengthen food safety systems in the countries of the Region. The key recommendations
made can be summarized as follows:

The large majority of countries of the region must urgently give higher priority to
building their capacity to respond to the unacceptable burden of illnesses caused by the
consumption of unsafe food.

Governments should consider institutional reforms which work toward unified food
safety agencies.

Investment in food inspection services and laboratories must be enhanced to ensure the
safety of the food which is consumed in the region and that which is produced and
exported from the countries of the region.

There is a need to establish or strengthen national food-borne disease data collection


and surveillance programmes in each country of the region and to facilitate timely intercountry exchange of relevant information.

To supplement national actions, governments of the region should make better use of
resources available in the region including, for example, specialized reference
laboratories, established surveillance systems, and training capacities.

A regional task force should be created to ensure the transfer of successful experiences
in various components of food safety management.

FAO, WHO and other concerned international agencies and donors are called upon to
support initiatives to address the food safety challenges and to play a more active role in
developing programmes for intra-regional cooperation.

FAO/WHO Regional Meeting on Food Safety for the Near East

II INTRODUCTION
1.
The Food and Agriculture Organization of the United Nations (FAO) and the World
Health Organization (WHO) jointly convened the FAO/WHO Regional Meeting on Food
Safety for the Near East (the Meeting) in an effort to facilitate discussion on practical actions
and recommendations to promote food safety in the countries of the Near East region. The
Meeting was held in Amman, the Hashemite Kingdom of Jordan (Jordan) from 5 to 6 March
2005 at the kind invitation of the Government of the Hashemite Kingdom of Jordan. The
Meeting was attended by high ranking policy officers and technical experts from 11 member
countries of the Near East Region of FAO and the Eastern Mediterranean Region (EMRO) of
WHO. It was also attended by 5 international organizations as observers. A list of all
participants is included in Annex 1.
2.
This meeting is part of a series of global and regional events that FAO and WHO are
convening to meet the needs of member countries for policy guidance and capacity building
in food safety. This series includes the First and Second FAO/WHO Global Fora (GF) of
Food Safety Regulators (GF1 - Morocco, 28 to 30 January 2002 and GF2 - Thailand, 12 to 14
October 2004), the Pan-European Conference on Food Safety and Quality (Hungary, 25 to
28 February 2002) and the FAO/WHO Regional Conference on Food Safety for Asia and the
Pacific (Malaysia, 24 to 27 May 2004). The Meeting was convened in light of the
recommendations and feedback from these events, direction from FAO/WHO governing
bodies, and the request of delegates of the region in an informal meeting at the 27th Session of
the Codex Alimentarius Commission (Geneva, July 2004).
3.
Further aims of the Meeting were to i) Exchange information on food safety
programmes and food control systems in the countries of the Near East region; ii) Identify
practical actions to strengthen national food control systems in the countries of the region; iii)
Promote the strengthening and/or the establishment of regional and sub-regional networks for
the exchange of food safety related information and experiences among all stakeholders; and
iv) Identify opportunities for improving regional cooperation in promoting food safety, taking
into account the prevailing conditions in the entire food chain.
4.

The Provisional Agenda for the Conference is found in Annex 2 (NEM 05/1).
III. OPENING CEREMONY (AGENDA ITEM 1)

5.
The opening ceremony began with a statement from the Regional Director for the WHO
Eastern Mediterranean Region (EMRO), given on his behalf by Dr Mohamed Aideed Elmi,
Regional Advisor, Food and Chemical Safety, WHO EMRO. In his presentation, he reminded
the Meeting of the growing food safety concern in the world and of the burden of food-borne
disease has on the world population. He recalled that in 1999, the WHO EMRO Regional
Committee adopted the Regional Plan of Action for Food Safety, which has led to a number
of new initiatives in this regard both at the national and regional level. The World Health
Resolution (WHA 53.15) which recognized the importance of food safety for public health
was also mentioned. The speaker expressed his hope that the Meeting would lead to concrete
actions to improve food safety in order to achieve the goal of safe food for all. The text of his
address is appended as Annex 3.
6.
In his opening remarks on behalf of FAO, Mr Hartwig de Haen, Assistant DirectorGeneral, Economic and Social Department, informed the Meeting of the series of regional and

FAO/WHO Regional Meeting on Food Safety for the Near East

global events that FAO and WHO are jointly organizing to provide fora for food safety
officials to share information on national experiences in regulating and promoting food safety.
He highlighted the importance of food safety for all people, in the interest of both public
health and economic efficiency and competitiveness. He recalled the challenges for the
countries of the region to improve the efficiency and effectiveness of their food control
systems and the specific conditions of the region in relation to the importance of food imports
and exports, which increase the potential of food safety risks. Mr de Haen further informed
the Meeting of various actions taken by FAO, in partnership with WHO and other
organizations, to assist member countries in their efforts to improve food safety and quality
and reiterated his Organizations readiness to further expand its capacity building programme
to assist the countries of the region in this field, if funds become available. The text of his
speech is appended in Annex 4.
7.
The Meeting was officially opened by His Excellency, Dr Ahmad Hindawi, Minister of
Industry and Trade of Jordan, who thanked FAO and WHO for providing Jordan the honour
of hosting this Meeting and for their work in improving food safety in the region. The
Minister highlighted the importance for the countries of the region to influence and meet
international food standards, in order to encourage increased food exports from the region, as
well as to ensure the safety and wholesomeness of imported food, in an increasingly global
trading environment. The critical role of the WTO SPS and TBT Agreements in this trading
environment, as well as the value of implementing a risk based approach to food safety, was
mentioned. The need for strengthening international and regional cooperation in order to
achieve improved food safety at the national level was also emphasized. The Minister noted
the importance which Jordan places on food safety, as evidenced by their hosting of this
Regional Meeting and by the various initiatives currently underway to improve their national
food control system, including the updating of national rules and regulations for food control.
The text of his speech is appended as Annex 5.
IV. DESIGNATION OF MEETING CHAIRS AND RAPPORTEUR (AGENDA ITEM 2)
8.
The Conference designated Dr Saleh Mowajdeh of Jordan as Meeting Chairperson, Dr
Ibrahim S. Al-Mohizea of Saudi Arabia, and Mr Amarah Meftah of Tunisia as vicechairpersons and Dr Fahmi Saddiq of Egypt as Meeting rapporteur. The Meeting expressed
appreciation to these members for their agreement to serve in these roles.
V. ADOPTION OF THE AGENDA (AGENDA ITEM 3)
9.
The Meeting adopted the proposed agenda and agreed to the timetable as presented by
the secretariat.
VI. FOOD SAFETY AND TRADE: THE IMPACT OF FOOD SAFETY STANDARDS ON FOOD AND
AGRICULTURAL TRADE IN THE NEAR EAST (AGENDA ITEM 4)
10. Dr Fatima Hachem, Food and Nutrition Officer for the FAO Near East Region,
presented the contents of the first discussion paper on Food safety and trade: the impact of
food safety standards on food and agricultural trade in the Near East (NEM 05/2). All the
discussion papers and Conference Room Documents (CRDs) for the Conference can be found
in Annexes 6 and 7. The paper addressed the importance of food and agricultural trade to the
region, as well as the challenges, constraints, and impact of food safety standards to this trade.
The presenter discussed the importance of the WTO SPS and TBT Agreements, as well as the

FAO/WHO Regional Meeting on Food Safety for the Near East

costs of compliance with these measures. The need to control both imported and exported
foods, as well as examples of banned and detained food exports were also presented. The
speaker also noted the increasingly important role of voluntary standards in international food
trade. A number of recommendations were suggested, which are included in a subsequent
section of this report.
11. The Meeting welcomed the document, thanked FAO for presenting the paper, and
highlighted the essential role of both food trade and food safety in the Near East region.
12. The Meeting stressed the need for comprehensive capacity building in national food
control systems. This includes adequate training on subjects such as HACCP, strengthening
national food legislation and regulations, as well as increasing investments to improve the
necessary infrastructure, such as food control laboratories and food inspection services. The
need for awareness raising along the entire food chain and implementation of a risk based
approach were also highlighted.
13. The Meeting discussed the importance for the countries of the region to be involved in
the Codex process, but also the increasingly stringent standards applied by developed
countries, which often deviate from those established by Codex. These standards were cited
as responding to consumer demands in those countries, rather than being producer driven.
The Meeting stressed that national standards for both domestic and international markets
should be the same and discussed the mechanisms which are in place to regulate international
food trade. The importance of the guidelines, codes of good practice, manuals and other
related texts which are developed by Codex, FAO, OIE and WHO in this regard was also
emphasized.
14. The Meeting suggested that common principles for food policy, including the
harmonization of regional standards, should be established for the region in order to increase
intra-regional trade and to protect consumers throughout the world. The development of an
information exchange network for rejected shipments and other trade related information
between the countries of the region was discussed. The Meeting also emphasized the
importance of regional and sub-regional groupings in improving food safety.
VII. FOOD SAFETY AND HEALTH: THE IMPACT OF CURRENT FOOD SAFETY SYSTEMS IN THE
NEAR EAST ON HUMAN HEALTH (AGENDA ITEM 5)
15.
Dr Mohamed Elmi, WHO EMRO, presented a paper on the impact of current food
safety systems in the Near East on human health (NEM 05/3). The paper addressed the issue
of food-borne diseases, food-borne disease surveillance, and the need for integrated action to
overcome the challenges of reducing the incidence of food-borne disease in the region. The
speaker presented the results of a survey carried out by WHO EMRO on food-borne disease
surveillance in the region, as well as examples of national food-borne disease surveillance
systems. It was noted that few comparative studies or data on the incidence of food-borne
disease in the region was available due to under reporting. A number of recommendations to
improve human health through strengthening food safety were presented, which are included
in the appropriate section of this report.
16. The Meeting welcomed the document, thanked WHO for presenting the paper, and
highlighted the essential role of food safety in improving human health in the Near East
region.

FAO/WHO Regional Meeting on Food Safety for the Near East

17. The Meeting emphasized the importance of raising the awareness of the public,
including physicians, of the importance of reporting food-borne diseases, while at the same
time increasing efforts to strengthen food-borne disease reporting and surveillance to generate
data to convince the public of its importance. It was noted that all stakeholders in food safety,
including veterinarians and officials from the agriculture, food control, and public health
sectors, and others must share their data in a transparent manner in order to target
interventions to the proper commodity or process which caused a particular food-borne
disease. The Meeting noted that the incidences of food-borne disease are high, even in
developed countries such as the United States of America. It noted the need to improve
national food-borne disease surveillance systems in the countries of the region before a
regional approach would be effective. The need to prioritize available resources for control of
food-borne diseases in the light of the conditions faced by the countries of the region was also
noted.
18. The Meeting noted the importance of generating and reporting accurate data to establish
long-term food safety objectives. It was also emphasized that countries and international
organizations must continue to work in all sectors, including primary production, to prevent
food-borne diseases, rather than to wait for data and react. The Meeting also discussed the
need to establish a pan-Arab food safety programme, modelled after the European Food
Safety Authority in order to develop regional risk-based food safety programmes focussing on
preventative actions. The possibility of sub-regional action to reduce food-borne diseases was
also discussed. The importance of understanding the definitions of terms such as hazard and
risk was also noted.
VIII. NATIONAL FOOD SAFETY SYSTEMS IN THE NEAR EAST: A SITUATION ANALYSIS
(AGENDA ITEM 6)
19. Mr Ezzeddine Boutrif, Chief, Food Quality and Standards Service, FAO, presented a
paper on national food safety systems in the Near East: a situation analysis (NEM 05/4). The
speaker provided a definition of food safety and food control systems, as well as the guiding
principles of a food safety system, including its shared responsibility, the concept of the food
continuum, and the need for a science-based system. An analysis of the situation indicated
that national food control systems vary considerably from one country to another, that several
international and bilateral agencies are often involved in providing capacity building in each
country, and that the political will to improve national food safety systems has been rising in
many countries in recent years, due to increasing consumer and media pressure. The
presentation outlined the situation regarding various aspects of national food control systems,
such as food inspection, food legislation, and participation in Codex work, and provided a
regional analysis and examples from the countries of the region on recent initiatives to
strengthen each of these aspects. Multiple recommendations for improving national food
safety systems were presented and are included in the relevant section of the report.
20. The Meeting expressed its appreciation to FAO for preparing the paper and agreed on
the importance of strengthening national food control systems and the needs of the region in
this regard.
21. The Meeting noted the difficulties in initiating changes in national food control systems
in times of political changes in that country. It was mentioned that private sector
organizations should be pro-active in their involvement in national food control matters, and
that national authorities should make every effort to identify and involve all relevant

FAO/WHO Regional Meeting on Food Safety for the Near East

stakeholders in food safety decision making. The importance of strengthening all aspects of
national food control systems, including enforcement of legislation, was emphasized, as well
as the need for increased funding and political will to enable this to occur. The importance of
science based measures and a well coordinated, risk based food control system, which also
considers socio-economic and other legitimate factors, was underlined.
22. Countries of the region reported on aspects of their coordinating mechanisms in place
for food safety. They indicated that although some of these mechanisms exist, often they are
not put into practice effectively and hence, there is a need for a more systematic approach to
coordination and cooperation. Some countries (Jordan, Saudi Arabia, and Tunisia) announced
the decision taken to establish a central food and drug administration in their country to serve
as the focal point in the country for national food safety risk assessments.
23. The Meeting discussed the importance of regional cooperation in training food safety
specialists, border inspection, laboratory capacity and other areas of food control. The
Meeting expressed their desire to develop practical, concrete actions to foster cooperation and
partnerships among the countries of the region.
24. Delegates also expressed their desire to obtain information from other countries of the
region regarding long-term plans for national food safety systems. The need for government
agencies within a country to work together to streamline the capacity building interventions
by various international and bi-lateral agencies, as well as the need for UN organizations to
work together in providing assistance in improving national food safety systems was also
highlighted.
25. The framework provided by the FAO/WHO publication Assuring food safety and
quality: Guidelines for strengthening national food control systems was cited as a useful
reference, as this document provides guidance on recommendations for best practices that
may be utilized in strengthening national food control systems.
26. Mr Nabih Ibrahim (Egypt) presented a case study of the diagnosis of Egypts food
safety system. The speaker outlined the strengths, weaknesses and plans for future action for
each of the specific elements of their national food control system. The elements of a
proposed food safety strategic plan for Egypt were presented, including actions planned to
address issues such as the implementation of the following: information exchange
mechanisms, Good Agricultural Practices, Good Manufacturing Practices, HACCP systems,
traceability, and improved food import and export procedures. The presenter noted that many
government ministries were involved during the short duration of the study, but that even
further cooperation at the national level was needed.
27. The Meeting welcomed the presentation, thanked Egypt for sharing the information, and
requested further information on the results of the studies which were undertaken. The
Meeting noted that the results of the study are available from www.efsic.org, the Egyptian
Food Safety Information Center website.
28. Ms Rima Zumot presented the risk based management approach for imported food
control which has been implemented in Jordan (CRD 1). This system was first introduced in
the Aqaba Special Economic Zone, where over 75% of food imports enter Jordan. The
speaker explained that the system categorizes food products into low, medium, and high risk
items, and assigns the products to undergo either analysis, inspection, or documents review

FAO/WHO Regional Meeting on Food Safety for the Near East

based on these criteria, as well as the historical safety record of each food manufacturer. The
speaker indicated that this approach has been very successful in Jordan and has also been
applied in the international airports in Jordan.
29. The Meeting expressed its satisfaction with the system developed by Jordan for import
inspection and indicated its interest in applying it in other countries of the region to improve
efficiency of inspection programmes and to protect consumers. It noted that the classification
of foods into high, medium and low risk groups was dynamic and was based on actual
statistical records for the past five years. The Meeting was informed that the United Arab
Emirates uses a similar system with bar-coding of food products which facilitates the
planning of food inspection activities, including an electronic reporting system that enables
rapid transmission of inspection results as well as back-tracing of contaminated products and
their suppliers. The delegation of the UAE indicated their readiness to share their experiences
with other interested countries of the region.
IX. REGIONAL, SUB-REGIONAL AND NATIONAL COOPERATION IN FOOD SAFETY IN THE
NEAR EAST (AGENDA ITEM 7)
30. Ms Fatima Hachem of FAO presented a paper on regional, sub-regional and national
cooperation in food safety in the Near East (NEM 05/5). The paper listed examples of FAO/
WHO cooperation in food safety and indicated the need for cooperation at other levels,
including i) within and between sectors in a given country; ii) public/private/civil society
cooperation; iii) between national and local authorities; and iv) international, regional and
sub-regional levels. The paper presented numerous recommendations for improved
cooperation, which are reflected in the subsequent section of this report.
31. The Meeting expressed its appreciation to FAO for preparing the paper and agreed on
the importance of improving cooperation at all levels. Several delegates reported on the
existing mechanisms for coordination of various food safety related activities at the national
level and commented on their effectiveness. The Meeting exchanged information on
successful initiatives to cooperate regionally and sub-regionally in food safety, including the
following: i) GCC common food import policy and inspection system; ii) agreements between
various countries (Egypt, Kuwait, Lebanon, Sudan, Syria; Egypt, Lebanon, Syria; Egypt,
Saudi Arabia, Syria; Iraq, Jordan, Palestine; Libya, Tunisia;) for food trade; and iii)
cooperation in training in food control and inspection.
32. The Meeting provided ideas for future regional collaboration including the following: i)
establishment of pan-Arab standards based on Codex standards; ii) publication of rejected
food shipments on the internet; iii mutual recognition of certification; iv) development of a
SCOT (strengths, challenges, opportunities and threats) matrix for all the countries of the
region, identifying the strengths and challenges of each country in order to benefit from the
strengths and address the challenges.
X. RECOMMENDATIONS OF THE MEETING
33.

The Meeting recommended that member countries of the region should:

In the field of national food safety policy and organizational coordination:


a)

Develop effective long-term national policies, objectives, and plans for food safety,
including raising the awareness of all stakeholders, including the public, of the

FAO/WHO Regional Meeting on Food Safety for the Near East

importance of food safety and enhancing political will and funding to strengthen all
components of national food control systems;
b)

Adopt science based measures and a well coordinated, risk- based food control system,
which also considers socio-economic as well as other legitimate factors;

c)

Build the capacity of national food safety systems to address emerging issues such as
food product traceability and to prevent non-intentional food contamination;

d)

Identify and actively coordinate the involvement of all relevant stakeholders, including
all concerned public institutions, the private sector and consumer groups, in food safety
decision making;

e)

Be guided by and benefit from the experiences of other countries in the region that have
implemented single agency systems for national food control

f)

Improve coordination at the national level of the capacity building interventions by


various international and bi-lateral agencies.

In the field of involvement in Codex:


a)

Provide national Codex contact points with the facilities and office information
technology necessary to enable active communication with the Codex secretariat, as
well as with national stakeholders and other Codex Contact points in the region;

b)

Strengthen/establish national Codex committees to include all relevant stakeholders and


to effectively prepare for and participate in international Codex work and provide the
necessary means to enable it to successfully implement its mandate.

In the field of food safety legislation and standards:


a)

Work towards the enactment of basic food laws to replace the fragmented legislation
currently governing food control in many countries of the region, utilizing the
experience of countries which have recently adopted such food laws as a guide in this
regard;

b)

Update/revise national regulations and standards to be in harmony with Codex texts,


including the Codex Principles of Food Hygiene and its annex on HACCP
implementation.

In the field of in-country inspection of food:


a)

Improve the technical skills of food inspectors through training and increase the funding
for and professional status of food inspectors;

b)

Implement a risk based approach to food inspection and apply electronic reporting of
food imports, benefitting from the experiences of Jordan and UAE in this field;

c)

Complement inspection and control of food by including coaching, guiding and auditing
of food safety management systems

In the field of national food control laboratories:


a)

Encourage the private sector to establish accredited laboratories to benefit both the
public and private sector and seek their official recognition;

b)

Convince government policy makers of the importance of accredited and recognized


laboratories and of the need to increase funding for the same;

c)

Work towards the accreditation of food control laboratories in key analytical


disciplines, such as mycotoxins, pesticide residues, heavy metals, miroorganisms, etc.

FAO/WHO Regional Meeting on Food Safety for the Near East

d)

Ensure that national laboratory accreditation bodies are independent and their decisions
are made in a transparent manner.

In the field of national food-borne disease surveillance


a)

Encourage all stakeholders in food safety, including the general public, animal health
specialists and officials from the agriculture, food control, and public health sectors, to
report and share their data on the incidence of disease in a transparent manner and
strengthen the mechanisms for reporting and surveillance;

b)

Use this surveillance data to prioritize relevant programmes and interventions that
address major food safety problems.

34.

The Meeting recommended that the region should work together in the following ways:

In the field of regional food safety policy and legislation:


a)

Develop a regional mechanism to: i) ensure a sustainable regional food safety system
that integrates the economy of the entire food chain and better protects consumers, ii)
establish and harmonize food standards, on products of interest to the region, that are
based on Codex standards where possible, iii) coordinate food control activities between
the countries of the region, iv) develop jointly funded initiatives for food control
activities in the region, and v) provide training in specific components of food safety;

b)

Utilize sub-regional groupings and bi-lateral partnerships to improve food safety;

c)

Along with FAO and WHO, develop a SCOT (strengths, challenges, opportunities, and
threats) matrix for all the countries of the region, identifying the strengths and
challenges of each country in order to benefit from the strengths and address the
challenges;

d)

Establish centres of expertise in the application of GMPs and HACCP and other areas
of interest.

In the field of involvement in Codex:


a)

Improve communication and consultation prior to major Codex meetings to effectively


work together to address regional concerns within the Codex system;

b)

Use the FAO/WHO Regional Coordinating Committee for the Near East and other
relevant regional gatherings as a means to build common positions on various Codex
issues;

c)

Develop a strategic plan (three-five years) for the region in matters related to Codex.

In the field of information exchange:


a)

Develop an information exchange network for rejected food shipments and other critical
trade related information;

b)

Share successful experiences in various components of food safety management;

c)

Inform each other of any changes in food standards and import/export requirements;

d)

Utilize the INFOSAN network as a means of exchanging food safety related


information with food safety authorities in the rest of the world.

In the field of food import/ export inspection and certification:


a)

Work towards the application of a uniform inspection scheme for food import/exports
throughout the region;

10

FAO/WHO Regional Meeting on Food Safety for the Near East

b)

Foster mutual recognition of inspection and certification systems among the countries of
the region.

In the field of food control laboratories:


a)

With the assistance of FAO/WHO, identify and develop regional centres of expertise in
laboratory disciplines such as pathogen serotyping, chemical contaminant analysis and
microbiological analysis;

b)

Enable these centres to serve as accredited reference laboratories, be a source of


information, provide training, serve in emergency situations, and facilitate interlaboratory testing.

35.

The Meeting recommended that FAO/WHO should:

a)

Along with the countries of the region, conduct a SCOT analysis of the food safety
system in every country of the region to identify where countries can benefit from each
other;

b)

Facilitate the development of regional centres of excellence/networks in areas such as


food-borne disease surveillance, laboratories, inspection, HACCP, etc;

c)

Encourage the empowerment of all stakeholders involved in food control at the national
level;

d)

Improve coordination of capacity building assistance between UN agencies, donors, and


other providers in improving national food safety systems;

e)

Harmonize the publication of the generic HACCP models developed by the WHO
Eastern Mediterranean Regional Centre for Environmental Health Activities (CEHA)
with the guidelines for the application of HACCP to small and less developed
businesses developed by FAO and WHO Headquarters and publish as appropriate;

f)

Update FAOs food inspection manual and disseminate the information to the countries
of the region.
XI. ADOPTION OF THE REPORT

36. The Meeting discussed the draft report and made suggestions for its revision. These
were taken into consideration by the Secretariat in finalizing the report.
XII. CLOSING OF THE MEETING
37. The Meeting expressed its warm thanks to the Government of Jordan for the efficient
organization of the Meeting and for its generous hospitality. The Meeting also expressed its
appreciation to FAO and WHO for organizing the Meeting. The Chairperson then closed the
Meeting.

FAO/WHO Regional Meeting on Food Safety for the Near East

LIST OF PARTICIPANTS
LISTE DES PARTICIPANTS
Algeria
Algerie
M. Sami Kolli
Sous Directeur
Ministre du Commerce
46 Bd Mohamed V
Alger
Tel:
213.216.31355/213.216.31375
Email: samikolli@yahoo.fr
Bahrain
Bahrein
Mr Mohamed Baquer Hussain
Head
Food Inspection Unit
Public Health Department
Manama
Tel:
973.1727.3683
Fax:
973.1727.9253
Email: AALI7@health.gov.bh
Egypt
Egypte
Mr Mohammed Fahmi Saddik
Professor Food Hygiene
National Institute of Nutrition
Alexandria
Tel:
203.64.3552/260.2457
Fax:
203.64.7476
Email: ilsi@tedarta.net.eg
Mr Nabih Abdel-Hamid Ibrahim
Director of Food Safety Information Centre
Food Technology Research Institute
Agricultural Research Centre
Ministry of Agriculture and Land Reclamation
Giza
Tel:
202.571.2049
Fax:
202.571.8325
Email: dr.nabih@internetegypt.com

11

ANNEX 1

Dr Zeinab A. H. Abdel Azeiz


General Director
Food Safety and Control
Ministry of Health and Populations
3 Magless El Shaab Street
Cairo
Tel:
7948152
Fax: 7921077
Email: zeinabHalem@yahava
Dr Hoda Abdel Fattah Hassan
Director of National Nutrition Institute
16 Kasr El-Aini Street
Cairo
Tel:
202.364.6413
Fax: 202.364.6467
Email: nniegypt@nni.org.eg
Dr Sohair Ahmed Gadalla
Director of Central Laboratory of Residue
Analysis of Pesticides and Heavy Metals
in Food
Agriculture Research Center
Ministry of Agriculture
Cairo
Tel:
761.1282
Fax: 761.1216
Email: sohairgadalla@hotmail.com
Mr Kamel Darweesh
Food Standard Specialist
16 Tadreeb El Modarrabeen Street
El Ameriya
Cairo
Tel:
202.284.5531
Fax: 202.284.5504
Email: moi@idsc.gov.eg
Dr Ahmed Gaballa
Scientific and Regulatory Affairs Manager
Atlantic Industries Free Zone
Nasr City
Cairo
Tel:
202.276.7138
Fax: 202.287.7620
Email: agaballa@mena.ko.com

12

Iraq
Dr Wathiq Muhammad
Food Safety Programme Manager
Food Inspection
Ministry of Health
Baghdad
Tel:
790.144.7246
Mr Abdil Hussien K. Fallah
Food Safety
Health Audit Department
Ministry of Health
Baghdad
Tel:
7901.334908
Dr Hashim S. Hammodi
Food Safety Programme in Iraq
Health Audit Department
Ministry of Health
Baghdad
Tel:
7901.446606
Dr Almuaimi Haitham Sadia Ibrahim
Food Safety Programme Iraq
Ministry of Health
Al Dora City
Baghdad
Tel:
790.555.3952
Email: 20201989-2@yahoo.com
haithamalnuaimi@yahoo.com
Mr Souod Alani
Head, Food Science and Human Nutrition
Dept.
Agricultural Research and Food Technical
Directorate
Ministry of Science and Technology
P.O. Box 765 Baghdad
Tel:
515.1930
Email: souodalani449@yahoo.com
Mr Waled Khalid Ali
Food Sampling System Manager/MOH/Iraq
Health Audit Department/MOH/Iraq
00964 Baghdad
Tel:
7901.446594
Email: walleednazk@yahoo.com
Mr William Hargraves
SPS/Food Safety
Iraq Private Sector Growth Employment
APO AE 09316
Baghdad

FAO/WHO Regional Meeting on Food Safety for the Near East

Jordan
Jordanie
Dr Saleh Mowajdeh
Director-General
Jordan Food and Drug Administration
Amman
Tel:
962.569.3112
Fax: 962.562.6325
Eng. Salem A. Quheiwi
General Director Assistant
Jordanian Institute for Standards and
Metrology
P.O. Box 941287
Amman 11194
Tel:
962.6.5665276
Fax: 962.6.5681099
Email: squheiwi@jism.gov.jo
Dr Fathi Hamed Ali Saleh
Head of Food Directorate
Director of Food Control
Jordan Food and Drug Administration
Amman
Tel:
962.569.3112
Fax: 962.562.6325
Email: fathi.saleh@jfda.jo
Dr Aya Al-Salti
Animal Production Department
Ministry of Agriculture
Amman
Dr Mohammed Isam Yamani
Head
Dept. of Nutrition and Food Technology
University of Jordan
Amman
Tel:
962.6.535500
Email: myamani@ju.edu.jo
Dr Mahmoud Al Zoubi
Secretary of National Codex Committee
P.O. Box 941287
Amman
Tel:
962 6 5680139
Fax: 962 6 5681099
Email: mzoubi@jism.gov.jo

FAO/WHO Regional Meeting on Food Safety for the Near East

Eng. Rima Zumot


Director of Health Control Directorate
Aqaba Special Economic Zone Authority
P.O. Box 2565
77110 Aqaba
Tel:
962.3.209.1000 Ext. 2083
Fax:
962.3.209.1017
Email: rzumot@aseza.jo
Dr Mohammad Obaidat
Head of the National Society for Consumer
Protection
Amman
Eng. Zakaria Sabah
Amman Chamber of Industry
Amman
Eng. Muna Habaybeh
Food Standard Officer
Jordan Institution for Standards and Metrology
Amman
Email: munahabaybeh@yahoo.com
Eng. Ola Herzallah
Food Standard Officer
Jordan Institute for Standards and Metrology
Amman
Tel:
962.777.237579
Fax:
962.6.568/099
Email: oherzallah@jism.gov.jo
oh2717@hotmail.com
Eng. Issa Qutheshat
Food Standard Officer
Jordan Institute for Standards and Metrology
Amman
Tel:
962.6.568.0139
Fax:
962.6.568.1099
Email: issaqutheshat@yahoo.com
Eng. Malak Abu Zeinah
Ministry of Agriculture
Amman
Tel:
962.6.686151

Kuwait
Koweit
Ms Zakeyah Al-Shammari
Head of Standards Section
Public Authority for Industry
P.O. Box 4690
13047 Safat
Tel:
965.530.2670
Fax: 965.530.2625
Email: Z. Shamri@pai.gov.kw
Ms Hashmia R. Al-Enezi
Food Standards Specialist
Public Authority for Industry
P.O. Box 4690
13047 Safat
Tel:
965.530.2672
Fax: 965.530.2625
Email: h.alanzei@paid.gov.kw
Lebanon
Liban
Ms Maryam Eid
Food Technology Expert
Ministry of Agriculture
Bir Hassan
Safarat St
Beirut
Tel:
961.3.567.542
Fax: 961.1.824100
Email: agrofood2002@yahoo.co.uk
Mr Atef Wafic Idriss
MENA Food Safety Associates
Syndicate of Food Industries
126 Sourati St. Lions Building No. 301
P.O. Box 113 6382
Hamra
Beirut 1103 2120
Tel/Fax: 961.134.3141/134 6218
Email: atef@idriss.net
Libyan Arab Jamahiriya
Jamahiriya arabe libyenne
Prof. Dr Eng. Ahmed Shembesh
Director General
National Codex Committee
P.O. Box 80342 Tripoli
Tel:
218.21.3693070
Fax: 218.21.3693071
Email: g.manager@Incsm.org

13

14

FAO/WHO Regional Meeting on Food Safety for the Near East

Prof. Dr. Yusef El-Mabsout


General Manager of the National Center on
Food and Drug Control
National Codex Committee
P.O. Box 80342
Tripoli
Tel:
218.21.4813500
Fax:
218.21.4809134
Email: yelmabsout@yahoo.com
Mr Ali Al-Maktof
Consultant
Ministry of Foreign Affairs
Tripoli
Libya
Tel:
218.21.340461-69
Fax:
218.21.3433011
Saudi Arabia
Arabie saoudite
Prof. Ibrahim S. Al-Mohizea
Vice President for Food Affairs
Saudi Food and Drug Authority (SFDA)
Riyadh
Tel:
966.1.4131238
Fax.
966.1.4133528
Email: isarm12@sfda.gov.sa
Mr Mohamed Al Hadlaq
Food Standards Consultant
Saudi Arabian Standards Organization (SASO)
P.O. Box 3437
Riyadh 11471
Tel:
4520000
Fax:
4520167
Email: alhadlaq7777@saso.org.sa
Eng. Habib M. Abd Alsamad
Quality Control Laboratory
Ministry of Commerce and Industry
Riyadh 11162
Tel:
966.1.4013265
Fax:
966.1.402.2539
Mr Bader Bin. Al-Saad
Agri. and Food Department Manager
Saudi Arabian Standards Organization (SASO)
P.O. Box 3437
Riyadh 11471
Tel:
966.1.452.0000/966.1.452.0166
Fax:
966.1.452.0167
Email: badr2424@yahoo.com

Dr Hamad A Al-Awfy
Director General
Laboratories and Quality Control
Laboratories and Quality Control Department
Ministry of Commercie and Industry
Riyadh 11162
Tel:
966.1.4013265
Fax : 966.1.4022539
Sudan
Soudan
Mr Gibreel Abdellatif Ahmed
General Manager
Sudanese Standards and Metrology
Organization
P.O. Box 13573
Khartoum
Tel:
249.183.799179
Fax: 249.183.799188
Email: gibreel57m@hotmail.com
Mrs Seham Siragaldeen Mergani
Microbiology Specialist
Sudanese Standards and Metrology
Organization
P.O. Box 13573
Khartoum
Tel:
249.83.775247
Fax: 249.83.774852
Email: ssmo@sudnet-net
Mr Hamdi Abbas Ibrahim
Director
Standardization and Quality Control Unit
Ministry of Agriculture and Forestry
Khartoum
Tel:
249.183.774.688, 771.675
Fax: 249.183.782.027, 781.749
Email: hamdi.20072000@yahoo.com
Hamdi163@hotmail.com
Tunisia
Tunisie
Mr Meftah Amara
Directeur gnral
Bureau de Mise niveau
Ministre de l Industrie, de lEnergie et des
PME
Rue 8011 Cit Montplaisir
Tunis
Tel:
216.7179.9728
Fax: 216.7179.6102
Email : mefteh.amara@email.ati.tn

FAO/WHO Regional Meeting on Food Safety for the Near East

Mr Moncef Cherif
Charg du Secteur Agro-alimentaire et de la
coopration bilatrale
Institut National de la Normalisation et
de la Proprite Industrielle
B.P. 57 Cit El Khadra
1003 Tunis
Tel:
216.71.785.5922
Fax:
216.71.781563
Email: Inorpi@email.ati.tu
Mr Mohamed Ben Fredj
Directeur Gnral
Centre Technique de lagro-alimentaire
12 Rue de lUsine
Charquia II
Tel:
216.7194.1080
Fax:
216.7194.0198
United Arab Emirates
Emirats arabes unis
Mr Ali Omar Abdullah
Director of Standardization Department
Emirates Authority for Standardization and
Metrology (ESMA)
P.O. Box 2166 Abu Dhabi
Tel:
791.2671.1110
Fax:
971.2671.5999
Email: benlfaqeh.esma@uae.gov.ae
Mr Khalid Mohammed Al Sherif
Assistant Director
Public Health Department
and Head of Food Control Section
Dubai Municipality
Public Health Department Food Control
Section
P.O. Box 67 Dubai
Tel:
971.4.2064201
Fax:
971.4.2231905
Email: kmsharif@dm.gov.ae
Ms Amina Ahmed Mohammed
Head of Food and Environment Lab. Section
Dubai Municipality
Dubai Central Lab. Department
Food and Environment Lab. Section
P.O. Box 7463 Dubai
Tel:
971.4.3011618
Fax:
971.4.3358448
Email: aamohammed@dm.gov.ae

Mr Abdulmouti Alhalawani
Standards Specialist
Emirates Authority for Standardization and
Metrology (ESMA)
P.O. Box 2166 Abu Dhabi
Tel:
971.2671.1110
Fax: 971.2671.5999
Email: helwani_ab.esma@uae.gov.ae
Eng. Mohamed Abdullah Abdulkader
Accreditation Department/ESMA
P.O. Box 2166
Abu Dhabi
Tel:
971.2.6761851
Fax: 971.2.671.5999
Mr Mohamed Omar Mohamed Al Bannay
Head of Public Health Department
Sharjah Municipality
P.O. Box 2356
Sharjah
Tel:
5650.0097/50.646.3292
Fax: 5652.2707
Email: al-bannay2002@hotmail.com
OBSERVER COUNTRIES
PAYS OBSERVATEURS
Italy
Italie
Mr Giuliano Papi
Commercial Attach
Embassy of Italy
P.O. Box 9800
Amman
Tel:
463.8185
Fax: 463.0226
Email: italcom@globalone.com.jo
Palestine
Eng. Suha Arar
Director of Food Safety
Environmental Health Department
Ministry of Health Building
Ramallah Nablus Street
Tel:
970.2240.9829/970.9587.4933
Fax : 970.2240.9827/9
Email: I_Atiya@yahoo.com

15

16

Eng. Ibrahim M. Yousef Ismail


Director
Environmental Health Department
Ministry of Health
West Bank
Email: I.Atiya@yahoo.com
Eng. Husni M. Al Najjar
Food Safety Unit Officer
Food Safety Unit
Al-Sourani City
Gaza City
Tel:
970.5930.9363
Tel/Fax:970.8280.1323
Email: Husni58@yahoo.com
Dr Bashar A. Shehada
Food Inspector in Preventive Medicine Dept.
Preventive Medicine Dept.
Ministry of Health
Al Rimal, Gaza City
Tel:
972.5960.1693
Fax:
972.8285.5745
Email: bhlove2767@hotmail.com
Mr Mohamed Al Sayyed
Director of International Cooperation
Palestine Standards Institution
Tel:
970.229.89650
Fax:
970.229.64433
Mr Ayman Abu Zarour
Food Processing Sector Manager
Palestine Trade Center PALTRADE
Al-wataniah Towers Building
5th Floor, P.O. Box 883
Ramallah
Tel:
970.59.265.218/972.240.8383
Fax:
970.52.240.8370
Email: ayman@paltrade.org
United States of America
Etats-Unis dAmrique
Mr Duane Spomer
Associate Deputy Administrator
Dairy Programs
Agricultural Marketing Service
U.S. Department of Agriculture
1400 Independence Ave., SW
Washington, DC 20250
Tel:
202.720.9382
Fax:
202.720.2643
Email: Duane.Spomer@usda.gov

FAO/WHO Regional Meeting on Food Safety for the Near East

Mr Abdel-Razak M. Kadry, DVM, PhD


Chief, Technical Analysis and Data Evaluation
Branch
Risk Assessment Division
Office of Public Health and Science
Food Safety Inspection Service
Room 333 Aerospace Center
U.S. Department of Agriculture
1400 Independence Ave, SW
Washington, DC 20250
Tel:
202.690.6608
Fax: 202.690.6337
Email: Abdel-razak.kadry@fsis.usda.gov
Ms Susan Sausville
Chief
Dairy Standardization Branch
Agricultural Marketing Service
U.S. Department of Agriculture
1400 Independence Avenue, SW
Room 2750 South Building
Washington, DC 20090
Tel:
202.720.7473
Fax: 202.720.2643
Email: Susan.Sausville@Usda.Gov
INTERNATIONAL ORGANIZATIONS
ORGANISATIONS INTERNATIONALES
CODEX ALIMENTARIUS COMMISSION
(CODEX)
Mr Kazuaki Miyagishima
Secretary
Codex Alimentarius Commission
FAO
Viale delle Terme di Caracalla
00100 Rome, Italy
Tel:
39.06.57054390
Fax: 39.06.57054593
Email: kazuaki.miyagishima@fao.org
Ms Annamaria Bruno
Food Standards Officer
Codex Alimentarius Commission
FAO
Viale delle Terme di Caracalla
00100 Rome, Italy
Tel:
39.06.57052654
Fax: 39.06.57054593
Email: annamaria.bruno@fao.org

FAO/WHO Regional Meeting on Food Safety for the Near East

CONSUMERS INTERNATIONAL
Dr Abdel Fattah Kilani
Consumers International
P.O. 926692
Amman 1190
Jordan
Tel:
962.6.5156983
Email: drkilani@hotmail.com
FOOD AND AGRICULTURE
ORGANIZATION OF THE UNITED
NATIONS (FAO)
Mr Hartwig de Haen
Assistant Director-General
Economic and Social Department
FAO
Viale delle Terme di Caracalla
00100 Rome
Italy
Tel:
39.06.5705366
Email: hartwig.dehaen@fao.org
Ms Fatima Hachem
Food and Nutrition Officer
Regional Office for the Near East
P.O. Box 2223
Cairo
Egypt
Tel:
20.2.331.6144
Fax:
20.2.749.5981
Email: fatima.hachem@fao.org
Mr John Riddle
Information Officer
News and Multi Media Service
FAO
Viale delle Terme di Caracalla
00100 Rome, Italy
Tel:
39.06.57053259
Email: john.riddle@fao.org
Ms Susanne Gelders
FAO Consultant
1036 Rue de Febieres
01710 Thoiry
France
Tel:
33.45020.8692
Email: Susanne@Gelders.net

UNITED NATIONS INDUSTRIAL


DEVELOPMENT ORGANIZATION
(UNIDO)
Mr Karl Schebesta
IDO/PIC/MGR
UNIDO
P.O. Box 300 Vienna
Austria
Tel:
43.1.26026/3490
Fax: 43.1.31346/3490
Email: k.schebesta@unido.org
Mr Ali Badarneh
National Programme Coordinator
United Nations Industrial Development
Organization
P.O. Box 67800 Salah El deen Street
East Jerusalem
Jerusalem
Tel:
970.2240.9413
Fax: 970.2258.52439
Email: alin@opalnet.com
WORLD HEALTH ORGANIZATION
(WHO)
Dr Mohamed Aideed Elmi
Regional Adviser
Food and Chemical Safety
World Health Organization
Eastern Mediterranean Regional Office
Abdul Razzak Al Sanhouri Street
P.O. Box 7608 Nasr City
Cairo 11371
Egypt
Tel:
202.276.5384/202/276.5385
Fax: 202.670.2492
Email: fcs@emro.who.int
elmim@emro.who.int
Mr Ezechiel Bisalinkyuai
Technical Officer
WHO Iraq Country Office
26 Yambu Street
Um Muthaina
P.O. Box 11821 Amman
Tel : 962.7950.53669
Fax: 962.6551.0437
Email: ezechielbirq.emro.who.int

17

18

FAO/WHO Regional Meeting on Food Safety for the Near East

WORLD ORGANIZATION FOR ANIMAL


HEALTH (OIE)
Mr Pavlos Economides
DVM FRSH Member Food Safety Working
Group OIE
World Organization for Animal Health
12 Rue de Prony
75017 Paris
France
Tel:
35799.628842
Fax:
35722.337752
Email : pavlos_economides@hotmail.com
Jordanian Secretariat
Eng. Ahmad Al Fahoum
Food Inspector
Aqaba Special Economic Zone Authority
P.O. Box 2565
77110 Aqaba
Tel:
962.3.209.1000
Fax:
962.3.209.1017
Email: afahoum.aseza.jo
Eng. Hussam Mazari
Food Safety Officer
Aqaba Special Economic Zone Authority
P.O. Box 2565
77110 Aqaba
Tel:
962.3.209.1000
Fax:
962.3.209.1017
Email: hmazari@aseza.jo
Mr Jadid Ayman
Head of Food Plants Establishments Dept.
Jordan Food and Drug Administration
Amman
Tel:
962.569.3112
Fax:
962.562.6325
Email: ayman.jadid@jfda.jo
Mr Daas Fuad
Jordan Food and Drug Administration
Amman
Tel:
962.569.3112
Fax:
962.562.6325
Email: fuad.daas@jfda.jo

Mr Kliibi Ghazi
Head of Imported Food
Jordan Food and Drug Administration
Amman
Tel:
962.569.3112
Fax: 962.562.6325
Email: Ghazi.Klaibi@jfda.jo
Mr Malhas Karam
Head of Food Laboratory
Jordan Food and Drug Administration
Amman
Tel:
962.569.3112
Fax: 962.562.6325
Email: food.lab@jfda.jo
Mr Qaqish Safa
Head of Food Additive and Special Formulas
Jordan Food and Drug Administration
Amman
Tel:
962.569.3112
Fax: 962.562.6325
Email: safa.qaqish@jfda.jo
Mr Qammaz Sameer
Director of Labs Directorate
Jordan Food and Drug Administration
Amman
Tel:
962.569.3112
Fax: 962.562.6325
Email: samir.qammaz@jfda.jo
Mr Hasanin Nasr
Jordan Food and Drug Administration
Amman
Tel:
962.569.3112
Fax: 962.562.6325
Eng. Tamara Qatarneh
Certification Department and Quality
Marketing
Jordan Institution for Standards and Metrology
Amman
Tel:
777.467118
Email: Tamar_Qatarneh@hotmail.com
Dr Reyad R. Shaker
Jordan University of Science and Technology
22110 Irbid
P.O. Box 3030
Email: reyadrs@just.edu.jo

FAO/WHO Regional Meeting on Food Safety for the Near East

Dr Ziad W. Jarachal
Jordan University of Science and Technology
22110 Irbid
P.O. Box 3030
Email: jarachfz@just.edu.jo
Dr Basem Abdullah
University of Jordan
Department of Nutrition and Food
Technology
Amman 11943
Email: basem@ju.edu
Dr Salma Khalil Turan
University of Jordan
Department of Nutrition and Food
Technology
Amman 11943
Email: stukan@ju.edu.jo
FAO/WHO SECRETARIAT
Mr Ezzeddine Boutrif
Chief
Food Quality and Standards Service
Food and Nutrition Division
FAO
Viale delle Terme di Caracalla
00100 Rome
Italy
Tel:
39.06.57056156
Fax:
39.06.57054593
Email: ezzeddine.boutrif@fao.org

Mr Peter Karim Ben Embarek


Food Safety Department
World Health Organization
20 Avenue Appia
CH-1211 Geneva 20
Switzerland
Tel:
41.22.791.4204
Fax: 41.22.791.4807
Email: benembarekp@who.int
Ms Londa VanderWal
Consultant
Food Quality and Standards Service
Food and Nutrition Division
Viale delle Terme di Caracalla
00100 Rome
Italy
Tel:
39.06.57055636
Fax: 39.06.57054593
Email: Londa.VanderWal@fao.org

19

20

FAO/WHO Regional Meeting on Food Safety for the Near East

ANNEX 2
(NEM 05/1)

FAO/WHO Regional Meeting on Food Safety for the Near East


Amman, Jordan, 5-6 March 2005
Provisional Agenda

Agenda
Item

Subject matter

Document
Reference

1.

Opening of the meeting

2.

Election of Officers

3.

Adoption of the Provisional Agenda and Timetable

NEM 05/1

4.

Impact of food safety standards on food and agricultural trade in


the Near East

NEM 05/2

5.

Impact of current food safety systems in the Near East on human


health

NEM 05/3

6.

National food safety systems in the Near East a situation analysis NEM 05/4

7.

Regional, subregional and national cooperation in food safety

8.

Other matters

9.

Adoption of the draft report

NEM 05/5
CRD

FAO/WHO Regional Meeting on Food Safety for the Near East

21

ANNEX 3

In the Name of God, the Compassionate, the Merciful


Message from
Dr Hussein A. Gezairy
Regional Director
WHO Eastern Mediterranean Region
to the
FAO/WHO Regional Meeting on Food Safety in the Near East
Amman, Jordan, 5-6 March 2005

Ladies and Gentlemen, Dear Colleagues,


On behalf of the World Health Organization, I have the pleasure of welcoming you to this
Regional Meeting on Food Safety in the Near East, here in Amman, Jordan, which is being held jointly
by FAO and WHO. I would especially like to thank the Government of Jordan for hosting this
important event as well as the Codex Regional Coordinating Committee for the Near East, the third
session of which will be held at this same venue from 7 to 10 March.
Following the occurrence in recent times of a number of extremely serious large scale food
emergencies, policy-makers and consumers in many countries are re-evaluating the existing food safety
strategies. Many of these food emergencies have involved more than one country, such as those
involving dioxin contaminations, bovine spongiform encephalopathy (BSE), foot and mouth disease
and, most recently, avian flu. Issues such as the increasing application of biotechnology in food
production, and the new climate in world trade and the challenges this implies, necessitate
comprehensive review and indeed overhaul of current national food control systems. A future goal in
food safety should be to develop sustainable, integrated, food safety systems to reduce health risks along
the entire food chain, from the primary producer to the consumer.
In the WHO Eastern Mediterranean Region, the Regional Committee adopted, in 1999, the
Regional Plan of Action for Food Safety. In adopting this plan, the Member States of the Region agreed
to assess their current food safety infrastructure and problems at national level and to carry out a country
diagnosis in order to prepare a country profile. They also agreed to develop, strengthen and implement
effectively their national food safety programmes; to continue to monitor and evaluate their food safety
activities, and finally to initiate a coordinated effort to improve food control systems. Emphasis was
placed on the inclusion of all relevant partners in food safety programme activities, such as government
departments in food safety, food control and public health, as well as industry, trade organizations,
research industries and academic bodies, and, last but certainly not least, consumer organizations.
Following the adoption of the plan, a number of new initiatives have been taken at national and regional
level.
On a global level, food safety is becoming an increasingly important public health issue, with
increased focus on the inclusion of consumers and consumer associations in decision-making processes.
The 53rd World Health Assembly passed resolution WHA 53.15 on food safety which recognized,
among other things, that food-borne diseases significantly affect peoples health and well-being and
have economic consequences, not only for individuals but for communities and countries as well. The
work of Codex Alimentarius was recognized as being important for protection of the health of
consumers. For future action, the Member States were urged to integrate food safety matters into
information programmes for consumers, particularly in school curricula, and to initiate culture-specific

22

FAO/WHO Regional Meeting on Food Safety for the Near East

health and education programmes for food handlers, producers and consumers. In addition, outreach
programmes have to be developed for the private sector in order to improve food safety at the consumer
level, and collaboration developed with consumer associations and the food industry in order to attain
good and ecologically safe farming, and good and hygienic manufacturing practices.
Food-borne microbiological diseases are widespread in both developed and developing
countries, and thousands of millions suffer from frequent episodes of diarrhoea, in many cases resulting
in serious further health consequences. While these microbiological contaminations of food represent
the majority of the cases, chemical hazards also represent a significant source of food-borne illness,
even though in many cases it has been proven difficult to link the disease directly with a food.
Ladies and Gentlemen, Dear Colleagues,
The role of the consumer in todays society needs careful consideration. Most developed
countries have a consumer protection agency. Societies are different, and the influences on society are
varied, and therefore it is important that the views of local or national consumer associations are
represented at national level to ensure that the so-called local interests and worries of consumers are
adequately reported and addressed.
The objective of this meeting is to promote overall food quality and safety through several
means: by exchanging information on food safety programmes and food control systems; by promoting
or establishing regional and subregional networks for information exchange; and by identifying
opportunities for improving regional cooperation in promoting food safety.
In addressing food safety issues jointly, WHO and FAO have covered a lot of ground since their
early years of cooperation. It has been recognized, for example, that more collaboration is needed at
country level, where food safety activities are taking place.
I expect that the technical presentations in this meeting, and your deliberations during the
working sessions, will indeed lead to concrete action, as well as plans for action in your countries, in
order to achieve the goal of SAFE FOOD FOR ALL.
I would like to thank our colleagues from FAO for their continuing collaboration, and the
Government of Jordan for hosting this important event. Finally, it only remains for me to wish you a
successful meeting, and a pleasant stay in this beautiful city of Amman.

FAO/WHO Regional Meeting on Food Safety for the Near East

23

ANNEX 4
FAO/WHO Regional Meeting on Food Safety for the Near East
Amman, Jordan, 5-6 March 2005
OPENING REMARKS
by
Hartwig de Haen
Assistant Director-General, Economic and Social Department
Food and Agriculture Organization of the United Nations
Excellencies, honourable guests, distinguished delegates, ladies and gentlemen.
It is my pleasure to welcome you on behalf of the Food and Agriculture Organization of the
United Nations to the FAO/WHO Regional Meeting on Food Safety for the Near East. This meeting is
part of a series of regional events, organized by FAO and WHO, to provide a forum for food safety
officials to share information and experiences on how the safety of foods may be improved. It is held in
line with the recommendations of the First FAO/WHO Global Forum of Food Safety Regulators in
Marrakesh, Morocco in January 2002 and the Second Global Forum convened in Bangkok, Thailand in
October 2004.
Allow me to thank the Government of the Hashemite Kingdom of Jordan for its generosity in
hosting the meeting, and the organizing committee for all its hard work. I would like to emphasize a few
concepts that are fundamental to the discussions during this meeting: first, the critical importance of
food safety; second, the challenges to improving food safety; and third, the practical actions being taken
by FAO and other partner agencies to promote food safety in the region.
The importance of food safety

As you know, food safety is critical for exports and imports in the Near East. As a whole, your
region relies on imports for over 60% of its food supply. Indeed, in some countries this figure
rises to 90%. In some of your countries, food exports are an important source of foreign
exchange earnings, so compliance with international market requirements and quality and safety
standards is essential. Such standards have become increasingly complex and, at times,
stringent, demanding greater vigilance and investment.
Ensuring safe and healthy food is an important precondition of food security and a crucial step
towards realizing the right to food. It is essential for human life everywhere. The World Food
Summit, organized by FAO in 1996, recognized that access to safe food is in itself an element of
food security. Rather than being a luxury of the rich, everyone should have the right to an
adequate supply of safe, nutritious food.
Good practices aimed at improving food safety also reduce food losses and increase food
availability. New technologies and practical control measures are available to improve the safety
of food, thereby extending its usable life.
WHO estimates that one in three people worldwide suffer from a food-borne disease every year,
and 1.8 million die from severe food and waterborne diarrhoea. Most of these illnesses are due
to microorganisms and chemical contaminants, which may occur naturally or be introduced at
some point along the food chain. Campylobacter and Salmonella species account for over 90%
of all reported cases of bacteria related to food poisoning worldwide.
Throughout the Near East, food-borne diseases are perceived as an unpleasant fact of daily life.
Indeed, incidents are often unreported. Although a few countries (Jordan, Kuwait, Oman and
Saudi Arabia) have systems in place to track food-borne diseases, surveillance mechanisms are

24

FAO/WHO Regional Meeting on Food Safety for the Near East

generally inadequate. As a result, estimates of food-borne illnesses are scarce, making it difficult
to evaluate the severity of food safety problems. Improvements in this area are clearly needed.
Challenges to improving food safety
Despite these important reasons to improve food safety, the increased availability of relevant
knowledge, tools and technologies, many challenges remain. Let me mention just five:
1)

Adherence to food safety standards has a cost. Depending on the step in the food chain where
the standard is set, these costs are borne by food producers, processors or retailers, but finally
they are also reflected in the price paid by consumers. This calls for efficiency in meeting
standards to prevent some suppliers from being pushed out of business.

Take the example of fruits and vegetables, an important export from several Near East
countries. Many of these exports are destined for markets in the EU. However, new
regulations in the EU since January 2005 require fruit and vegetable imports to be traceable
at all stages of production, processing and distribution, creating new challenges in many
producing countries.
Compliance with EUREPGAP requirements has also been costly. Taking into account
depreciation of these investments over time, one tomato enterprise in Morocco (operating on
10 hectares with 50 employees) estimated that EUREPGAP compliance accounted for some
12% of its farm production costs and 4% of the value of its tomato exports.
The EUs ban on exports of fish and fish products from the Gulf States in 1998 provides
another example of the investments needed to comply with food safety standards. One
survey estimated the cost of compliance at US$250,000 per factory.

2)

Can we afford zero risk standards? I am aware that zero tolerance for food contaminants with
severe health impact, is the general principle on which many national standards are established.
Indeed, many people take the term safe food to mean food with zero risk, but zero risk is often
unattainable. Rapid progress in analytical detection methods for even very low residue levels of
veterinary drugs led to restrictions of food exports of animal origin from Asia in 2001 and 2002,
raising new questions about the soundness of aiming for zero risk. Clearly, food must be safe for
human consumption. Indeed this is the ultimate rationale of standards and regulations adopted by
Codex. However, where there is a margin for practical decisions in risk management, the benefits
of aiming for absolute food safety should be balanced against the real extent of potential harm to
consumers as well as the often high compliance costs.

3)

Recent food scares have underlined how food safety problems can cross borders.
Globalization, rising trade in food and agricultural products and increasing international travel
have made it more difficult for countries to respond effectively to food crises without cooperation
from their neighbours and trading partners. This makes it more important than ever to deepen
food safety cooperation through the development of regional networks that provide a means to
share relevant information and knowledge, and enhance readiness to plan and react to food
emergencies.

4)

In many parts of the Near East, consumer awareness about food safety remains limited.
One recent survey in Jordan has indicated how many housewives lack even basic knowledge
about safe food handling and preparation techniques. Food safety could be considerably
enhanced simply by raising public awareness and knowledge about food safety. Developing
policies and programmes to inform, educate and communicate with consumers should therefore
be an immediate priority.

5)

In spite of improvements to official food control systems in the region, several countries still
have overly fragmented or outdated food control systems. Strengthening the capacity of
official food control agencies, the food industry and consumers, based on their respective roles

FAO/WHO Regional Meeting on Food Safety for the Near East

25

and responsibilities, is of the utmost importance. This will require clear political commitment and
support for food safety, as well as substantial investment, and demand-driven technical
assistance.
This meeting is just one example of ongoing efforts by FAO and WHO to improve food safety
globally and here in the Near East Region.
Practical actions by FAO and partners to promote food safety
FAO is involved in a wide range of activities, many of which are carried out in collaboration
with WHO, to enhance food safety. These include:
1)
2)
3)
4)
5)
6)

7)

8)

Provision of scientific advice on food safety risks to members of the Codex Alimentarius.
Organization of expert consultations on topical, open issues such as microbial risk assessment,
acrylamide in foods and genetically modified foods.
Establishment of a Standards and Trade Development Facility, together with WHO, OIE, WTO
and the World Bank, to support and coordinate capacity building efforts in food safety, plant
and animal health.
Development of manuals and guidelines to support training and provide technical advice, for
instance to strengthen national food control systems, carry out risk analysis or facilitate
participation in Codex.
Implementation of an FAO/WHO Trust Fund to enhance the participation of developing and
transition countries in the vital work of the Codex Alimentarius Commission.
Capacity building and technical assistance. For instance, FAO has organized five regional and
sub-regional workshops in the Near East on various aspects of food safety in the past three
years, and is currently supporting projects in seven countries, with several others under
development.
Improving access to information. Along with the organizations responsible for international
standard setting in sanitary and phytosanitary matters, FAO has developed an International
Portal on Food Safety, Animal and Plant Health, which offers national governments and
trading partners access to relevant official information.
Finally, FAO is committed to work with WHO and member countries to support
implementation of the Global Strategy on Diet, Physical Activity and Health, recently adopted
by the World Health Assembly to address the rising burden of non-communicable diseases
through the promotion of healthy diets and lifestyles.

Conclusion
As I believe you will agree, improving food safety in the Near East is imperative for a number
of reasons. Certainly, many of your countries have invested considerable resources in modernizing and
improving food control programmes during the last decade. These achievements must be strengthened
and expanded, not only to take advantage of trade opportunities, but also to protect public health.
Regional cooperation and information exchange at all levels can provide a means to advance
this goal. FAO and WHO have convened this meeting for exactly these purposes. We stand ready to
assist your countries in your efforts to strengthen capacity to better regulate and ensure the safety of
food for all your citizens. In this context, one concrete area where regional cooperation may be pursued
could be the development of regional or sub-regional systems for food-borne disease surveillance and
food contaminant monitoring programmes. I would urge you to consider how to develop and implement
such systems during the next few days.
Finally, I thank you in advance for your interest and commitment in addressing these issues
during the next two days, as well as in the subsequent Codex Coordinating Committee meeting. I wish
you all the best in your discussions and look forward with anticipation to the results of your work.

26

FAO/WHO Regional Meeting on Food Safety for the Near East


ANNEX 5

The Speech of
H.E. Dr. Ahmad Al-Hindawi,
Minister of Trade and Industry,
Chairman of the Board of Directors of
Jordanian Institution of Specifications and Measurements
at the opening ceremony of the
FAO/WHO Regional Meeting on Food Safety for the Near East,
Amman, 5-6 March 2005
Representative of UN Food and Agriculture Organization
Representative of World Health Organization
Secretary General of Codex
Representatives of participating countries of Codex Committee for the Near East Region
Distinguished Guests
Ladies and Gentlemen.
In my name and on behalf of the Government of the Hashemite Kingdom of Jordan, I welcome
you all in Amman, the capital of your second home country to attend the coordination meetings of Food
Safety for the Near East Region (FAO and WHO), and I would like to express my thanks for your
acceptance of our invitation to attend the meetings, and to express thanks for all parties that participated
in the preparation process of the meetings.
As you are all aware, food safety in its comprehensive meaning includes safe food of high
quality that meets the expectations of customers and protects from diseases transferred by food.
All food legislations and food safety specifications are enacted for the benefit of international
food trade whether in our region or at the international level. In addition, that diseases transferred by
food are many and some are fatal. As well as such diseases affect both regional and international trade
and industry and lead to huge losses in the economical investments of food industries and judicial
conflicts among countries. Also the low quality of food harms the states trade reputation both
nationally and internationally. In addition that food damage affects the human health and wastes money
which is currently the most important economical resource.
Ladies and Gentlemen,
From this stems the importance of Codex to set specifications, parameters and codes of practices
to guarantee food safety, protect consumers and ensure best practices in food trade. The importance of
such specifications, parameters and codes increases after joining WTO agreements; especially SPS and
TBT agreements which require and acknowledge that national and regional specifications should meet
international standards in order to facilitate trade exchange among states and to have smoother
accessibility to the others markets.
The new world trade atmosphere based on transparency and free movement of goods had urged
the governments to set effective monitoring systems on food, and to update food safety legislations and
regulations to be in line with the international specifications and codes and to be in consistent with
Codex recommendations.

FAO/WHO Regional Meeting on Food Safety for the Near East

27

Ladies and Gentlemen,


The situation in the developing countries is rather different. While we notice that the industrial
and developed countries have huge export capabilities due to the adoption of most recent food
legislations concerning the health and safety of man, in addition to the most strict food specifications,
the developing countries struggle to set food safety systems and face difficulties to meet requirements of
vegetables safety of the SPS agreement. This leads to huge financial losses of such countries which in
return will deprive the countries of having access to export markets due either to poor status of food
safety systems or lack of clear procedures and measures for the health and the safety of vegetables. In
addition those developing countries do not keep up or update food legislations and specifications along
with those in the developed countries which dominate the export markets, plus the difficulties that
developing countries face such as lack of technical expertise in field of food legislation and control,
along with many agencies that are responsible of food safety.
Among many difficulties that developing countries face is that their needs are not taken into
consideration during the process of setting international food standards and specifications due to their
non-participation in setting initial basis of such international food legislations; in particular I refer to the
specifications of Codex which will later increase the probability of being affected by diseases
transferred by food and the chemical contamination of such food items.
Bad practices in the fields of food safety and control in stages of import, export, transportation
or handling had made consumers lose confidence in the food they take.
Therefore, the topic of food safety is of top and permanent priority of agendas of governments
and international organizations due to the difficulty of solving problems on the national level and being
problems on the regional and international levels. Thus stems the importance of your meetings to
address such issues and take appropriate solutions for such problems.
In conclusion, once again I welcome you and thank you for your participation in these meetings,
and wish you nice stay. I wish you all success in your meetings and to take decisions and
recommendations of high degree of importance for the welfare and safety of food of the people of our
dear Region.

28

FAO/WHO Regional Meeting on Food Safety for the Near East


ANNEX 6
NEM 05/2

Agenda Item 4

FAO/WHO Regional Meeting on Food Safety for the Near East


Amman, Jordan, 5-6 March 2005

IMPACT OF FOOD SAFETY STANDARD ON FOOD


AND AGRICULTURAL TRADE IN THE NEAR EAST
I.

INTRODUCTION

1.
Food safety has ascended to the forefront of international trade discussions following the
conclusion of the Uruguay Round in 1995. Since then, sanitary and phytosanitary standards and
regulations in developed countries have become increasingly comprehensive and stringent, in some
cases restricting trade and/or significantly increasing the costs of food exports from countries in the
Near East Region.
2.
Trade in agricultural and food products is essential for countries in the Near East. In a Region
where natural resources, especially water, are scarce, meeting food needs and ensuring food security
depend to a large extent on food imports; therefore, systems to control their quality and safety are vital
for public health. Food exports, on the other hand, provide an important means for countries in the
Region (non-oil economies in particular) to generate foreign exchange. Effective food safety systems
are therefore also critical to maintain and expand market shares in food and agricultural exports.
3.
Although several countries of the Region have been taking steps to develop new and improved
food safety systems, the capacity and efficiency of many countries need to be improved to control the
safety of locally produced and imported food for public health, and to ensure and demonstrate
compliance with food safety standards in export markets. This is particularly important as the Region'
s
exports are dominated by fruits, vegetables, olive oil and fish, for which food safety requirements are
very strict and continuously changing, compared with other products, and because the bulk of these
products are exported to the EU, where food standards are higher than in other markets to which the
Region'
s products are shipped.
4.
This document reviews the status of food and agriculture trade in the Near East as well as the
impact of food safety standards on food and agriculture trade and recommends practical actions for
governments and FAO and WHO to enhance food safety in the Region and promote agricultural and
food trade.

II.

FOOD AND AGRICULTURAL TRADE IN THE NEAR EAST REGION

5.
Although countries in the Near East Region account for less than 4 percent of world agricultural
trade; agriculture still represents a high percentage of the GDP for many of them. Food trade plays an
essential role in ensuring food security and/or generating foreign exchange earnings in many countries.
6.
Given the limited natural agricultural resources, especially water, and the rapidly growing
populations in the Region, countries increasingly rely on imports to cover their food needs and sustain
food security. Over the last 25 years, imports of food have grown by 7 percent annually, and have
exceeded the value of agricultural exports. Most countries are net food importers and have large deficits
in food production, particularly for cereals and vegetable oils. Approximately 30 percent of cereals used
in the Region are imported. From 1997 to 1999, Algeria, Egypt, Yemen and the Gulf States imported

FAO/WHO Regional Meeting on Food Safety for the Near East

29

more than 50 percent of their requirements of wheat and wheat flour which are the main staple foods in
those countries. In some countries up to 30 percent of milk and dairy products and 20 percent of meat
consumed come from imports. About 30 percent of imported agricultural and food products
(particularly meat, dairy, cereals, sugar, fats and oils) come from the European Union (EU) countries.
Most countries, especially the non-oil economies, are facing difficulties to generate sufficient foreign
exchange earnings to finance food imports.
7.
Fruits, vegetables and fish are the leading food exports from the Region. During 1997-2002
exports of primary fruits and vegetables alone made up over 14 percent of the Regions total value of
agricultural exports. Almost 70 percent of agricultural exports from the Mediterranean Basin countries
currently go to the EU. About 85 percent of these exports are made up of fresh and processed fruits and
vegetables, olive oil and fish.
8.
Fish represents an increasingly important and high-value food export commodity for several
countries in the Region. Morocco is the largest exporter of fish among Arab and African countries. Its
main customers are the EU and Japan. The export of each kilogram of fish products is equivalent in
value to the import of about four kilograms of other food products. In Mauritania, fish exports are
highly concentrated on a single species the common octopus. Exports are destined to Japan (40
percent) and the EU (60 percent). For some Gulf States, such as Oman, fish is the second largest source
of export earnings after oil.

A.

Intra-Regional trade

9.
Countries have ratified a number of Regional Trade Agreements. The most important of which
are: the Arab Free Trade Area (1996), the Arab Maghreb Union (1989) and the Gulf Cooperation
Council (1981). In practice, these agreements are not fully implemented. For instance, according to the
agreements between Arab countries on trade exchange facilities and transit trade; most primary
agricultural commodities are exempt from tariffs, and tariff rates are subject to a 50 percent reduction
for processed agricultural products such as butter, cheese, sugar, apricot syrup, and dried onions and
garlic. However, in general, full tariff rates are applied and complicated administrative procedures
continue to be required in most countries.
10.
Intra-regional agricultural and food trade is limited in scope and largely focused on two or three
countries and a few products. With the exception of Oman, the value of imports coming from within the
Region is less than 10 percent for most other countries. Major constraints and challenges facing intraRegional trade include the lack of diversity in agricultural products, non-tariff barriers, inadequate
trading support services and divergent political and economic interests.

B.

Trade with developed countries

11.
Most countries in the Region, especially those in the Mediterranean Basin, have strong
economic ties with developed countries, particularly the EU. The relative importance of the EU market
for countries in the Mediterranean Basin varies significantly from country to country. More than 50
percent of exports from the Near East to the EU come from Egypt, Morocco, Syria and Tunisia. The
composition of agricultural exports to the EU also differs widely. For instance, fruits and vegetables are
important exports to the EU for all countries in the Mediterranean Basin except Lebanon and Syria. Fish
is an important commodity for Algeria, Morocco, Oman, Tunisia, UAE and Yemen. Potatoes are an
important export commodity for Egypt, while olive oil is only important for Tunisia, which accounts for
more than 55 percent of its agricultural exports to the EU.
12.
Several countries in the Region are involved in the Euro-Mediterranean Partnership, which aims
at creating a Free Trade Area between the EU and countries in the Mediterranean Basin by 2010. To
date, partnership agreements have been signed by Algeria, Cyprus, Egypt, Jordan, Lebanon, Malta,

30

FAO/WHO Regional Meeting on Food Safety for the Near East

Morocco, the Palestinian Authority, Tunisia and Turkey. Agricultural goods are not included in the free
trade agreement, but are subject to preferential trade rules.

C.

Challenges and constraints to food and agricultural trade

13.
The high costs of complying with the standards recognized by the WTO SPS and TBT
Agreements continue to create obstacles to market expansion. This is particularly acute for the small
economies in the Region. In order to be able to take advantage of and defend their rights, and meet their
obligations under the WTO, countries must develop their capacity to participate effectively in the WTO
system.
14.
Barriers to markets for fruits and vegetables in the EU and elsewhere impede exports from the
Region. The Uruguay Round has not resulted in significant improvements in market access for fruit and
vegetable exports from the Region. Most of the Regions exports of fruit and vegetables to the EU are
subject to tariffs that vary by product, season and country of origin. During periods when imports
compete with EU domestic production, higher tariffs are imposed. Tariff escalation also presents a
barrier for processed food exports from the Region. Although countries like Cyprus, Egypt, Lebanon,
Turkey, the Maghreb countries and others have good export potential for processed food products; they
are constrained by high trade barriers in many developed countries.

III.

IMPACT OF FOOD SAFETY STANDARDS ON FOOD AND AGRICULTURAL


TRADE IN THE NEAR EAST

15.
Many countries in the Region are facing a challenge to respond in the most appropriate way to
the demands of their citizens for safe and healthy food on the one hand, and to WTO requirements for
the elimination of technical barriers to trade, on the other hand. In general, most countries in the Region
have limited capacity to plan and implement policies that affect food safety and trade, to implement
relevant international agreements, and to take advantage of trade opportunities. Several countries face
difficulties in meeting international safety and quality standards because of their weak capacity in
scientific research, testing, conformity and equivalence. As a result, a major challenge in the Region is
to raise the SPS and TBT standards of exports to reach internationally recognized levels, as well as the
often higher standards set by developed countries.
16.
Given the strong reliance of the Region on food imports, ensuring the safety and quality of
imported food is a recognized concern throughout the Region. In this context, many countries regard the
dumping of food that is low in quality, adulterated or close to shelf-life expiry on their markets as a
serious concern. For instance, between 6 to 7 percent of imported consignments in the UAE were
rejected in 2001-2003 due to non-conformity with local food safety standards. In Bahrain, 379 tons of
imported food products unfit for human consumption (due to contamination with lead, mercury and
cadmium or contamination with pathogenic micro-organisms) were confiscated over a six-month period
in 2003. Unsafe food imports have acquired greater significance following recent food safety problems
in Europe and elsewhere (such as BSE and dioxin in meat and poultry) with many countries
acknowledging their limited capacity to take appropriate actions to protect their consumers in this
regard.
17.
In some cases, countries in the Region have imposed restrictions on imported products, which
have been questioned by other countries because of lack of scientific justification. These trade concerns
have included the requirement for a maximum moisture content of 5 percent for frozen poultry
(considered too low by some WTO members), prohibition of beef imports with a fat content greater
than 7 percent, expiry date for certain products, etc. Sometimes, countries in the Region applied zero
tolerance to certain imported foods, which need now to be replaced by sanitary measures based on risk
assessment. In addition, information on sanitary and phytosanitary measures is generally insufficient
and often not available.

FAO/WHO Regional Meeting on Food Safety for the Near East

31

18.
In terms of exports from the Region, most countries face unfavourable market access in the
markets of greatest interest to them. Sanitary and phytosanitary standards applied by developed
countries have represented some of the most important barriers to food and agricultural exports. For
instance, from January to June 2001, 27 percent of food exports from Egypt, Jordan, Lebanon and Syria
to the United States were rejected by the Food and Drug Administration due to non-compliance with the
U.S. safety measures (filth, microbiological contamination, greater than permitted levels of pesticide
residues or food additives) and 58 percent due to labelling problems.
19.
Product bans have resulted in significant economic losses for the exporting countries of the
Region. In September 1997, Iranian pistachios (the countrys third most important foreign exchange
earner after oil and carpets) were banned from entering the EU because of a high content of aflatoxins.
Japan imposed a similar ban on Iranian pistachios in October 1998. As a result, Iran lost its 80 percent
share of Japans pistachio market.
20.
Bans on food exports from the Region have also resulted in considerable difficulties to re-enter
and regain market share in once important developed country markets. For instance, in September 1998,
exports of Egyptian potatoes to the EU were halted because of contamination from brown rot following
an EU decision requiring imports to be derived from certified disease-free areas. Following this
decision, the EU considered all imports diseased unless proven to be disease-free. As a result, Egypt
was obliged to submit dossiers to prove the disease-free status of its potato growing areas. However, the
EC authorities recognized only 23 of the 133 dossiers submitted by Egypt claiming that it was due to
inadequate documentation (illegible maps and insufficient translation from Arabic) and only five areas
were granted pest-free status.
21.
Although countries have sometimes been able to comply with SPS measures, often the available
technical and financial resources have been inadequate, and achieving compliance has been difficult and
time consuming. For instance, in 1998 the EU banned fish and fish products from the Gulf States due to
failure to meet environmental and health regulations based on HACCP. Exporters suddenly lost their
market share, and the public and private sector was faced with considerable costs to comply. Adopting
quality management regulations based on HACCP and demonstrating compliance (including
modifications and reconstruction to meet sanitation requirements, new testing laboratories, personnel
training, consultant fees, HACCP documentation, etc.) is often costly and may require support from
governments. The EU lifted the ban in Oman in 1999, Yemen in 2002 and UAE in 2003, once fish
exports were certified as fully compliant.

IV.

CONCLUSION

22.
Most countries in the Region have yet to harmonize their national food safety standards with
international standards, which is a complex task. As a result, they are obliged to demonstrate the
equivalency of their SPS requirements with those of developed countries, which hinders access to
developed country markets and increases the costs for exporters. The form and level of international
standards is sometimes inappropriate and/or unachievable for countries in the Region because the
current procedures through which international standards are established do not adequately consider
developing countries needs and special circumstances.
23.
Countries of the Region should be prepared for the upcoming challenges related to the testing
and certification of food imports and exports, including irradiated food, food derived from genetically
modified organisms, traceability, organic food and the provisions of scientific risk assessment whenever
there is diversion from international standards.

32

FAO/WHO Regional Meeting on Food Safety for the Near East

V.

RECOMMENDATIONS TO PROMOTE FOOD SAFETY AND FOOD TRADE


IN THE NEAR EAST

(i)

Recommendations for Governments

24.

Based on the above, it is suggested that Member Countries of the Region should:

a)
Raise awareness among policy and decision-makers of the importance of food safety and quality
for consumer protection, food trade and economic development. This should be carried out through
seminars, workshops and communication campaigns targeted at senior government officials, food
industry, the media and consumer associations.
b)
Enable food producers and industry to take advantage of international and regional export
opportunities through:

Strengthening post-harvest distribution and marketing including transportation and shipping


facilities, packaging facilities, provision of information on foreign markets and SPS and
TBT requirements, and post-harvest technologies;
Increasing awareness and capacity to meet the obligations of the SPS and TBT Agreements.

c)
Use existing Regional and sub-Regional groupings to reach consensus on issues related to food
and agricultural trade with a view to increasing attention to Regional trade concerns related to food
safety, support efforts to pursue unfair cases before the WTOs SPS Committee, and increase
bargaining power in global trade negotiations.
d)

At the Regional level:

ii)

Encourage countries to make available information on rejected food consignments and the
reasons for rejection to the public domain through internet web-sites.

Recommended Actions for FAO and WHO

25.
Within the available financial and human resources, FAO and WHO are called upon to
strengthen the capacity of countries to manage food safety and improve food and agricultural trade
through the provision of appropriate needs-based technical assistance, at Regional, sub-Regional and
national level, as well as to help in implementing the above action plan.

FAO/WHO Regional Meeting on Food Safety for the Near East

33

Annex 1: Membership of Countries in the Near East Region in the World Trade Organization
(WTO) and International Standard Setting Bodies

Afghanistan
Algeria

World Trade
Organization
(WTO)

Codex
Alimentarius

World Organization
for Animal Health
(OIE)

International Plant Protection


Convention (IPPC)

Applied

Azerbaijan

Bahrain

Cyprus

Djibouti

Egypt

Iran

Request
submitted2

Iraq

Jordan

Kazakhstan

Kuwait

Kyrgyzstan

Request
submitted2

Malta

Mauritania

Morocco

Oman

Pakistan

Qatar

Request
submitted2

Tajikistan

Tunisia

Turkey

Turkmenistan

United Arab Emirates

Uzbekistan

24

31

21

Lebanon
Libyan Arab
Jamahiriya

Saudi Arabia
Somalia
Sudan
Syrian Arab Republic

Yemen
Total Members

Applied

Applied

Applied

Applied
15

1 In the process of negotiation to become members of the WTO.


2 Requested accession but working parties on application have not yet been established.
Source: WTO. 9 June 2004. Membership in WTO and International Standard-Setting Bodies. Committee on Sanitary
and Phytosanitary Measures. G/SPS/GEN/49/Rev 6 www.wto.org

34

FAO/WHO Regional Meeting on Food Safety for the Near East

REFERENCES
Al-Mashjary, M. 2003. Presentation to METAP High Level Meeting on Economic Tools for
Environmental Sustainability (Yemen, 27 June 2003) http://lnweb18.worldbank.org/mna/mena.nsf
/Attachments/Hi+Level+Mashjary+27+June/$File/27+June-f-Mohammed+Al-Mashjary-Fish+PPT.pdf
Bahrain Economic Development Board. 2003. Contaminated Food Items Seized. Press Release, 21
September 2003. http://biz.bahrainedb.com/NewsIn.asp?Article=57714&Sn=9
Hassib, M., Ragab, H. & Hachem, F. 2003. Trade, Market Access and Food Safety in the Near East
Region. Presented to FAO-IsDB Technical Workshop on Regional Programmes for Food Security
towards Sustainable Food Security and Poverty Alleviation (Jeddah, Saudi Arabia, 8-9 October 2003)
FAO. 2003. Trade Liberalization Policies, Intra-Regional Trade and Opportunities for Sustainable
Agricultural Development. Paper presented to the 26th FAO Regional Conference for the Near East
(Tehran, Republic of Iran, 9-13 March 2002)
FAO. 2003. Food Control Systems: Modern Approaches in the Near East Region. Report of FAO/WHO
Workshop (Cairo, Egypt, 19 January 2003)
FAO. 2003. WTO Agreement on Agriculture: The Implementation Experience. Case Study on Egypt
http://www.fao.org/DOCREP/005/Y4632E/y4632e0c.htm#bm12
INFOSAMAK/FAO. 2003. Report of Presentations and Discussions Sessions at Expert Consultation on
International Fish Trade and Food Security (Casablanca, Morocco, 27-30 January 2003)
http://www.tradefoodfish.org/articles.php?pageid=art&article=article03

FAO/WHO Regional Meeting on Food Safety for the Near East

Agenda Item 5

35

NEM 05/3

FAO/WHO Regional Meeting on Food Safety for the Near East


Amman, Jordan, 5-6 March 2005

THE IMPACT OF CURRENT FOOD SAFETY SYSTEMS IN THE NEAR


EAST/EASTERN MEDITERRANEAN REGION1 ON HUMAN HEALTH
Introduction
The availability of wholesome and safe food is a basic human right and is essential for adequate
human health. The problem of the consumption of contaminated food and its detrimental effect on
human health has not been fully studied in the Region. However, governments should take the necessary
measures to ensure the availability of safe food for all in order to sustain the health and economic
development of their people.
On a global level, food safety is becoming an increasingly important public health issue, with an
increased focus on the inclusion of consumers and consumer associations in decision-making processes.
In 2000, the 53rd World Health Assembly adopted a resolution on food safety in which it was stated,
among other topics, that food-borne diseases (FBD) seriously affect peoples health and well being, and
that these diseases have economic consequences not only for individuals, but for communities and
countries as well. Further, the work of the Codex Alimentarius Commission was recognized as being
important for the protection of the health of consumers.
Food-borne diseases
Generally, food-borne diseases are understood to be those diseases that are the result of
exposure to pathogenic microorganisms, such as bacteria, viruses and parasites, which tend to have
acute effects on human health. However, chronic, and in some cases acute, food-borne illness may also
be caused by the presence of various chemical substances including residues of pesticides and veterinary
drugs, unlawful food additives, mycotoxins, biotoxins and radionuclides that enter the food intentionally
or unintentionally. An overview of the main types of contaminants causing food-borne disease is
available as CRD3.
Food safety, food-borne disease surveillance and the need for integrated action
The farm to fork concept defines a food safety system as one comprehensive entity, in which
food production, supply and consumption are considered as a continuous process rather than a series of
separate activities. The operational changes resulting from the adoption of this concept should make it
possible to link food contaminant monitoring and food-borne disease surveillance data to better control
the risks affecting human health.
The main reasons for the widespread and often large-scale occurrence of food-borne diseases are
the lack of overall quality control systems, and the lack of scrupulous attention to food hygiene
throughout the food production and distribution chain. Increased travel and trade heighten potential food
safety problems, making the need for rapid response systems even more evident. The presence of
regional, national and local monitoring and surveillance systems that facilitate the reporting, detection,
rapid response, estimation of the burden of food-borne disease outbreaks and prioritization of food
safety controls will strengthen both the public health as well as the trade sector.
1

The term Near East region used in this document refers to the member states of the FAO Near East Region,
along with the member states of the WHO Eastern Mediterranean Region.

36

FAO/WHO Regional Meeting on Food Safety for the Near East

Food-borne disease surveillance


Surveillance is the routine collection of data for public health action. The chain of events that
must occur for an episode of an illness to be captured as a laboratory-confirmed case and be reported to
infectious disease surveillance systems in the public health care system is as follows: 1) food is
contaminated, resulting in persons becoming ill; 2) if the illness is of sufficient concern, some persons
will seek medical care; 3) the attending health care provider (when sufficiently concerned about
diagnosing the illness properly) obtains a specimen from some ill persons and submits to a clinical
laboratory for diagnostic purposes; 4) the clinical laboratory tests as appropriate and confirms the
incidence of food-borne pathogens; 5) and the laboratory-confirmed case is reported. If any step of this
process is missed, the case will not be reported accurately.
The main types of food-borne disease surveillance are syndrome- or laboratory- based.
Surveillance activities can, and should, take place at all levels of the previously described chain of
events, though not necessarily on a continuous basis. Aggregated information about exposure, prevailing
illnesses, and pathogen-specific diseases can be collected at an occasional basis, for strategic or
planning purposes. However, the surveillance system must operate in such a way that emerging patterns
and outbreaks are identified.
Although not feasible for all countries, laboratory surveillance is more precise than syndromebased surveillance as many diseases share the same symptoms. Further, laboratory analysis provides an
opportunity for sub-typing for increased specificity. The complexity of the food supply and
consumption chain makes the collaboration of microbiologists to identify the organisms and
epidemiologists to analyze the findings essential. This process becomes more effective when
microbiologists from human, veterinary, and food-related institutes all work together in food-borne
disease surveillance.
The data from disease surveillance should allow for the estimation of the percentage of cases
that are food-borne, and more specifically, the number of cases that can be attributed to specific food
commodities. This information is required in food safety risk management, as additional transmission
routes also exist for most food-borne pathogens such as through water, animal contact or from the
environment. Also, risk managers can better target controls when the specific pathogen food commodity
combination can be established.
Food-borne diseases in the Near East
In the countries of the Near East region, food-borne diseases with symptoms such as diarrhoea
and even fever are a fact of daily life and are generally perceived as a mild and self-limiting episode.
Medications, if used at all, are bought over the counter and disease episodes go unreported. Some
diseases like diarrhoea and cholera are traditionally seen as water-borne, rather than food-borne,
diseases and if reported, may be recorded as such. Medical attention is often only sought too late, when
the disease has become extremely debilitating and only drastic treatment might be effective. Certain
regional or local habits, such as the consumption of raw and cooked salads, and certain specific food
preparation techniques, such as the preparation of cheeses from raw milk, enhance the opportunity for
microbiological contamination and thus the spread of food-borne diseases.
Many factors contribute to the high incidence of food-borne disease in the region. Good
manufacturing practices (GMPs) and quality assurance systems such as HACCP have been introduced
to the food production and catering sector in all countries of the Near East region, but are generally not
widely applied. Street food vending tends to be an important food source for a large part of the
population in a number of the Member States, and often the vendors have little or no formal education in
food handling practices.

FAO/WHO Regional Meeting on Food Safety for the Near East

37

Food-borne disease surveillance in the Near East region


Data on food-borne disease incidence in the region tends to be sparse, since most countries of
the region have no systematic surveillance or even an adequate reporting mechanism in place for foodborne diseases, at least not one that communicates with food safety authorities. Even if a notification
system exists in the country, these diseases are not actively reported.
Accordingly, the incidence of food-borne diseases is often not reflected in the setting of any
national food safety strategies. Research papers on specific subjects such as vulnerable populations or
newly emerging pathogens tend to be published, but in general it is hard to obtain a general picture of
the prevalence of food-borne diseases in any given country in Near East region, or in any country of the
world.
However, some Member States of the Region do have well functioning health systems, good
public health laboratories, and stable surveillance system and have developed information and
communication systems which allow them robust responsive systems in the event of disease outbreaks.
The health system is supported by other existing infrastructure such as, water supply, good sanitation
system, and public education level. These countries do report outbreaks.
The health information systems are based on mandatory notifications, outbreak investigation and
sentinel surveillance, and hospital records. The mandatory notification of FBD suffers from a number of
limitations such as difficulties in outbreak detection, identification of single case, and characterization of
long term trends.
The food-borne diseases that are included in the reporting list of the countries of the region are
cholera, bloody diarrhoea, other diarrhoeas, shigellosis, amoebiasis, food poisoning, salmonellosis,
typhoid and para-typhoid, brucellosis, viral hepatitis A, intestinal and pulmonary tuberculosis,
echinococcosis, giardiasis, toxoplasmosis, fashiolniansis, and other infections (see table 1). CreutzfeldtJakob disease has recently been added to the list, but is only reported by one country in the region thus
far. More countries report cholera and general food poisoning outbreaks, but very few countries of the
region report diseases such as salmonellosis.
Due to the variances in the level of food-borne disease reporting between countries, comparisons
of the level of FBD in the countries of the region is not meaningful. Countries with more advanced FBD
surveillance systems will report a much higher number of FBD, even though there may very likely be
fewer diseases in countries with a more developed food control system, including an improved FBD
surveillance system (See Figure 2).
Table1. Number of countries in which FBD are included in reporting system
Number of countries of the region
Food-borne diseases by type
reporting FBD

Cholera
Food poisoning outbreaks
Typhoid Fever
Acute diarrhoea
Brucellosis
Bloody diarrhoea
Hepatitis A
Salmonellosis
Giardiasis
Shigellosis
Amoebiasis
Helminths
NCJD
Toxoplasmosis
Fascioliasis

22
22
18
16
15
14
7
6
5
5
3
3
1
1
1

38

FAO/WHO Regional Meeting on Food Safety for the Near East

Table 2. The Number of FBD reported by country.


COUNTRY
Afghanistan
Bahrain
Djibouti
Egypt
Iran
Iraq
Jordan
Kuwait
Lebanon
Libya
Morocco
Oman
Pakistan
Palestine
Qatar
Saudi Arabia
Somalia
Sudan
Syria
Tunisia
UAE
Yemen

Number of reported food-borne


diseases
2
14
4
10
10
10
10
13
11
10
7
10
5
7
9
11
2
5
5
7
16
5

The countries of the region can be divided into three main groups regarding the status of foodborne disease surveillance in that country.
Group one consists of Afghanistan, Djibouti, Mauritania, Pakistan, Palestine, Somalia, Sudan
and the Republic of Yemen. These countries are the least developed in terms of food-borne disease
surveillance and food safety infrastructure. Other supportive infrastructures, such as sanitation and water
supply are weak and inadequate. The food-borne disease- related priorities in these countries are to
reduce occurrence of acute diarrhoeas.
Group two countries, including Algeria, Egypt, the Islamic Republic of Iran, Iraq, Jordan,
Lebanon, Libyan Arab Jamahiriya, Morocco, Oman, the Syrian Arab Republic, and Tunisia, have
adequate disease surveillance in place in which common food-borne diseases are included. Substantial
progress has been made in recent years in improving the general food safety infrastructure in these
countries. For example, Jordan finalized a sentinel study on the burden of food-borne disease in
September 2003. However, much remains to be done in the field of food safety, including an adjustment
of national food safety priorities to also deal with specific food pathogens.
Group three countries, consisting of Bahrain, Kuwait, Qatar, Saudi Arabia, and the United Arab
Emirates, possess adequate basic infrastructures in food-borne disease surveillance and other supportive
environmental structures and programmes are functional. Their priority concern is largely food chemical
contaminants and hazard analysis, including bacteriological and viral analysis. However they do not
report their surveillance data or information on food contaminant monitoring to the WHO Regional
Office as there is no mechanism for the regional collection of this data.
Results of WHO EMRO survey on food-borne disease surveillance in the region
The WHO EMRO office recently requested information from several countries of the region on
1) the status of their food-borne disease surveillance system, 2) whether the system is integrated into
their overall national disease surveillance system, 3) the prevalence of food-borne disease in their
country, and 4) whether food-borne disease statistics have been used for establishing and evaluating

FAO/WHO Regional Meeting on Food Safety for the Near East

39

priorities in FBD prevention and control. Several countries of the region responded, including
Afghanistan, Iran, Jordan, Lebanon, Libya, Oman, Pakistan, Saudi Arabia and Somalia. Afghanistan,
Iran and Somalia reported that FBD surveillance does not exist. Data from Jordan, Lebanon, Libya,
Oman and Saudi Arabia is illustrated in table 3 to 7 below.
According to the preliminary report (2003) of a burden of food-borne disease sentinel study in
Jordan, 2.5% of 80 stool specimens cultured were positive for Salmonella spp, and 16.2% were
positive for Shigella spp. Using a series of calculations based on the total population of Jordan (5.3
million people in 2002) and laboratory surveys, it was estimated that for one month (in late summer), at
least 271 cases of salmonellosis, 1899 cases of shigellosis, and 854 cases of brucellosis occurred in
Jordan. The Ministry of Health Statistics in Jordan estimated the incident rate (per 100,000 people) of
notifiable FBDs as shown in Table 3.
Table 3. Average incidence rate (per 100,000 people) of food-borne diseases in Jordan
for the period 1998-2002
FBD
2002
1998
Bloody Diarrhoea
4.8
12.7
Typhoid and Paratyphoid
0.6
1.4
Hepatitis A
10.2
16.9
According to the Ministry of Health, Lebanon, the national disease surveillance system reported
the following cases of five different FBDs for the year 2003 (Table 4):
Table 4. Lebanon notified FBDs (2003)
Brucellosis
193
Dysentery
158
Food Poisoning
68
Typhoid Fever
891
Viral Hepatitis A
616
The Libya Ministry of Health reported the number of food poisoning cases registered in
hospitals for 2001-2004 as shown in Table 5:
Year
2001
2002
2003
2004

Table 5. Food Poisoning Cases, Libya


Number of Cases
297
278
129
779

According to the Ministry of Health, Oman, the notifiable FBDs for 1985-2002 are as shown in
Table 6:
Table 6. Oman FBD incidence rate from 1985-2002

FBD

1985

1990

1995

1996

1997

1998

1999

2000

2001

2002

Shigellosis
(Bacillary
Dysentery)
Amoebiasis
(Amoebic
Dysentery)
Acute
Gastroenteritis
and Diarrhoea

4276

2540

2449

2636

1738

1388

1427

1582

1523

1158

3787

5393

512

6969

5567

4388

4387

4312

5047

5440

----

273920

78823

162535

135506

97036

105435

112212

109065

112904

40

FAO/WHO Regional Meeting on Food Safety for the Near East

According to the Ministry of Health, Saudi Arabia, the prevalence rate of the food-borne
disease and poisoning outbreaks for 2001-2003 are as shown in Table 7.
Table 7. Prevalence rate of the food-borne disease and poisoning outbreaks in Saudi Arabia
FBD

2001

Hepatitis A
Typhoid and Paratyphoid
Amoebic Dysentery
Salmonellosis
Shigellosis
Food Poisoning Outbreaks

2002

14.72
1.76
13.3
9.24
2.83
11

2003

13.65
1.82
21.39
11.85
2.2
12

9.55
1.83
10.57
10.07
2.22
16

Despite the difficulties of obtaining accurate FBD surveillance data in the Region, it appears that
there is a decline of FBD incidence in Gulf States (see data above from Saudi Arabia and both above
and below from Oman). This was likely due to a number of interventions, such as increased sanitation,
milk pasteurization, canning foods, herd vaccination, economic development, improved housing, use of
refrigerators, safe water supply, food monitoring and improved consumer information. For example, as
shown in Figure 1, acute diarrhoea and other gastroenteritis incidence declined in Oman from the year
1985 until 2002. Similarly, there is a significant decline of FDB incidence in Jordan, Saudi Arabia and
Lebanon.

Figure 1. Acute Gastronentieritis and Diarrhea / Oman 1985-2002


300
273.92

250

Population in thousand

200
178.823
162.535

150
135.506

100

97.036

112.212

105.435

109.065

112.904

113.468

50

0
1985

1990

1995

1996

1997

1998

1999

2000

2001

2002

Year

Source from the Ministry of Health, Oman 2005

Examples of national food-borne disease surveillance systems


Egypt2 boasts an epidemiology training programme in operation since 1992. A serious foodborne illness outbreak on a cruise ship in 1996 justified the launch of a programme on vessel sanitation,

FAO/WHO Regional Meeting on Food Safety for the Near East

41

which has been extended to include hotels and restaurants. Disease surveillance has seriously been
addressed since 1999, but its implementation is still problematic due to the great number of vertical
programmes, limited laboratory capacity and widespread underreporting.
In Jordan2, the food-borne disease surveillance system is based on syndromic surveillance, with
an ongoing shift towards laboratory- based surveillance. Presently, operational research is ongoing to
establish the incidence of salmonella, shigella and brucella, and to improve administrative and logistical
procedures in the food-borne disease surveillance system. A need has been stated for increased and
improved collaboration with the private, as well as the agricultural sector. Under-reporting affects the
results of the surveillance system, and the ongoing research will give a measure of the proportion of
underreporting through a population- based survey into the health care seeking behaviour for fever and
diarrhoea patients.
In Lebanon2 the notification of a number of food-borne diseases is obligatory. In 2001, of the 92
reported food poisoning cases, there were 17 episodes identified. After investigation, it became
evident that there were 112 cases in total, of which 84 were hospitalized. The episodes were due to
salmonella (5), shigella (1), faecal contamination (2), chemical contamination (1), nothing found (4), not
tested (5). An episode could also be due to more than one contaminant. The vectors identified were raw
meat (5), cooked meat (1), sandwiches (3), sweets (1), other (3) and unspecified (4).
Saudi Arabia has had a food-borne disease surveillance system with obligatory notification since
1975. In 2003, 16 outbreaks were reported and investigated. Outbreaks generally peak in the hot
summer months.
In a review of all reported food-borne disease cases from 1997 till 20032, the total laboratory
results show a large percentage of Salmonella cases, 47.17% in total.
Laboratory result

Number of cases

Percentage

Salmonella
Salmonella (B)
Negative organism
Staph. Aureus
Staph.aur.enter.
Mixed organism
E.coli
Bacillus cereus
Shigella
Total

6525
2010
3034
1962
864
1212
1078
801
607
18093

36.06
11.11
16.77
10.84
4.78
6.70
5.96
4.43
3.35
100.00

In the same review in Saudi Arabia, it was found that the food items typically causing illness in
a home setting, fresh milk and fresh laban, do not cause any disease in public settings. Chicken and meat
account for a large number of cases in both setting, with chicken shawerma only being available in
public settings. The total number of the cases reported for home settings is almost double the number of
cases in public settings. For more results, see table below.

Presentations at the Global Salm-Surv pre-level 3 and level 3 Training Courses on Food-borne Diseases
Surveillance, WHO/EMRO, Cairo, Egypt, July 2003 and February 2004

42

FAO/WHO Regional Meeting on Food Safety for the Near East

Food item
Chicken
Chicken shawerma
Meat
Fresh laban
Fresh milk
Egg

Home
Number of cases
248
0
272
398
294
72

Percentage
15
0
16
23
18
4

Public
Number of cases
379
233
193
0
0
65

Percentage
37
23
19
0
0
6

Cheese
Rice
Fish
Others
Total

70
167
40
142
1703

4
10
2
8
100

24
38
11
68
1011

3
4
1
7
100

In addition, in the review in Saudi Arabia, an analysis of the contributing factors shows that the
main causes for contamination levels to persist in foods are the improper maintenance of storage or
cooking temperatures. Infected food handlers actually contribute very little to the total number of cases,
as does inadequate cleaning of utensils. For more detailed figures see table below.
Contributing factor

Home

Public

Inadequate cooking
Inadequate reheating
Inadequate thawing
Keeping food at room temperature
Preparing food a day or more before serving
Inadequate cleaning of equipments
Use of untreated food
Inadequate refrigeration
Infected food handlers
Unknown

7
15
5
16
8
9
34
13
1
2

47
9
20
17
11
4
17
3
5

Further data on incidents of food-borne diseases which have been collected from presentations
at (regional) meetings, publications and research papers is available as CRD4.
Regional challenges
While great care should be taken not to draw regional conclusions from isolated local, provincial
or national examples, it may nevertheless be stated that trends can be observed in the Near East region
that demand greater attention by the countries respective food safety systems. The food safety issues
facing the countries of the region vary greatly, depending on national income status, status as an
exporting or importing country, national infrastructure, educational level, and level of the provision of
consumer information.
Some of the main challenges related to food safety and human health include:
1.
2.
3.

Poor epidemiological characterization of food hazards, food-borne diseases and its direct and
indirect impact on public health;
Inadequate public health infrastructure including laboratories
Weak leadership role of the health sector in the development of food safety policy, plans and
programmes as an essential public health function

The challenges related to specific groups of food-borne diseases and food-borne diseases include
the following:

FAO/WHO Regional Meeting on Food Safety for the Near East

43

Microbiological contamination is a fact of the region, as is often stated; however, the data to
corroborative facts to underline this statement are hard to collect. Data on the full spectrum of known
food-borne pathogens and their prevalence in the respective daily diets of the countries are not available.
Chemical contamination, either through misuse or abuse of substances or by environmental
pollution is another fact, and regretfully inadequately and inconsistently addressed by all relevant
authorities.
Antimicrobial resistance will become a severe threat to public and animal health in the near
future unless stringent measures are taken to not only control the use and misuse of antimicrobials, but
also to educate the general public and the concerned professional groups in the consequences of their
present habits.
Zoonoses continue to threaten public and animal health, and as a consequence affect trade
greatly. The need for inter-sectoral action cannot be stated enough for this specific area.
Food-borne disease surveillance systems, where existent, do generally operate in a rather
reactive manner. The final goal of such a system would be to become pro-active by enabling the users
to project future scenarios and take relevant public health or other measures. Since these measures
generally lie outside the sphere of influence of the food-borne disease surveillance system itself, there is
a great need for interaction and collaboration with the rest of the food safety system.
Conclusion
The impact of food safety systems in the Near East region on human health is difficult to
determine. Comparative studies are not available; an overview of neither pathogens nor disease
incidence is available for most countries; and trends in disease incidence are generally not available yet
due to the rather recent commencement of data collection. The initial increase in the incidence of foodborne disease can mainly be contributed to improved data collection mechanisms rather to a decrease in
food safety, and should therefore be considered with caution.
Member States must continue to work towards putting food safety firmly in their national public
health agenda. The establishment of integrated food monitoring and food-borne disease surveillance
systems requires effective collaboration and coordination with all stakeholders from the health,
agriculture and trade sectors. The burden of FBD in the region is still very high and efforts must be
undertaken to reduce the effects of food-borne disease on human health.
Recommendations
In view of the above-described challenges related to food safety and human health, governments
of the region should:

work to strengthen the place of food safety on the national public health agenda
enhance their capacity to plan and carry out a national food-borne disease surveillance
programme
enhance their ability to collect data on the incidence of contaminants in food, including exposure
assessments.
undertake risk assessments on food safety hazards of particular importance to their country, or
develop the capacity to do so if needed.
develop mechanisms to facilitate communication and cooperation between all relevant food
control authorities. These should include food inspection services, food control laboratories,
food-borne disease surveillance systems and food contaminant monitoring systems.
create a mechanism for implementing necessary corrective measures to reduce the load of foodborne diseases and improve human health

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FAO/WHO Regional Meeting on Food Safety for the Near East

develop the scientific and technical capacity to prevent, control and manage trans-boundary
risks to human, animal or plant health.
create a rapid food-borne disease alert system
strengthen national food control systems (strengthen food control management, modernize food
legislations, improve inspection services, etc) to support improvements to food-borne disease
surveillance systems.

References
WHO/EMRO, Dec 2002, Food safety, food-borne diseases, and the need for integrated systems. Report
on the Regional consultation of food-borne disease surveillance.
WHO, 2002. WHO Global Strategy for Food Safety. Safer food for better health. http://www.who.int/fsf
WHO/EMRO, July 1999. Technical Paper on Food Safety. Presented to the 46th Session of the Regional
Committee foe the Eastern Mediterranean. http://www.emro.who.int/fos

FAO/WHO Regional Meeting on Food Safety for the Near East

Agenda Item 6

45

NEM 05/4

FAO/WHO Regional Meeting on Food Safety for the Near East


Amman, Jordan, 5-6 March 2005

NATIONAL FOOD SAFETY SYSTEMS IN THE NEAR EAST


- A SITUATION ANALYSIS
Introduction
A national food safety system can be defined as the set of regulatory and non-regulatory
institutions involved in activities aiming at ensuring the safety of the national food supply. It includes
the official food control system, which is defined by FAO/WHO1 as being "the mandatory regulatory
activity of enforcement by national and local authorities to provide consumer protection and ensure that
all foods during production, handling, storage, processing and distribution are safe, wholesome and fit
for human consumption; conform to safety and quality requirements; and are honestly and accurately
labelled as prescribed by law. It also includes voluntary quality assurance programmes implemented
by food producers and processors to ensure the safety of their products; the food safety risk assessment
activities undertaken by relevant academic and scientific institutions; and the activities of professional,
industry and consumer associations aimed at promoting food safety.
Three main guiding principles govern modern food safety systems and directly impact on their
effectiveness, namely: the realization that food safety is multi-sectoral; that food safety should be
addressed throughout the farm to fork food continuum; and any decision, measure or approach should
be science based.
The multi-sectoral challenge
One of the particularities of food safety is that it requires professionals from different
disciplines, often with different objectives, to work together towards a common goal of protecting the
health of the consumer and promoting fair practices in food trade. Therefore, in most countries, the
responsibility over food safety and quality is shared between a number of government departments and
institutions which often include the Ministries of Agriculture, Health, Trade, Industry and others. The
effective involvement of these ministries and institutions in a well-coordinated and complementary way
poses a real challenge for national food safety managers.
The food continuum
It is now widely recognized that it is impossible to provide adequate consumer protection by
merely sampling and analyzing the final food product. The introduction of preventive measures at all
stages of the food production, processing, transportation, handling and distribution chain is essential to
achieve food safety and is economically sound. Many, but not all, potential food hazards can be
controlled along the farm-to-fork food continuum through the application of good agricultural practices
(GAPs), good manufacturing practices (GMPs) and good hygienic practices (GHPs), along with the
application of Hazard Analysis Critical Control Point (HACCP) system.

Assuring food safety and quality: Guidelines for Strengthening National Food Control Systems, FAO/WHO,
2003. Full document available at ftp://ftp.fao.org/es/esn/food/guideFCS_en.pdf

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FAO/WHO Regional Meeting on Food Safety for the Near East

Science as the basis risk analysis


Whereas the application of science in the setting of standards is common practice, the use of
science as the basis for decision making in food safety is less common. One of the main challenges in
food safety today remains the application of risk analysis as a structured methodology for decision
making, involving risk assessment, risk management and risk communication. In many developing
countries, the lack of adequate data on the exposure of different population groups to various food
contaminants constitutes a serious barrier to the application of food safety risk analysis.
National food safety systems in the Near East region
The status and performance of food safety systems in the Near East region varies considerably
from one country to another, reflecting the existing differences in economic conditions and in
agricultural and food sector development between the countries of the region. In recent years, an
increasing number of these countries have made serious efforts to update and strengthen their food
safety systems and infrastructures. Some countries have engaged in profound reform of their food safety
system by moving towards the integration of some of the functions of the system and in the introduction
of modern risk-based approaches to food safety management. These efforts have led to a relative
improvement in the effectiveness of the food safety systems in protecting the health and economic
interests of consumers and in enhancing food export capabilities of a number of countries. The situation
is, however, far from being adequate as many serious problems continue to persist.
Organization of food control services
In most countries of the Near East region, responsibility over food safety is shared among
several agencies. Issues directly related to public health, such as food hygiene and sanitation and foodborne disease surveillance are dealt with by the health authorities at central and local/municipal levels,
while matters related to food production, processing and distribution including the control of the quality
and safety of foods of animal origin fall under the authority of the Ministry of Agriculture. In the Gulf
States, because of the relatively limited importance of the agricultural sector in the overall economies of
these countries, and the concentration of food- related operations in urban areas, the main responsibility
over food control lies with the municipal authorities.
Throughout the Region, efforts have been made or are underway to reform and improve food
control systems. For instance, in Algeria, the government, with assistance from FAO, WHO and
UNIDO, is carrying out a detailed study of the existing food control system and facilities with a view to
recommending a national strategy to improve the efficiency of the current system and address the
existing problems. Under the Technical Cooperation Programme2 (TCP), FAO is also assisting the
country in the establishment and functioning of a National Codex Committee. In Jordan, special effort
has been made by the Government in recent years to re-organize and streamline the food control
activities at national and provincial level through the establishment of a Food and Drug Administration
with authority over the control of the safety of foods and drugs in the country. In Morocco, under a
FAO/TCP project3, the government has developed, in 2004, a 5-year Road Map for the integration of
the food control system in the country and the creation of an agency that serves as the central regulatory
authority in food control and coordinates the overall food control activities in the country. Attached to
this agency, but organically independent, a scientific committee will be created to serve as the countrys
focal point for food safety risk assessment. In Lebanon, under a UNIDO-executed project, a new draft
food law has recently been developed which provides for the establishment of the Lebanese Food Safety
Agency to implement the food law. Chapter IV of this draft food law covers the scope, tasks,
organization and operation of the Lebanese Food Safety Agency. The draft is under consideration by the
concerned ministries and institutions in the country. In Saudi Arabia, in 2003, the Government
established the Food and Drug Administration which is responsible for the enforcement of the food and
2
3

TCP/ALG/3003 Appui la cration et au renforcement dun comit national Codex.


TCP/MOR/0168 (A): Appui la cration de l'
Agence de la qualit et de la rpression des fraudes

FAO/WHO Regional Meeting on Food Safety for the Near East

47

drug legislation in the country. The establishment of food standards remains with the Saudi Arabia
Standards Organization (SASO). In Tunisia, the National Agency for the Control of Food and
Environmental Safety has been created with the objective, among others, of coordinating the relevant
activities among the various agencies involved. Other countries, such as Kuwait, Oman and Syria have
made special efforts to revive already existing coordinating mechanisms (inter-ministerial committee,
food control council, etc.) to improve efficiency and minimize duplication or gaps. In Yemen, under a
new FAO/TCP project4, a new national codex committee is under creation with coordinating
responsibilities not only on Codex matters but also on national food control activities.
In most countries of the Gulf Cooperation Council (GCC) and in particular in the United Arab
Emirates (UAE), the municipal authorities play a central role in food control management. Other
relevant ministries are involved mainly in the development of food legislation (regulations, standards)
and in quarantine services. There is a definite trend towards the harmonization of the food safety
systems in the different member countries of the GCC, starting with the food legislation and gradually
covering the other aspects of the system.
In Egypt, Iran, Libya and Mauritania the multiple agency system model prevails to a large extent
with a tendency to focus the consultation and collaboration process at the level of the development of
food legislation (including food regulations and standards) leaving the tasks of enforcement to the
concerned ministries/authorities, each in its area of competence.
It is evident that a great effort is under way in many countries of the region to reorganize their
food control systems with a view to making them more efficient and less complex. This effort needs to
be continued and strengthened in respect of the application of the three basic principles cited earlier, and
further expanded to cover other countries of the region. The tools issued by FAO and WHO in this field
(see references) could provide a useful support.
Food laws, regulations and standards
In general, food legislation in the countries of the region is characterized by a set of fragmented
enactments under the mandates of the Ministries of Agriculture (for animal products, plant protection
and animal health quarantine), the Ministry of Health (Public health law, food hygiene/sanitation law,
etc.), the Ministry of Commerce/Trade (food import and export control), the Municipal authorities
(retail markets, food services, etc.) and others. Only a few countries (Jordan, Saudi Arabia) have
recently enacted new food laws that cover all foods, and integrate the work of all concerned agencies.
However, a number of other countries are actively working on the establishment of such a single food
law. In particular, Lebanon, with support from UNIDO and UN/ESCWA, has developed a draft food
law to improve the efficiency and capacity of its food control system to meet present day requirements.
This has been undertaken through a thorough review of the role and function of the main players, the
establishment of a national coordinating mechanism, and the training of a core group of trainers. These
efforts have resulted in a new draft food law which is now under consideration by several governments
(Lebanon, Morocco, Oman, Pakistan and Syria).
Food standards are generally issued by the national food standard organization which always
covers not only food, but also other consumer products. Most countries of the region have established
strong standards organizations, with the assistance of UNIDO and other international organizations.
These organizations often participate in Codex work and contribute indirectly in the effectiveness of the
food control.
Some other countries, such as Jordan, recently revised their food laws, harmonized their food
safety standards with Codex and moved towards a food safety system based on risk analysis. These
reforms have reduced laboratory analysis costs by half and decreased clearance process time due to a
semi-automated archiving system for tracking and reporting of food products.
4

TCP/YEM/3003 - Strengthening the Food Control System and Establishing a National Codex Committee

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FAO/WHO Regional Meeting on Food Safety for the Near East

At the sub-regional level, it is opportune to make a special mention of the on-going effort in the
GCC countries to develop a common food control regulatory system with harmonized procedures for
inspection, testing and compliance. The sub-region has already embarked in the implementation of a
common entry policy for imported food products. In the Arab Maghreb Union, efforts to put in place a
common food regulatory system and a common market among the member countries are still in an
embryonic phase.
The national standards setting institutions for the majority of the Near Eastern region are mostly
independent of the food control authorities. Whereas there is a general representation of the various
professions in the development of standards, there tends to be a lack of consideration of the complete set
of actors, i.e. agriculture, health, trade, industry and consumers in the setting of priorities for standard
development and in contributing to their elaboration.
Harmonization with Codex Alimentarius standards in order to comply with WTO requirements
is ongoing or has been finalized for those countries5 that are either members or observers of WTO.
Food inspection
Field inspection work is usually carried out by officially recognized food inspection agents
attached to different authorities (Ministry of Agriculture, Ministry of Health, Ministry of Trade,
Municipal authorities, etc). Most of these agents have been trained in carrying out classical food
inspection tasks at retail sale level and have little, if any, knowledge of modern risk-based approach to
food control. A few countries, however, have initiated programmes to prioritize inspection procedures
and improve cost-effectiveness. For instance, in UAE, inspection systems for domestic and imported
foods utilize customized computer software covering the entire inspection operations, which enhances
access to information, focuses attention on high risk foods, accelerates the clearing process for food
imports, increases incentives for better performance and improves overall food safety. A similar system
has been developed by the Aqaba Port Authority in Jordan for the inspection of all food products
imported by Saudi Arabia. It is in the practice of food inspection work that overlapping (or gaps) in the
tasks of the mandates of different corps of inspectors may be seen.
Quality assurance
There is a growing acceptance and increasing use of Good Manufacturing Practices (GMP),
Good Agricultural Practices (GAP) and the Hazard Analysis and Critical Control Point (HACCP)
system throughout the region. In a number of countries, quality management regulations based on
HACCP have been adopted for fish and fish products to regain access to importing markets such as the
European Union countries. Steps have been taken in other countries to ensure quality assurance and
good production practices for major food export commodities, often in consultation with, or supported
by, importing countries. In addition to food safety related processing requirements, issues such as
regulations specifying growing locations and other production requirements have been developed.
Although GMP and quality assurance systems such as HACCP have been introduced throughout
the Region, they are not fully integrated in the domestic inspection systems which continue to focus
primarily on end-product control. In a number of countries, many industries apply HACCP on a
voluntary basis in order to improve food safety domestically as well as increase their share of export
markets. In Oman, Tunisia, UAE and Yemen, quality management regulations based on HACCP have
been adopted for fish and fish products to regain access to importing markets (ex. EU market). In
addition, Tunisia has introduced provisions for the application of HACCP by the fish industry in its food
safety legislation. Some countries, such as Lebanon, Morocco, Oman, and UAE have or are developing
legislation and guidelines on GMP and the HACCP system. The Islamic Republic of Iran has introduced
legislation requiring HACCP certification for food exports and has strengthened its national capacity to
5

See table in NEM 05/2

FAO/WHO Regional Meeting on Food Safety for the Near East

49

monitor and control residues (pesticides, animal drugs and chemical residues) in foodstuffs with FAO
assistance.
Steps have been taken in other countries to ensure good production practices (GAP, GMP and
HACCP) for major food export commodities, often in consultation with, or supported by, importing
countries. For instance, in Egypt, regulations specifying growing locations and other production
requirements have been issued for potatoes and peanuts, and are being prepared for vegetables and fruits
in order to meet European Union (EU) standards.
Food Control Laboratories
Despite the efforts made by many countries of the region to establish modern facilities and
acquire modern equipment and supplies, the laboratory services of most of the countries of the region
are in constant need of continuous improvement of capacity and capability. Laboratories have limited
scientific and technical expertise, financial resources and equipment, have difficulty in obtaining
necessary reagents and reference materials and lack internationally recognized accreditation. These are
all major obstacles to improved analytical capabilities in the region.
In the Gulf States, a particular effort was made during the 1980s and up to this date, to
continuously develop and update their laboratory services for food control. The accreditation process of
these laboratories has been progressing slowly mainly because of the lack of suitable accreditation
bodies in many countries of the region. Only a few laboratories in Egypt, Iran, Morocco, Tunisia and
UAE have received accreditation for certain analysis, from external auditors.
Food contaminant monitoring and food-borne disease surveillance
Although some countries have adequately functioning mechanisms for reporting food-borne
diseases, most countries of the region have no reporting mechanism in place, at least not one that
effectively communicates with national food control authorities. Additionally, underreporting is
common. As a result, the incidence of food-borne diseases is often not reflected in the setting of national
food safety strategies. Food safety measures are not given the priority they deserve with regard to
chemical and microbiological contaminants of relevance to the region.
Participation in Codex work
All countries of the Near East region are members of the Codex Alimentarius Commission except
Yemen. Their participation in Codex work, however, is very erratic and certainly not as effective as it
could be in protecting their interests. With the assistance of FAO, Morocco has established a well
functioning National Codex Committee which has enabled the country to significantly improve its
participation in Codex work. Similar efforts are underway in Algeria, Lebanon, Syria, Tunisia and
Yemen. The FAO/WHO Trust Fund on Codex established late 2003, could help in improving the
participation of the region in Codex sessions. However, the requests received so far from the eligible
countries of the region are still limited to have a real impact of the meeting results.
Recommendations for action at national level
It is recommended that national food control/food safety authorities undertake the indicated
activities in each of the following areas:
Coordination, national food safety strategies
1.

raise awareness among policy and decision-makers of the importance of food safety and
quality for consumer protection, food trade and economic development.

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FAO/WHO Regional Meeting on Food Safety for the Near East

2.
3.

minimize duplication and clarify the roles and responsibilities of relevant institutions,
and prepare a national food safety profile indicating the role of each institution in the
overall national food safety system.
develop a national strategy for food safety based on a holistic approach that includes the
three aforementioned guiding principles for food safety: multi-sectoral involvement, the
farm to fork food continuum and a scientific basis.

Harmonization of legislation
4.

take the necessary action to revise or update their food legislation in accordance with
international food safety agreements and standards (notably Codex Alimentarius), and
taking into account cultural habits and other specific local needs of consumers and food
producers.

In the field of food inspection


5.

modernize, strengthen and maintain the capacity of food inspection services for all food
products in all locations within the country by clarifying the mandate and
responsibilities of the respective food inspection services and ensuring that they reflect
the national food safety strategy and regulations.

In the field of laboratory services


6.
7.
8.
9.
10

improve infrastructure by providing adequate equipment, instruments and technology to


support the application of modern techniques and processes in food analysis.
improve their ability to conform to basic analytical quality assurance requirements and
ensure that quality assurance systems meet international standards.
seek the accreditation of at least one national food control laboratory according to
international standards to provide exporters with validated export certificates.
develop laboratory protocols and standard operating procedures at the national level.
train laboratory personnel in modern analytical techniques.

In the field of food quality assurance


11.
12.
13.
14.

adopt systems for good agricultural practices and on-farm food safety practices.
strengthen the technical and managerial capacity of food processors in implementing
good hygiene practices, good manufacturing practices and the use of quality assurance
systems.
address areas such as street food by conducting special programmes to educate street
food (and other) vendors in safe food handling.
encourage self-regulation and control through the establishment of relevant associations.

Participation in Codex work


15.
16.
17.

establish national mechanisms for consultation on Codex issues and for preparing
national positions on subjects related to Codex that involve all stakeholders (including
consumers).
ensure participation of appropriate technical experts in Codex meetings.
promote sustained participation in the work of technical committees of particular
relevance to national interests.

Information exchange/rapid alert


18.

build national capacity to identify and prioritize food safety issues through risk analysis.

FAO/WHO Regional Meeting on Food Safety for the Near East

51

19. develop mechanisms to facilitate communication and cooperation between food inspection
services and other institutions involved in food control, particularly food control laboratories
and food-borne diseases surveillance and food monitoring systems.
20. create a rapid alert system and mechanism for communication with food control authorities
and for implementing necessary corrective measures.
21. develop and implement communication strategies that take into account priority issues to be
addressed and communication channels available.
22. develop a transparent system for collecting data on rejected food consignments in
international markets.
References
FAO. 2003. Food Control Systems: Modern Approaches in the Near East Region. Report of FAO/WHO
Workshop (Cairo, Egypt, 19 January 2003).
FAO. 2003. Trade Liberalization Policies, Intra-Regional Trade and Opportunities for Sustainable
Agricultural Development. Paper presented to the 26th FAO Regional Conference for the Near East
(Tehran, Republic of Iran, 9-13 March 2002).
FAO. 2003. WTO Agreement on Agriculture: The Implementation Experience. Case Study on Egypt
http://www.fao.org/DOCREP/005/Y4632E/y4632e0c.htm#bm12.
FAO/WHO. 2001. Summary Report of the FAO/WHO/ILSI Regional Workshop on Risk Analysis:
Exposure Assessment (Cairo, Egypt, 27-28 January 2001)
Gelders, S. Microbiological Contamination of Foods Current Status and Need for Action. Presentation
to the AFC/WHO/FAO Inter-country Workshop on Emerging Food safety Issues and Consumer
Protection (Amman, Jordan, 28-30 October 2001).
Hassib, M., Ragab, H. & Hachem, F. 2003. Trade, Market Access and Food Safety in the Near East
Region. Presented to FAO-IsDB Technical Workshop on Regional Programmes for Food Security
towards Sustainable Food Security and Poverty Alleviation (Jeddah, Saudi Arabia, 8-9 October 2003).
INFOSAMAK/FAO. 2003. Report of Presentations and Discussions Sessions at Expert Consultation on
International Fish Trade and Food Security (Casablanca, Morocco, 27-30 January 2003)
http://www.tradefoodfish.org/articles.php?pageid=art&article=article03
WHO. 1999. Technical Paper on Food Safety. Presented to the 46th Session of the Regional Committee
for the Eastern Mediterranean (July 1999) http://www.emro.who.int/nfs/FoodSafety-TechnicalPaper.pdf

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FAO/WHO Regional Meeting on Food Safety for the Near East

Agenda Item 7

NEM 05/5

FAO/WHO Regional Meeting on Food Safety for the Near East


Amman, Jordan, 5-6 March 2005

REGIONAL, SUB-REGIONAL AND NATIONAL COOPERATION IN FOOD SAFETY


IN THE NEAR EAST

Introduction
Individual achievements in the field of food safety, while desirable and necessary, are of little
use and will not be truly sustainable if they are not coordinated and integrated with the activities and
achievements of others. Cooperation in food safety at national, sub-regional, regional, as well as
international levels presents many challenges, but provides many opportunities for synergistic benefit.
Effective cooperation and coordination in food safety, as in any subject, begins at the local and national
levels and builds up to the sub-regional, regional, and eventually the international levels. All actors
involved in food safety at all levels can learn from, as well as assist, one another, which will allow all
stakeholders to benefit from the improved levels of food safety, and thus improved human health and
economic development. Cooperation in food safety is particularly important in the Near East Region,
where on average, food imports make up 60% of the regions food supply and comprise up to 90% of
food consumed in some countries. Countries of the region, as well as all actors at the national level,
depend on each other to protect the safety and quality of their food supply.
Assuring food safety requires cooperation
The multidisciplinary nature of food safety and quality work requires the cooperation of many
professionals: food scientists, toxicologists, public health workers, microbiologists, chemists, legal
advisers, and many others. Assuring food safety and quality, therefore, demands cooperation among the
various stakeholders to develop, agree upon, and effectively implement a carefully formulated common
vision which encompasses the objectives of the different stakeholders.
Many challenges can hinder effective cooperation, including competing interests of those
involved and perceived lack of time to effectively cooperate. However, through a network of
cooperation, stakeholders can utilize the resources available throughout the network, rather than
duplicating activities or expertise available elsewhere in the network. This reduces unnecessary inputs,
shares labour, improves the quality of ideas, and generally increases the output of the cooperation. A
great deal of cooperation already occurs in the area of food safety, but this cooperation can be enhanced
in a number of specific ways to benefit all those involved.
FAO/WHO cooperation in food safety
FAO and WHO work together in many different ways in the area of food safety. A report on
cooperative activities related to capacity building, as well as the provision of scientific advice, will be
presented as Agenda Items 3 and 8 in the subsequent Third Session of the FAO/WHO Regional
Coordinating Committee for the Near East1. FAO and WHO work together in the following ways in an
effort to improve food safety and quality in their member states:

Agenda and working documents available from: http://www.codexalimentarius.net/web/current.jsp?lang=en

FAO/WHO Regional Meeting on Food Safety for the Near East

1)
2)

3)
4)
5)

53

through the Codex Alimentarius Commission, in the establishment of international food


standards and related texts;
through expert bodies such as the Joint FAO/WHO Expert Committee on Food Additives and
Contaminants (JECFA), the Joint FAO/WHO Meeting on Pesticide Residues (JMPR), the Joint
Expert Meetings on Microbiological Risk Assessment (JEMRA) and various expert
consultations on subjects such as biotechnology, for the provision of scientific advice to Codex
as well as FAO/WHO member countries;
by jointly conducting international, regional, and at times national events to assist in various
aspects of food safety capacity building;
by jointly developing tools designed to assist in various aspects of food safety and quality; and
by providing funding for increased participation in the activities of the Codex Alimentarius
Commission.

This meeting is one example of the cooperation between FAO and WHO in the area of food
safety at a regional level. Although the coordination mechanisms must be continuously improved, FAO
and WHO strive to work in a complementary manner to work toward a common goal of improving food
safety and quality. FAO and WHO are working to continuously improve the communication between
and among headquarters and the regional and national offices.
FAO and WHO are working towards improving their cooperation in food safety at the country
level. A joint FAO/WHO capacity building programme will be implemented (in three countries in Asia)
in the upcoming months. This was a result of a joint FAO/WHO needs assessment mission to the
countries involved in the project. Improved communication and coordination between FAO and WHO
at the country level is also needed for the nomination of participants to attend meetings, as information
is not always accurately communicated to the interested parties and as a result, countries may not be
properly represented at FAO/WHO events.
While this cooperation between FAO and WHO requires continual strengthening, the principles
of this cooperation and the lessons learned can also benefit national governments. Three important
aspects of this cooperation at the national level will be discussed in the following sections.
Cooperation at local and national levels
Regional, sub-regional, and even international cooperation in food safety cannot be effective and
sustainable without a solid foundation of local and national cooperation and coordination. There are
many important aspects of cooperation for national governments to consider.
1)

Cooperation within and between sectors

Food safety, by its very nature, involves many different traditional sectors and ministries of
national government structures. Ministries of health are concerned with protecting human health, while
ministries of agriculture are generally responsible for the production of food and agricultural products.
Ministries of trade and industry are generally concerned with increasing trade opportunities and
improving the output of the nations farms, fisheries, and processing facilities. While each of these
sectors have different objectives for achieving food safety and different interests, the common vision of
food safety for the advancement of their country should be held in mind in all their policies and
activities. Ministers and politicians concerned with each of these sectors must be convinced of the
importance of food safety to their respective sector so that they will work to prioritize food safety
matters and will enable improved cooperation between these sectors. These different sectors can
actually complement each other when cooperating in the area of food safety. The different interests of
each provide a check and balance to ensure that approaches to food safety are effective to protect human
health, prevent consumer fraud, protect the interests of small farmers and food processors, improve the
overall economy of the country through increased export opportunities, and still be economically

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FAO/WHO Regional Meeting on Food Safety for the Near East

feasible. National governments should encourage effective interaction both between ministries and
within ministries, despite the difficulties faced in doing so.
Food safety also plays an integral role in achieving national food security. Food safety is
inherent in the definition of food security and also has many benefits to improving food security2.
Accordingly, those concerned with improving national food security should also work towards
improving food safety.
Food safety also plays a critical role in promoting tourism to a country. One report of a foodborne disease outbreak can cause people to be less likely to return or to visit a certain location, which
can have serious economic repercussions. Tourists may even visit a location because of the food that is
served there. In this case, the safety of the food is especially important. In this respect, food safety
officials should work with tourism officials to ensure that food is safe, as well as to generate increased
political and economic support for ensuring food safety.
Food chain approach to food safety
National governments are increasingly interested in implementing a food chain approach to
food safety, as this approach focuses on preventing food safety issues, rather than on end product
control3. This concept underlines the value of integrating the control of plant and animal health with
food safety. This concept can be very effectively applied in the countries of the region, as inspection of
imported foods, plants, and animals could be streamlined to fit under one inspection system, rather than
employing separate inspectors for each of the sectors. FAO held an expert consultation on Biosecurity4,
which affirmed the value of this approach to controlling sanitary and phytosanitary risks.
In order for countries to effectively implement a food-borne disease surveillance system and to
link these diseases to their causative food agent, officials from public health laboratories, health care
workers and food control officials must all work together. In order for this system to be truly effective in
monitoring and controlling these risks to the food supply, information on animal and plant diseases, as
well as environmental contaminants should be shared so that integrated control measures can be taken.
All the personnel involved in these systems should be trained in the proper detection and reporting of
these diseases, so that the information is accurate and useful.
In 2002, the Ministry of Health of Jordan, in collaboration with WHO, the Centers for Disease
Control, USA, and Health Canada initiated a study for establishing the burden of acute gastroenteritis
infections as well as fever of unknown origin, in order to quantify typhoid and brucellosis prevalence.
The additional goal of the study was to strengthen or create the required infrastructure for the purpose of
the study as well as food-borne disease surveillance. By conducting operational research, and
strengthening the components of the system, the burden of disease could be established. The model of
this study was developed with the intention of developing guidelines for undertaking similar studies in
the other countries of the region, with the intended dual objectives similarly formulated: establishing the
burden of a certain food-borne disease or symptom and strengthening the food-borne disease
surveillance system as such.
National Codex structures
Governments must ensure that their respective national Codex structures effectively provide
information to all national stakeholders. Codex contact points must ensure that information is
disseminated to all ministries and stakeholders involved. National governments of the region must also
2
3

More information on this concept is available from: http://www.fao.org/es/ESN/food/meetings_mrt_en.stm


A paper on FAOs strategy for a safe and wholesome food supply to be presented at FAOs Committee on
Agriculture (COAG 2005) will soon be available from: http://www.fao.org/unfao/govbodies/eims_search/
conference_search_en.asp?meeting_id=4
FAO Technical Consultation on Biosecurity (Bangkok, January 2003) http://www.fao.org/biosecurity/

FAO/WHO Regional Meeting on Food Safety for the Near East

55

coordinate their national positions for Codex meetings, provide input before the meetings, and work to
more effectively provide national data to the FAO/WHO expert bodies (JECFA, JMPR and JEMRA) so
that the recommendations made by these bodies accurately reflects the situation in the countries of the
region.
Coordination of participation at regional and international activities
National governments must ensure that the various sectors involved in food safety are informed
of international and regional events of interest to that sector and that the most relevant people attend the
events, so that the national preparation, contribution, and follow-up is effective and useful. The ability to
coordinate this participation also indicates the ability of government to more generally coordinate
improvements to national food control systems.
2)

Public/private cooperation

While cooperation between the various sectors involved in food safety is essential, cooperation
among the various types of actors involved in food safety is also important. The countries of the region
are increasingly recognizing the importance of involving industry and civil society in food safety
discussions. This is evidenced by the composition of national delegations to Codex meetings, which
often include representatives of consumer groups, civil society, industry, and academia/research, in
addition to government officials. While it is the responsibility of governments to regulate and to provide
an enabling environment for food safety, the food industry is ultimately responsible for the production
of safe food for consumers. This cooperation between different stakeholders can take the form of
sharing financial and human resources and also encompasses cooperation in the implementation of
activities and policies.
3)

Vertical cooperation

In addition to the importance of national governments effectively participating in regional and


international activities, which will be addressed in the subsequent section, national governments must
also cooperate with local, municipal, and regional authorities within their country. This is especially true
in the area of street foods where many governments are working with city authorities to control the
safety of these foods. Local food-borne disease surveillance and food contaminant monitoring data must
also be shared with national governments in order for effective control measures to be implemented.
Regional and sub-regional cooperation
The global nature of food and agriculture continues to increase, further outlining the importance
of regional cooperation. Especially in the Near East region, people and animals tend to cross national
borders with great frequency, and may not always be carefully controlled. Because of the large volume
of food and agriculture trade, regional cooperation to improve the safety of food and agricultural
products is essential.
Governments which are working towards more effective cooperation at a national level have the
opportunity to cooperate sub-regionally, regionally, and eventually, at an international level. Many of
the same concepts of national cooperation can be applied to regional cooperation. Countries of the
region may have competing interests, making cooperation challenging, yet there are many benefits to
regional cooperation, including pooling of resources, sharing of competencies, and increasing synergy.
Countries of the Near East region have affirmed the benefits of sharing experiences and learning
from each other. As previously noted, FAO and WHO have implemented various regional and global
events which have allowed the countries to come together to discuss the issues facing the region in the
area of food safety and ways to work through these issues. Many countries of the region have

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FAO/WHO Regional Meeting on Food Safety for the Near East

successfully undertaken improvements to their food safety systems in recent years, and these
experiences, as well as the lessons learned, can be of great value to other countries.
While differences do exist, many of the countries of the region have comparable food and
agriculture production systems, related cultures and food preferences, and similar weather patterns.
Sub-regional groupings, such as the Gulf Cooperation Council, Maghreb countries, and others are
extremely important in this regard as the countries in these sub-regional groupings are more alike in
these and other characteristics, and also share common borders. These sub-regional groupings are able
to implement more targeted projects and have an established political relationship, which makes
implementing joint activities more feasible and sustainable. In designing regional projects, it is
imperative that the sustainability of these projects is taken into consideration.
At times, regional collaboration can appear to be of greater benefit for the lesser developed
countries in the group than those that are more developed. However, due to the global nature of food
safety concerns, countries which share borders and are trading partners must work together to ensure the
safety of all products as diseases or contaminants in one country can easily affect other neighbouring
countries.
Specific areas for regional cooperation
Codex related activities
The FAO/WHO Regional Coordinating Committee for the Near East (CCNEA) will be meeting
in its Third Session from 7 to 10 March 2005. While the initiation and continuation of this committee is
an important accomplishment in the coordination of the countries of the region in the international
Codex system, the active participation of the countries of the region in the activities of this committee
and of the entire Codex system must increase in quantity and quality. Countries must work to more
actively prepare their positions for all Codex meetings so that the needs of the region are reflected in the
texts adopted by Codex and the policies adopted.
Countries of the region must also work together to ensure that accurate data from the region is
considered in FAO/WHO expert bodies providing scientific advice, and that experts from the region are
involved in this process. The Near East region has many experts in these areas and valuable data to
provide, but must work to more actively provide this information. A database of these experts should be
developed so that this information can be easily accessed and utilized when necessary.
Coordination of input to WTO
Because of the importance of food trade to the region, the decisions of the WTO, especially the
SPS Committee, greatly affect the economic and health status of the countries of the region.
Governments of the region should work together towards reaching a consensus on issues related to food
and agriculture trade with a view to increasing attention to regional trade concerns related to food safety,
support efforts to pursue unfair cases before the WTOs SPS Committee, and increase bargaining power
in global trade negotiations.
Develop regional centres of expertise
Countries of the region should work together to identify the relative strengths in each country
and then to match these strengths with those countries requiring assistance in a particular area. Regional
centres of expertise can be developed in areas (discussed in subsequent sections) such as training,
laboratories, street foods, and other areas of regional interest.

FAO/WHO Regional Meeting on Food Safety for the Near East

57

Capacity building efforts


Various countries of the region have a great deal of expertise in specific subjects such as
HACCP, GMPs, biotechnology, food inspection, etc and can provide training for officials from other
countries in their area of expertise. Some of the countries of the region are recipients of technical
assistance projects, while other countries of the region are capable of providing technical assistance and
capacity building support to other countries. The providers of this assistance, as well as the recipients,
must better coordinate their efforts so that projects are not duplicative and reflect the actual needs of the
country receiving the assistance.
Harmonization of legislation and equivalency
Efforts should also be made to harmonize food safety legislation in the region in order to
facilitate inter-regional trade and to ease inspection policies. It should also lead to the establishment of
equivalency between the food control authorities of the region.
The concept of equivalence has been recognized in the SPS Agreement and is also being
encouraged at the international level by Codex, with a view to using pooled resources more effectively,
avoiding duplication of inspection and testing, and ensuring that health and safety requirements are met
effectively. This will also serve as an important means of facilitating trade by recognition of the
standards and certification systems of the exporting country to provide for an equivalent level of
protection against health risks as those of the importing countries and also lead to reduced rejection rates
and provide for reduced inspection of export products in overseas markets. Equivalence agreements are
normally signed between the importing and exporting countries individually. However, if such
agreements are developed at (sub)-regional level, in the form of regional agreement for recognition of
the equivalence of specified SPS measures of all countries in the region, it would not only benefit trade
within the region but also give strength to negotiating equivalence agreements with third-party
countries.
Food inspection
The GCC countries have implemented a sub-regional common border inspection policy5 which
allows food products entering any border post in the sub-region to be accepted in any country in the subregion. This approach reduces duplication of efforts and streamlines food trade. Other sub-regional
groupings should be encouraged to implement such a policy.
It is also important for countries of the region to share information with each other and work
together to ensure that sub-standard food products which are rejected from one border post are not sent
to another border post and then accepted there due to a lack of inspection.
Laboratories
The expertise of the region in specific analytical laboratory techniques, such as mycotoxins,
heavy metals, pesticide residues, microbiological contaminants, biotechnology, etc could be shared
through the establishment of a network of accredited regional reference laboratories. Such a network
would enable countries to benefit from the facilities available in other countries to reduce costly
duplication. The organization of a regional proficiency testing programme for the key food
contaminants of the region is an important element in the development of food analytical capabilities in
the region and should be given serious consideration. The above-mentioned centers of expertise could
be designated to develop such a programme, with international and bilateral assistance.

Report of FAO/WHO Regional Workshop on Food Control Systems (Cairo, January 2003) where this system
was presented: ftp://ftp.fao.org/es/esn/food/meetings/2003/egypt_report.pdf

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FAO/WHO Regional Meeting on Food Safety for the Near East

Certification and accreditation


Facilities for certification and accreditation in different areas, such as export certification,
HACCP and ISO 9000 should be developed within the region, irrespective of the country of operation.
A country which has recognized experience in one area could assist other countries of the region in this
field.
Food-borne disease surveillance, food contaminant monitoring
Once a food-borne disease surveillance and food contaminant monitoring system has been
effectively implemented at a national level, the countries of the region should agree on the designation
of one appropriate institution that would collect all this information and data, analyze it and produce a
periodic report on the situation in the region as a whole. Countries should make their national report
available to this institution. This type of reporting allows for the eventual development of a rapid alert
system, which would benefit all countries of the region. Scenarios for (regional) response should be
prepared in advance of a possible outbreak or recall, rather than responding to such an event. Effective
mechanisms for communication with food control authorities and for implementing necessary corrective
measures must also be continuously strengthened.
Regional risk assessment body
The countries of the region may be interested in risk assessments on specific pathogen
commodity combinations or other issues which affect the region that have not yet been addressed by
international risk assessment bodies. National governments may not have adequate resources to
implement these risk assessments, but the governments of the region could pool their resources and
expertise to conduct these needed risk assessments. The safety assessments conducted by FAO/WHO
can, of course, serve as a basis for such regional effort. The European Food Safety Authority 6 also
conducts such regional risk assessments and the mechanism used in this regional institution could serve
as a model for the countries of the Near East.
Special research projects
The expertise in the academic and research institutes of the region should be utilized to
implement projects of interest to improve food safety. In particular, subjects related to the safety of local
and traditional food products and ways of improving their quality (including nutritional) and safety
would be of great relevance. Similarly, research on the shelf life of strategic food products, under the
prevailing weather and cold chain conditions in the region, would be of benefit to all countries.
Conclusion
Effective food safety systems require cooperation and collaboration at all levels. It is obvious
that without collaboration in such fields as Codex work, harmonization of legislation, inspection, and
others, it would be difficult for the region to reach the level of performance in food safety that their
population deserves. Efforts are needed by governments and other stakeholders to promote this type of
activities. FAO and WHO and other provider agencies stand ready to provide this support where needed.
Recommendations
The text contains suggestions for recommendations which may be considered by the meeting
when formulating its recommendations for member governments and FAO/WHO on this subject.

http://www.efsa.eu.int/

FAO/WHO Regional Meeting on Food Safety for the Near East

59
ANNEX 7
Conference Room Document 1
English only

FAO/WHO Regional Meeting on Food Safety for the Near East


Amman, Jordan, 5-6 March 2005

RISK MANAGEMENT APPROACH ON IMPORTED FOOD CONTROL


(prepared by the Delegation of the Hashemite Kingdom of Jordan)
1.

Introduction

Following Jordans accession to the WTO in April 2000, fundamental restructuring was
undertaken in the food safety domain, namely issuing the first Food Act and adopting risk management
approach within Jordans strategic framework; Recognizing that the domestic food market very much
depends on imports, a risk management approach was primarily to be implemented on food imports,
arriving via the port of Aqaba where over 75% of imports are admitted to Jordan. The traditional
imported food control system imposed a 100% sample collection and laboratory analysis on all food
imports to Jordan regardless of their health hazard, with no systematic product traceability nor recorded
history on importers performance. The system was completely in a manual form, time consuming and
without measurable tools to administer the official staff performance and traders complaints and
violations track. Minimal information was collected on handwritten sheets without any structured
template forms to be filled out or electronically stored data for further statistical analysis for risk
managers and policy makers.
2.

Risk Based System Concept

Monitoring of imported food for compliance with national/international safety and quality
standards and other requirements is based upon a risk management approach of control. The system
places emphasis on those products determined to be high-risk food products in terms of human health
based upon known and potential food hazards associated with these foods. Monitoring of lower risk or
no risk food products will be maintained at a surveillance level to assure consistent compliance by
importers, shippers and exporting enterprises. Such Risk Based System allows for some refinements and
improved effectiveness to the food control process. It calls for an assessment of the risks associated with
the known or potential hazards of food. This process takes into consideration before the control
measures are applied, the nature of the hazards, and the impact on the consumer in terms of severity,
which results in a clear idea of what should be examined for which types of hazards based on a priority
system associated with the severity of the risk to the consumers. It allows for the allocation of resources
to be clearly devoted to the most important areas of consumer protection. It enhances the effectiveness
of the control measures by having a predetermined automated plan of what consignment entries will be
sampled and what they will be tested for, while not spending scarce resources on entries which have
little to no impact on the health of the consumer.
Recognizing Jordans limited financial resources to undertake a full lengthy risk assessment,
instead, a thorough benchmarking study was carried out referencing to various international
organization researches and government risk assessments. The literature was studied by a national
specialized team, designed and structured with some refinements based on practical experience, climatic
and further cautious criteria to acquire public acceptance.

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FAO/WHO Regional Meeting on Food Safety for the Near East

Criteria based on the public health risk associated with various foods or other compliance or
procedural factors were utilized to select food entries for appropriate monitoring, where food products
have been categorized into three groups; High, Medium and Lowrisk groups. Control is exercised
electronically through the computerized Selectivity Module of the Automated System for Custom Data
(ASYCUDA) which was massaged into a closed cycle to adapt food categories and their selectivity
criteria. Food entries entered into the ASYCUDA system are identified by their Harmonized system-HS
code for clear and accurate management by food control officials and importers throughout the
clearance procedures.
For archiving and tracking purposes, a Food Import Management Information System (FIMIS)
was engineered, programmed and deployed successfully on September 2002 as an information
electronic archiving database to assist food officials in identifying risk areas and analyzing raw data
utilizing Online Analyses Processing (OLAP) into a meaningful policy decisions, regarding the safety of
imported food products.
The system will provide information useful in communicating and coordinating Jordanian
activities with international efforts to improve the overall safety and quality of food trade, particularly in
the region.
2.1

Food Categories Classification

Food categories include those of high level of public health risk, those that represent a moderate
level of risk and those that represent a low level of risk. High-risk foods will be monitored (sampling
and analysis) at the highest level of surveillance, while moderate risk products will be monitored at a
lower level of surveillance. Low risk products will be monitored at the lowest level of surveillance.
Food items have been classified for Health & Safety Control purposes in three categories based
on the possible health risk associated with each food category. As demonstrated below; the first food
category includes foodstuff items with the highest risk and exposure to contamination and the third food
category includes foodstuff items with the lowest risk and exposure to contamination.
A)

High risk food products:

12345678910 11 12 13 14 15 16 17 18 19 20 -

Frozen novelties; Dairy and Milk and milk by-products; Fluid and Dried
Cheeses from pasteurized milk and Cheeses from un-pasteurized milk
Frozen Dairy products; Ice-cream and Processed Eggs; Liquid, Frozen and Dried
Products containing eggs; Mayonnaise
Bakery; Frozen and Ready to serve (i.e. Bakery & Cakes containing milk & eggs)
Yellow Cheeses; Cooked
Meat (incl. Poultry) products; Cooked, Dried, Smoked, Salted, Cured and Fermented.
Infant cereals, cereal-substitutes & Baby formula
Special food products; Dietary purposes
Nuts and nut products, Coconut; Flaked and Dried
Sesame, Sesame paste (Tahineh) and Peanut butter
Raw Vegetables; Pre-cut, Packaged
Raw, fresh Vegetables and mushrooms (e.g. tomato, eggplant; Preserved in oil.
Low acid foods; Retorted (e.g. Mortadella)
Acidified Low acid foods; Aseptic processing, modified atmosphere packaging
Low acid foods; preserved and semi-preserved (e.g. Exotic foods)
Marine products; Pickled, Spiced and Marinated (salted)
Ground raw Meat products (e.g. Sausages and hamburgers)
Marine products; Salted, Dried, Smoked, Cured & Fresh chilled, Frozen & Cooked
Meat (including Poultry) products; Raw fresh chilled & Frozen including offal

FAO/WHO Regional Meeting on Food Safety for the Near East

B)

Medium risk food products:

123456789101112131415161718-

Chocolate; primary manufacture (from cocoa beans)


Bakery products; Ready to serve (i.e. not containing milk & eggs as dried crumbs)
Mineral, spring water; Bottled and Malt beverages
Chocolate (including all types) and Cocoa and cocoa derivatives
Milk and milk by-products; Liquid Condensed and Evaporated
Jams and Sugar Confectionary (i.e. Candies, Haloum and Halawa)
Food Supplements and Frozen novelties (non-dairy)
Coffee whiteners, whips and creams
Fruits fresh; Processed or Dried
Vegetables; Fresh, Dehydrated and Dried
Spices and Soups; Dried and Yeast and bacterial cultures
Mixes and bases; Dried (e.g. Cake mixes, Jelly, Custard and Caramel)
Eggs in shell (table serve) and Butter
Fillings and Toppings and Gelatine desserts and puddings; Dried
Flour and Starch, Chips and Breakfast cereals (e.g. Corn flakes)
High Acid foods; Retorted or hot filled or Aseptic processing (e.g. Ketchup & Mustard)
Biscuits, Wafers and Cakes and Chewing gum (all types)
Fruit Juices and Concentrates and Fruits; Dried (e.g. Dates and dry figs)

C)

Low risk food products:

12345678910 11 12 13 -

Carbonated Beverages
Coffee and Tea (all types and shapes)
Dairy products; Jameed
Sugar and sugar syrups, Honey and black honey and Molasses
Oils, Fats, Margarine and Butter blends
Fruits; Fresh and Frozen
Grains and grain derivatives (except flour)
Salt and Vinegar
Vegetables; Frozen and Beans
Alcoholic drinks and Distilled Liquors
Carbonated beverages concentrates, Flavour extracts and Food Additives
Pasta, spaghetti and couscous
Dried Herbs (e.g. mint & oregano)

61

*
In cases where an imported food item is not listed in the above food categories, it shall be
treated as a food item falling in the high risk category until a final classification is determined.
2.2

Selectivity Criteria and Levels of Inspection

The national team worked alongside an international food trade consultant on setting the
selectivity criteria taking into consideration a caution margin throughout the first few years of
implementation and agreeing by consensus that the document review process will be mandatory
regardless level of inspection.
Selectivity criteria and levels of inspection based on the food categories classification shall be:
80-100% of foodstuff consignments falling within Category One (high-risk category), shall
be subject to inspection and sample collection for laboratory analysis.
25-50% of foodstuff consignments falling within Category Two (medium-risk category),
shall be subject to inspection and 50% of foodstuff shipments subject to inspection shall be
further subject to samples collection for laboratory analysis via an electronically
programmed method.

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FAO/WHO Regional Meeting on Food Safety for the Near East

5-10% of foodstuff consignments falling within Category Three (low-risk category), shall
be subject to inspection and sample collection for laboratory analysis electronically.
Selectivity Criteria
High Risk foods
Medium Risk foods
Low Risk foods

2.3

Red Channel
Lab. Analysis
80-100%
15-25%
5-10%

Yellow Channel
Cargo Inspection
-------15-25%
--------

Green Channel
Document Review
0-20%
50-70%
90-95%

Imported food entries that are subject only to document review and found to be satisfactory
without cargo examination or sampling are expected to clear the health inspection requirements
within one working day.
Imported food entries that are subject to document review and cargo examination are expected
to clear the health inspection requirements in three working days. Imported entries that arrive in
containerized reefer shipments may require 2-3 additional working days in order to arrange for
the cargo to be off-loaded for appropriate examination when necessary.
Despite what has been stated concerning levels of inspection and sampling collection based on
food categories, an additional 10% of all food consignments shall be subject to inspection via
the Random electronic method, whereby sample collection for laboratory analysis from such
consignments will be left for the decision of the Inspection and Sampling Committee based on
the sensory inspection results.
Pertaining to banned food that have been officially declared prohibited to enter Jordan will
neither be inspected nor samples collected for consignment.
Concerning automatically detained food; i.e.
1- Foodstuff items with evidence to continuous non-compliance with health and safety
requirements
2- Foodstuff items entering Jordan for the first time; where consignments will be subject to
inspection and laboratory analysis for five successive shipments, and in case they were
found in compliance with health and safety requirements, the detention will be lifted and
foodstuffs will be subject to the regular risk-based food control inspection levels.
3- Foodstuff items rejected from other countries.
4- Foodstuff items that have been notified upon by other countries or related international
organizations.
Clearance of such foodstuff items will be carried out ONLY after compliance with conditions of
document review, inspection and laboratory analysis results stating fitness for human
consumption.
Incentives and Penalty scheme
Incentives for foodstuff consignments in compliance with health & safety requirements:

In cases where five successive foodstuff shipments for the same food item classified in first,
second or third category and obtained from the same manufacturer/source and have proved
compliancy with health and safety requirements after being inspected and having passed
laboratory analysis, then:
A- All foodstuff consignments shall be subject to inspection.
B- Sample collection for laboratory analysis purposes will be carried out on one consignment
out of four consignments which have been inspected.
C- Same foodstuff item obtained from same manufacturer/source shall be given such benefit as
long as it complies with health & safety requirements.

FAO/WHO Regional Meeting on Food Safety for the Near East

63

Whereas, where a foodstuff consignment was not found to be in compliance with health and
safety requirements, then benefits given shall be withdrawn and the consignment will be subject
to the regular risk-based food control inspection levels until evidence of compliance is proved
for the next successive five shipments.
3.

Implementation Phase-Action Plan

The riskbased food control system has been discussed and investigated thoroughly among all
related national line authorities since September 2000 where the final approval of the system was issued
by the National Food Council in July 2001.
A comprehensive, time bound implementation plan was prepared and accomplished covering the
following main themes:
Issue the first Food Law of Jordan which will adapt to the new system concept on December
2001;
Construction of a refrigerated inspection food centre for reefer shipments examination and
portion sample collection with suitable transportation vehicles to the food laboratory, where it
was launched on 17 Nov. 2002 and has been able to host approx. 40% of the actual reefer
containers;
Substantial renovation of the existing food laboratory in Aqaba with newly installed equipment
and sufficient training on quality assurance program and laboratory methodology of analysis
working towards accreditation to ISO 17025;
Renovation of ample office space for the food clearance centre to serve all related national
agency officials with required logistics at the Port zone where channelling, document review and
all other paper procedures take place;
Provide necessary portion field sampling equipment with practical training sessions and
introducing the sampling number code concept;
Unifying and harmonizing the health certificates required submission on port of entry according
to food groups and Introducing a new concept of third party accredited single Health Certificate
and E- certificate approval as beginning of year 2003;
Revising and updating some of the national standards and regulations; i.e. Shelf life standards,
sample size as well as the temperature for reefer cargos regulations;
Develop a systematic unified form for the clearance procedures of all imported food
consignments to be filled out by national line agency representatives;
Develop risk channelling protocol with the associated food groups electronically utilizing tools
of ASYCUDA software. Thus, enabling importer agents to file the entry forms electronically to
be further assessed throughout the clearance procedures.
Design and structure a database archiving system that captures all import data, certificates, test
analysis results with statistical tools to enable data analysis for a solid based risk management
system, providing sets of reports on various parameters.
The risk based imported food control system was officially launched at Aqaba port of entry on
20 May 2002 and extended to the rest of Jordan borders of entry during 2004
4.

Performance Assessment
From 20 May 2002, where the risk based system for imported food control was officially
launched, until 31 January 2005, imported food consignments were processed as follows:

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FAO/WHO Regional Meeting on Food Safety for the Near East

Value

Percent%

Timeframes
(Day :Hr :Min)

Total Number of consignments

17428

100%

-----------

Red channeled consignments

9718

56.0%

24:01:00***

Yellow channeled consignments

1015

6.0%

05:20:00**

Green channeled consignments

6695

38.0%

01:14:00*

Number- Rejected consignments

70

0.4%

-----------

Food Consignments

* 50% of the green channel shipments (median) were cleared in (00:19:43)


** 50% of the yellow channel shipments (median) were cleared in (03:02:05)
*** 50% of the red channel shipments (median) were cleared in (20:24:44)
The main food types were meats, poultry and milk, dairy products, followed by grains, fish,
fruits
Over 3500 reefer containers were inspected in the food inspection centre (Nov 2002 to Sept
2004)
Activating an electronic certification programme for animal origin products; where over 145
electronic health certificates have been issued for meat products imported from New Zealand
since 17 November 2003 and from Australia mid October 2004. Thus, providing means of
trustful and accurate documentation without the need of authorization from Embassies at
country of origin
Long before RBS for food imports was implemented; there was no capture of actual timeframes
of consignments clearance. Thus creating many delays with no means of detecting the liability whether on public or private sector- (with 100% sampling and laboratory analysis); clearance
time frames varied between 10-30 days with blurred and fuzzy responsibility.
Since the Launch of the RBS; set clearance timeframe were anticipated for each channel and
following 18 months of real practical operation where officers are documenting channelling and
final health clearance time by day and time (hour: minutes); ASEZA was able to gather raw data
(during the period 1 January- 31 September 2003) and subject them to further statistical analysis
on SPSS detecting the actual clearance timeframes highlighting spots of malfunction from both
the public and private sector contributing to clearance delays and drawing a clear roadmap of
accountability and responsibility of each stakeholder involved.
Aqaba Special Economic Zone Authority has issued the SOP- Standard Operating Proceduresfor all phases entailed with health clearance of imported food consignments. Additionally,
drawing out the detailed procedural flow chart and publishing the Food Importers Guide
bilingual manual early 2004 - available electronically on www.aqabazone.com website.
5.

Results and Conclusions

With the implementation of such a risk management approach for imported food control
programme, Jordan was able to:
Decrease by about 50% of redundant sampling and test analysis
Drop the amount of bulk samples into reasonable portions to fit the lab analyses
Reduce timeframes required for clearance of imported food consignments
Resources oriented towards enhancing inspection methodologies and proper field cargo
examination, portion sampling and more thorough laboratory tests to assess the safety and
quality of imported foods
Establish the first electronic national database information system to build a strong data
collection, tracking records, well analyzed trends, enhanced reporting and notification with
equal incentive-penalty program based on merit

FAO/WHO Regional Meeting on Food Safety for the Near East

65

Systemize transparent clearance procedures where stakeholders acknowledge their responsibility


and accountability
Build a model for the region that can assist many developing countries to reach a risk
management control approach with fairly reasonable resource allocation corresponding with
globalization requisites
Jordan believes that risk management approach is the gateway towards a fair, transparent and
merit-based treatment in the International food trade while maintaining science based decisions
towards improved Consumer Safety & Quality Protection measures.

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FAO/WHO Regional Meeting on Food Safety for the Near East

Conference Room Document 2


English only

FAO/WHO Regional Meeting on Food Safety for the Near East


Amman, Jordan, 5-6 March 2005

RISK MANAGEMENT APPROACH ON FOOD COMPLIANCE - MODEL STRATEGY


(prepared by the Delegation of the Hashemite Kingdom of Jordan)
1.

Introduction

In January 2001, the geographical area surrounding the Port of Aqaba (where about 75% of food
imports occurs), became the Aqaba Special Economic Zone (ASEZ) of an area 375km2, administered by
a legal independent Authority, which has complete mandate over the administration of the activities
within the zone
The Aqaba Special Economic Zone (ASEZ) offers businesses and residents a planned
environment consisting of high quality infrastructure, facilities, and support services, as well as an
attractive package of incentives and liberal policy environment to help increase your operating
efficiency.
The Aqaba Special Economic Zone (ASEZ) is a private sector-driven development initiative that
maximizes private sector participation in a duty free, tax-advantaged and flexible regulatory operations
environment with a vision to make the zone a leisure destination and trade hub in the region
The Authority has jurisdiction over all common areas of responsibility associated with law and
order, security, trade and development, public health, and public administration, among other
responsibilities. For this purpose, ASEZA law no. 32/ 2000 came very powerful and thus memorandums
of understandings were signed to submit responsibilities on phases to the zone authority avoiding
duplication and redundancy of work done between the official government authorities.
As a member of the WTO, Jordan has accepted the responsibility of the terms of Membership.
This means that the measures imposed in protecting the public health against hazards associated with
food from imported sources must not be trade restrictive, arbitrary, or disguised technical barriers to
trade. Measures are also to be scientifically justified using risk assessment methods acceptable at the
international level.
2.

Purpose

The objective of this document is to develop an integrated Risk management strategy for the
Food Compliance system model implemented in Aqaba Special Economic Zone- Jordan to be
undertaken by the Health Control Directorate at Aqaba Special Economic Zone Authority.
3.

Food Compliance - Risk management Concept:

Based on the objective of Aqaba Special Economic Zone Authority to implement a risk
management approach of food compliance in the zone as been introduced in 1999 by Codex
Alimentarius to the international community and following the benchmarking process carried out with
various regional and international models and in light of the actual findings in the zone;
criteria:

Aqaba Special Economic Zone Authority has designed the system according to the following

FAO/WHO Regional Meeting on Food Safety for the Near East

67

3.1: Adopted All Definitions of food safety risk analysis related to this document based on the
Codex Alimentarius formal published texts;
Additionally has defined risk categories:
High-Risk Business= Where potential exists to put vulnerable groups (i.e. infants, frail
elderly, pregnant & the sick) or large number of consumers at serious risk due to the
nature of food, manner of food preparation or processing, facilities provided and control
system in place
Medium- Risk Business= Where high-risk, ready to eat foods are not prepared, but the
scale of business is large such as (Shellfish, fish, raw and cooked meat, cooked poultry,
cooked chill and freeze meals, milk, eggs, cooked rice and pasta & foods containing these
ingredients)
Low-Risk Businesses= Where the potential to cause harm to consumers is low

3.2: Adopted the Risk Categorization of activities as demonstrated below


Activity Type
Primary Producers:
Honey
Natural water/ Ice
Poultry
Manufacturers & Packers
Alcoholic Drinks
Baby Foods
Bakery
Caterer
Cereal products
Chocolates
Confectionary
Sweet/Sugar Confectionary
Cook Chill
Crisps
Delicatessen foods
Fish Processing/ Smoking
Other Fish Processing; freezing
Food Additives
Fruits & Vegetables; Ready
Fruits & Vegetables; Further cook
Ice cream
Jams & Jelly
Meat Products
Milk Products
Oils & Fats
Soft drinks
Warehouses; No packing
Warehouses; Food Packers
Distributors, Retailers & Transporters
Alcoholic Drinks
Bread Shop
Coffee Shop
Cold Store
Dry Goods
Fish & Fish products

Risk Category
Low
High
Low
Low
High
Medium
High
Low
Medium
High
Low
High
High
High
High
Low
Low
High
Medium
High
Low
High
High
Low
Low
Low
Medium
Low
Medium
Medium
Medium
Low
High

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FAO/WHO Regional Meeting on Food Safety for the Near East

Flour Confectionary; Bread


Flour Confectionary; Egg & Cream
Frozen Foods
Fruits & Vegetables
Ice Cream
Meat & its products; Raw Meat
Meat & its products; Cooked Meat
Milk & Milk products including local labneh & Cheese
Oils & Fats
Soft Drinks
Sugar Confectionary; Sweets and Cakes
Sandwiches & Salads
Delicatessen
Falafel, Foul & Humos Shop
Health Food Shop
Newsagent/Gift shop
Nuts Roasts & Spice Mills
Fishmonger
Greengrocer/ Fruits & vegetables
Grocery
Grocery; with Greengrocer
Supermarket
Department Store
Food Stalls
Vending machine; High Risk perishables
Vending machine; Non-High Risk stable
Food Stall Chilled High Risk foods
Food Stall Fruits & Vegetables
Food Stall Raw Meat/ Fish
Food Stall Cooked Meats/ Shawermah
Food Stall Candy Floss
Food Stall Chip Van
Food Stall Ethnic Food
Food Stall Ice Cream
Food Stall Pop Corn
Food Stall Juices
Food Stall Tea/ Coffee
Service Sector
Restaurant/ Canteen
Canteen (hot & cold drinks & sandwiches); with Grocery
Hotel; Serving Meals
Hotel; No meals or restaurants
Pre school; Serving Meals
Pre school; Snacks Only
Schools; Serving meals
Schools; Ready to eat foods
Meals-on-Wheels
Take Away/ Outside catering
Passenger ferry; Kitchen facilities
Guest House; Serving meals
Holiday/Labor Camp
Public House; Serving food
Public House; Not serving food

Low
High
High
Medium
High
Medium
High
High
Low
Low
Medium
High
High
High
Medium
Low
Low
High
Low
Medium
Medium
High
High
High
Low
High
Low
Medium
High
High
High
High
High
Low
High
Medium
High
High
High
Medium
High
Medium
High
Medium
High
High
High
High
High
High
Medium

FAO/WHO Regional Meeting on Food Safety for the Near East

69

Nursing Home; Long term care facility


Hospital
Prison
Manufacturers Selling primarily Direct to Consumer
Bakery; Flour products Only
Butcher/ Poulterer
Butcher; with Grill restaurant
Bakery; with Confectionary
Ice cream

High
High
High
Medium
High
High
High
High

Note: Food Businesses could fall into more than category; then should be treated on the basis of
highest risk category. Any deviation from the above Risk Categorization shall be justified on the
record of the specific activity; where certain activity may obtain lower categorization due to its
history Gold List/Black List Concept

3.3: Adopted the routine frequency of inspection - Grading system matrix as follows:
Jordan- ASEZ/Year
High Risk

Medium Risk

Low Risk

A 100-90% B 75-89%
C 74-60%
D 59-45%
E 44-30%
A= 3 times (13 weeks)
B= 4 times (10 weeks)
C= 9 times (5 weeks)
D= 13 times (3 weeks)
E= 26 times (2 weeks)
A= 2 times (16 weeks)
B= 3 times (13 weeks)
C= 6 times (7 weeks)
D= 9 times (5 weeks)
E= 17 times (2 weeks)
A= 2 times (20 weeks)
B= 3 times (16 weeks)
C= 5 times (9 weeks)
D= 6 times (7 weeks)
E= 13 times (4 weeks)

3.4: For the purpose of system automation and easier data manipulation, ASEZ was categorized
into fourteen coded plots based on closeness and density of economic activities thus
enabling the proper coding for each food activity in a specified area/region

3.5: Adopt the violation code based on the Jordan Food law No. 79/ 2001, summarized in:
Sanctions/ Penalties

Clause 22-A:
Imprisonment of
min. 3 monthsmax.12 months
OR;
A Fine of min. JD
1000-max. JD 3000
OR both penalties

Cases subject
* Clause 17-A: Handled Adulterated/Fraud Foods AND Unsafe for Human
Consumption:
If it contains a toxic or harmful agent, excluding pesticides or
contaminants for which a maximum residue limit has been
established by international or national standards or technical
regulations for that food and that residue has been found in that
food to be within the established limits
If it contains a food additive that is not permitted in that food
If it is rotten, decayed, putrid or deleterious material whether

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FAO/WHO Regional Meeting on Food Safety for the Near East

Clause 22-B
Imprisonment of
min. 2 monthsmax.6 months
OR;
A Fine of min. JD
250- max. JD1000
OR both penalties

Clause 22-C
Fine of min. JD 250max. JD 500

whole or in part, taking in account the technical regulations and


standards for the food
If it is handled under conditions or circumstances which may
cause the food to become unsafe or unsuitable for human
consumption
If it is a product of a diseased animal or an animal that has
perished by means other than by slaughter and its product is not
fit for human consumption
If it is packed in a container made of a material that is not
approved for such food packaging
If it is exposed to radiation and its radiological activity rate is
above the maximum permitted limits established at the
international levels
If it contains hormones, chemicals, veterinary drugs or the
residues of any of these agents and the residue levels exceed
established maximum residue limits established by international
or national standards or technical regulations, or there is no
standard or technical regulation permitting their use or the
residue of these non-permitted agents in food
If the shelf life of the food is expired according to the label and
was proved unfit for human consumption by laboratory analysis
If it contains a food additive that is approved for that food but has
been added in amounts that exceeds the established maximum
permitted limits as determined by international or national standards
or technical regulations
* Clause 17-B: Handled Adulterated/Fraud Foods:
If it contains a food additive that is approved but not permitted
for that food as determined by the technical regulations
If any of its ingredients is removed, changed or reformulated
unless stated in the label and such processes had been approved
within the terms and instructions issued by the FDA general
manager
If a substance is added to it and the substance diminishes the
foods nutritional value with the aim of benefiting economically
or when added in order to conceal a certain defect or shortage or
to add bulk or weight to the food.
If the shelf life of the food is expired according to the label and
there was NO prove that the food is unfit for human
consumption by laboratory analysis
If it was handled in conditions abusing the scientific principles
of food handling
If it was breaching the quality standards determined by the technical
regulations
* Clause 18: Handled Misbranded/Cheated Foods:
If it is not harmful imitation of another food unless the label
states clearly that it is an imitation before mentioning the name
of the original food directly and the label has been approved by
the concerned authority for use before the foods handling
If the food is filled or prepared in a misleading manner
If the food contains any artificial flavor, color or permissible
food additive, and the label does not reveal those facts and the
presence of such substances does not comply with the contents
of this food
If the label is false or misleading

FAO/WHO Regional Meeting on Food Safety for the Near East

Clause 23
Imprisonment of min.
12 months to max.36
months
OR;
A Fine of min.
JD 1000-max.
JD3000
OR both penalties

Clause 24
A Fine of min. JD 25-max.
D250

71

If the label does not state the following:


1. Name of the Food.
2. Name and address of the manufacturer, packaging party
3. Statement of contents in terms of weight or measure or
count.
4. Statement of ingredients in the order of their
preponderance.
5. Storage method when the food is made of substances that
require certain storage conditions.
6. Date of production or validity (expiration date) when the
food is considered to have a limited shelve life
If the label includes words, expressions or data that are not
readable or understandable for the lay person within the usual
conditions of handling
* Who promote, disseminate, or participate in disseminating misbranded
food
* A person who handles any food before being licensed and approved for
handling by the provisions of this law
* A person who disposes of food while under seizure according to the
provisions of this Law
* A person who re-opens a shop that has been shut down according to the
provisions of this Law
* A person who re-handles food that has been decided to be destroyed
* A person who handles any expired food
* A person who introduces changes to the expiry period of any food other
than stated in the original label of this food
* A food that was handled before licensing the activity according to the
instructions issued by the Minister (Clause 15)
* Violations in cases not mentioned above

* Note: 1st & 2nd Sanctions above:


Clause 22-D: If a violation is repeated for a second time, the violator shall be subject to twice the
minimum penalty stipulated in the Provisions of this Article. If a violation is repeated more than twice,
the violator shall be subject to twice the maximum penalty and shall be prohibited from resuming practice
for am minimum of 12 months
Clause 22-E: For the purpose of this law, the violation committed within the same year where penalties
are imposed
Clause 20: Notwithstanding what was stated in any other legislation, the Minister/Chief shall have the
right, according to declared timeframe, to:
1. Issue a written order to prohibit the handling of foods which are misbranded or adulterated or
which prove to hazardous or potentially hazardous to health or unfit for human consumption.
2. Prevent the display of foodstuff in a manner that violates the food safety requirements or
subject such foodstuff to contamination.
3. Issue a written order to withdraw from the market within a period he specifies any food that
falls under the provisions of clauses (1,2) of this paragraph.
4. Issue an order for seizure of such food under the provisions of Clauses (1,2 and 3) in this
Paragraph and which prevents disposing therewith. In such cases, the Minister has the right
decide the site where the food is to be kept until the Court reaches a decision thereabout.
5. Authorize in writing any of the Directorates employees to inspect the food place and to collect,
without charge, samples of imported or locally produced food for the purpose of testing and
analyzing it to determine its suitability for human consumption and compliance with the food
standards or technical regulations, all at the expense of the owners or possessors, except for fees

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FAO/WHO Regional Meeting on Food Safety for the Near East

for samples of handled food items taken for the purposes of periodic control activities of the
Directorate.
6. Prohibit the storage of any imported food in the Kingdom or the free zones if found to be unfit
for human consumption.
7. Prohibit any processes, which modify the foods stored in the free zones that may result in the
falsehood of data on the label, excluding the manufacturing processes that have been approved

3.6: Legal Actions taken upon violations shall be as following:


Phase one- Improvement Notice (     )
 

Phase Two- Warning Notice (
)
Phase Three- Violation order (    )
Phase Four- Closure of establishment
Specific cases were detected and documented as shown below to create systematic means:
Violation

Action

Display of food unfit for human consumption and/or expired shelf life

violation

Food stored in toilet rooms

violation

Rodents & insects (cockroach, ant, fly, mice) in the food premises

warning

Opened garbage & refuse containers

warning

Food and / or packages damaged or destroyed

warning

No declaration of expiry / production dates on identification label

warning

Unclean equipments , utensils, tools, machines, surfaces

warning

Poor personnel hygiene

warning

Toilet close to the kitchen

warning

Poor cooling & freezing of refrigerators

warning

Food storage in aluminum utensils

warning

Carcass display outside the refrigerator

warning

Unclean rinse water

warning

Unclean refrigerator

warning

Unwrapped /uncovered food

warning

Unclean food premises esp. in critical places

warning

No health certificates

warning

Prepared of food items outside the food premises

warning

Presence of litter & unnecessary articles

notice

Staff not wearing appropriate working aprons and gloves

notice

No window sieves

notice

Improper arrangement / isolation of food in refrigerators

notice

Display of food items outside the food premises

notice

Pets inside the food premises

notice

Unclean stores

notice

Poor maintenance of fixtures & sewage drains

notice

Poor maintenance of floors, walls, ceiling and store area

notice

FAO/WHO Regional Meeting on Food Safety for the Near East

73

3.7: Adopted the designed generic inspection report that shall apply to all food activities
according to the key legend matrix identifying inspection criteria according to the food
activity type.
The inspection report is evaluated using 100 point scoring system of the inspection as
below:
Inspection Report Sections

Scores

Section A: Food
Section B: Food Protection & Preparation
Section C: Personnel
Section D: Food Equipment & Utensils
Section E: Water
Section F: Sewage
Section G: Plumbing & Fixtures
Section H: Toilet rooms & Dressing facilities
Section I: Solid Waste & Refuse Disposal
Section J: Vermin Control
Section K: Floors, Walls & Ceilings
Section L: Lighting and Ventilation
Section M: Operations

9
19
13
18
4
3
3
6
3
7
4
4
7

3.8 Based on ASEZ Business census data, an initial first round of on-site verification took place
between September and October 2003 and revisited in May 2004 to capture all activities on
a unified data pool and evaluate the average initial grade of the activity to determine the
regular frequency of inspection schema per risk category. Food Inspectors shall commerce
based on the data obtained and update consistently during the field inspections
Until the Post audit Automation project is completed and fully functional by end 2005,
inspection results shall be documented manually on Inspection Report and data shall be
entered electronically on excel sheets designated per each activity/ geographical location for
traceability purposes and interpreted via access application on an active and live shared
folder created within the main food servers for the food inspection unit team

3.9 Implementing Food Safety Awareness program


With distinguished ASEZA Food character and Do it Right Protect your Bite slogan,
The materials (i.e. Phase one concluded in five themes) were disbursed starting May 2004
targeting various audience segments (Food managers and handlers, consumers including
housewives and children, tourists and official channels)
This is important to create the corporate image of ASEZA especially Health & Food Control
work role model with a precedence educational objective prior to drawing accountability and
liability thus increasing consumer confidence and elevating industry capacity for economic
benefits in food trade
Food Inspectors were subject to extensive training prior to their field inspections and will be
subject to more upon introduction of the automated system of the post audit and inspection
activities
Plan of Awareness Activities is:
3.9.1 Basic Food Awareness Campaign (i.e. Food Safety Truth, Temperature Chart,
Kitchen Tips, To go & Serve and Kids Food Zone)
3.9.2 Advanced Food Safety Awareness Campaign with more detailed features and
measures with themes on FBD and HACCP as well as

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FAO/WHO Regional Meeting on Food Safety for the Near East

3.9.3 Food Safety Training- Coaching programs Campaign (i.e. Introduction of HACCP
system, school class on food safety, etc)
3.9.4 Certification of Food managers/ Food handlers within the zone via regular one-two
days of orientation workshop performed by Food Inspection unit trainer
Awareness Campaign information can be accessed on:
http://www.aqabazone.com/environment/E_Food_Control_Aware.html

3.10: Adopt the Work plan phases for preparation, launching and implementation of the risk
based system of food compliance in ASEZ illustrated in this Concept document and mapped on
detailed plan matrix as track record of the system model conception summarized in:
3.10.1. Recruiting and training of food inspectors; August- October 2003
3.10.2. Field trips to create the inventory of food related activities in the zone per location;
October- December 2003 Still On going
3.10.3. Classifying each type of activity according to the associated health risk as recommended
in the risk categorization table
3.10.4. Clean Up campaign to promote the very basic concepts January -Feb 2004
3.10.5. Food Safety Awareness Phase one campaign including workshops for food
managers/food handlers in ASEZ; March-July 2004
3.10.7. Regular inspection system while developing automation concept & architecture Starting
3rd mid 2004
3.10.8 Automation of the whole post audit and inspection system; undergoing. To be launched
by October 2005

4.

Risk management Model - ASEZ Findings

4.1 ASEZA Food Inspection team was able to analyze the current risk level situation in the zone
concerning the food sector
4.2 Over 850 Food activities were identified in the zone, of which 43% classified high risk, 44%
medium risk and 13% low risk
4.3 Highest number of food activities are Groceries followed by Restaurants and Supermarkets
which a rapid increase of activities over a short period of time
4.4 Most of the food activities grading were ranging between grade B and grade C (60-89%)
which indicates the need for better and thorough inspection activity alongside coaching
enforcement and public awareness
4.5 Classified food activities based on their standard type until December 2004:

Activity Type
Alcoholic drinks
Bakery
Bread Shop
Butcher
Butcher with Grill
Canteen
Canteen with Grocery
Cereal Products
Coffee shop
Department Store
Falafel & Humos
Fishmonger
Frozen foods
Greengrocer
Grocery
Grocery with Greengrocer

No. of Activities
13
10
11
32
4
28
32
1
34
2
34
12
6
31
302
2

FAO/WHO Regional Meeting on Food Safety for the Near East

75

Hotels serving meals


Hotels; No meals
Ice
Ice Cream
Milk & Milk products including local labneh &
cheese
Natural water
Newsagent; Gift shop
Nuts roasts and Spices mill
Passenger ferry; Kitchen facilities
Poulterer
Preschools; Ready to eat food
Rail buses facilities; Sandwiches
Restaurant
Schools; ready to eat foods
Sugar Confectionary; Sweets
Supermarket
Warehouses; No Packing
TOTAL

2
1
3
23
3
11
1
2
103
33
5
69
15
871

4.6 Food Activities detected risk Category until December 2004:


Risk Cat
High
Medium
Low
Closed
Total

22
20
2
3

No.

387
395
89
18
889

43.3
44.7
9.9
2.1
100

4.7 Food Activities Grading results until December 2004:


Grade
A
B
C
D
E
Closed
Removed
N/A
Total

No.

21
176
448
120
3
24
32
65
889

3.1
22.6
45.4
14.5
0.5
2.8
3.2
7.9
100

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FAO/WHO Regional Meeting on Food Safety for the Near East

FAO/WHO Regional Meeting on Food Safety


for the Near East
Amman, Jordan, 5-6 March 2005
Conference Room Document 3
English only

Causes of
food-borne
disease / food
poisoning

CHEMICALS
BACTERIA
FUNGI
PARASITES
VIRUSES
PRIONS

INFORMATION
NOTES

FAO/WHO Regional Meeting on Food Safety for the Near East

77

Introduction
Food-borne disease or food poisoning occurs as a result of consumption of food contaminated with
either biological or chemical agents. These can also be grouped as infective agents and toxic agents.
Toxic agents:
These can be described as chemical substances or agents which can be naturally occurring in the food,
be a by-product of microbial (bacterial toxins, mycotoxins) or algal growth (biotoxins), residues of
veterinary drugs and pesticides used in primary production, contaminants from the environment,
industrial by-products or accidents such as heavy metals, dioxin, PCBs, radioactive substances or
substances leaching from packaging materials
Infective agents
Bacteria:
These microbiological agents are long know for their use in food preservation e.g. fermentation but are
also the primary cause of food spoilage and important cause of food and waterborne disease. Food
plants and animals can be colonized and/or infected with bacteria during primary production and this is
an important source of contaminated foods. Food can also be contaminated with bacterial from the
environment via water, air, contact surfaces, insects, rodents etc.. Observance of good agricultural
practices, good hygienic practice and good manufacturing practices are critical to minimize their
introduction to the food chain.
Viruses:
These very small particles are thought to be responsible for a large proportion of food-borne disease.
They require a host in order to grow and multiply but are capable of survival outside a host for periods
of time. They are most often spread by person to person contact or faecal contamination of food and
water.
Parasites:
Parasites are sometimes considered to be a problem in tropical regions or areas with poor sanitation.
However, outbreaks of food-borne disease caused by parasites in recent years have highlighted the
widespread nature of the problem. Globalization of food trade has also been a factor in parasitic foodborne disease with some protozoan parasites capable of producing very resistant forms (oocysts) which
can survive outside the host for long periods of time.
Prions:
Compared to those previously mentioned prions are a recent addition to the list of agents that cause
food-borne disease. The first data describing bovine spongiform encephalopathy in cows was only
published in 1987 and it was 1994 before the first possible case of nvCJD was reported. Much research
has been undertaken in the past 10 years and the risk of contracting nvCJD from beef products has been
estimated to be very low. Yet the fatal nature of the disease means that the detection of even one animal
positive for BSE within a country has huge economic consequences.

Toxic/chemical agents
Exposure to chemicals in food can result in acute and chronic toxic effects ranging from mild and
reversible to serious and life threatening. These effects may include cancer, birth defects and damage to
the nervous system, the reproductive system and the immune system. Chemical substances of most
concern include pesticide residues, antibiotic residues, hormone growth promoters, and heavy metals.
Chemical substances that constitute food-borne hazards can be categorized as follows:

industrial and environmental contaminants;


biologically derived substances and contaminants;

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FAO/WHO Regional Meeting on Food Safety for the Near East

contaminants produced during processing;


improperly used agrochemicals;
improperly used additives.

Although microbiological contamination causes more food-borne illness, consumers tend to be most
concerned about chemical contamination of their food supply. The recent contamination of agricultural
products in Europe with dioxin confirmed the general publics fears of chemical contamination of the
food supply. For many chemical contaminants, low levels of consumption are both unavoidable and
harmless. Because the period of time between exposure to chemicals and any negative health impact
tends to be long, it is difficult to definitely attribute disease actual foods.
The protection of public health from chemical hazards has been long been based on the outcomes of
safety assessments risk assessments. FAO and WHO have been addressing the issue of chemical
contamination for over 40 years, through risk assessment bodies such as the joint FAO/WHO Expert
Committee on Food Additives, JECFA1, and the Joint FAO/WHO Expert Meeting on Pesticide
Residues, JMPR2. The assessments are the basis for international guidelines and national regulations.
A short overview of different toxic or chemical agents which can occur naturally or be found as
contaminants in foods is provided below.
Industrial and environmental contaminants
This group comprises a wide range of substances such as heavy metals, radionuclides, PCBs, dioxins,
nitrites/nitrates etc.
Heavy metals, such as arsenic, cadmium, cobalt, copper, lead, mercury can contaminate crops and
animals through environmental exposure to natural sources, but also through environmental and
industrial pollution. Mercury for example is commonly associated with large fish species such as tuna,
shark and swordfish. Mercury finds its way into the environment through industrial pollution such as the
combustion of mercury containing coal in power plants and older chlor-alkali plants, which use mercury
to convert salt to chlorine gas and caustic soda. Lead is often associated with canned foods, acidic foods
and drinking water and it comes from vehicle emissions, smelting and paints among others. Cadmium is
often found in molluscs and crustaceans and crops such as grain. Cadmium is released into the
environment through the emissions or wastes form manufacturing facilities of cadmium containing
products such as cadmium pigmented plastics, cadmium stabilized polyvinylchloride (PVC) products,
cadmium alloys etc. or the improper disposal of nickel-cadmium batteries.
Radioactive substances such as Caesium 137 or Iodine 131 may contaminate food through industrial
accidents, fall-out, and natural sources.
Nitrites/nitrates are often associated with fertilizers and agriculture run-off and can contaminate
vegetables and drinking water. PCBs and dioxins are by-products of fires, including bonfires, and some
manufacturing processes. The manufacture and general use of PCBs stopped in the 1970'
s and their use
is now banned. The major industrial releases of dioxins are subject to environmental controls. However,
PCBs and dioxins are long-lasting environmental contaminants. The highest concentrations are found in
fatty foods such as liver and oily fish. The main sources of dioxins in the diet are from meat, meat
products and milk and dairy products

Joint FAO/WHO Expert Committee on Food Additives (JECFA) http://www.who.int/pcs/jecfa/jecfa.htm or


http://www.fao.org/es/ESN/Jecfa/index_en.stm
2
Joint FAO/WHO Expert Meetings on Pesticide Residues (JMPR) http://www.who.int/pcs/jmpr/jmpr.htm or
http://www.fao.org/ag/agp/agpp/pesticid/

FAO/WHO Regional Meeting on Food Safety for the Near East

79

Substances such vinyl chloride monomers can be introduced to food through leaching from packaging
materials such as PVC. As a result many countries now have limits regarding the level of residual
monomers that are permitted in food packaging and contact materials.
Biologically derived substances and contaminants
Mycotoxins are fungal metabolites produced by number of fungal species. They can have serious
effects on human health. when ingested, inhaled or absorbed through skin and cause lowered
performance, sickness or death in man as well as animals and birds. There are over 200 kinds of
mycotoxin, produced by about 150 different fungi, but only a small number occur in foods and feeds at
levels likely to cause concern. Acute effects of mycotoxication include headache, fever, nausea,
diarrhoea, vomiting, weakness, tremors, convulsions and in some cases death. Long term effects include
cancer and genetic and birth defects.
Mycotoxins are produced when fungi infect agricultural crops particularly cereals and oilseeds and nuts
during the growth of the crop and/or during post-harvest storage. They may also occur in milk, meat and
associated products as a result of animals eating mycotoxin contaminated feedstuffs.
The main mycotoxins affecting humans are as follows:
Ergot alkaloids (St Anthonys fire)
Reports of this date back to the Middle Ages.
Associated with cereals infected with Claviceps purpurea.
Aflatoxins
Produced by strains of Aspergillus flavus
Associated with nuts, cereals, etc.
There may be carryover from animal feed to foods of animal origin for humans. An example of this
is aflatoxin M1 in milk.
Aflatoxins are acutely toxic, and have also been shown to be carcinogenic (they cause cancer) for
humans.
Fumonisins
These are produces by Fusarium spp
Found worldwide primarily associated with maize
Patulin
These are produced by Penicillium spp, and Aspergillus spp
They are mainly associated with apple and apple based products
Ochratoxin A
This is produced by Aspergillus ochraceus and Penicillium verrucosum
Mainly associated with barley and wheat, but also other cereals, vines, coffee, spices, nuts, figs.
Table 1 provides an overview of conditions for fungal growth and mycotoxin production.
Bacterial toxins are the mechanism by which some pathogenic bacteria produce disease. Bacterial
toxins take 2 forms: endotoxins and exotoxins. Endotoxins are cell associated lipopolysaccharides (LPS)
only produced by certain bacteria known as Gram negative bacteria. They can cause fever, septicaemia
and even death. These toxins are very heat resistant and are associated with bacteria such as
Escherichia coli and Salmonella. Exotoxins are soluble proteins secreted by growing bacteria. Examples
include the following: Tetanus toxin Clostridium tetani; Diptheriae toxin - Corynebacterium
diiphtheria; Shiga toxin - Shigella dysenteriae; Botulinum toxin Clostridium botulinum; and
Staphylococcus toxin. They are produced by both gram positive and gram negative bacteria and are

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FAO/WHO Regional Meeting on Food Safety for the Near East

extremely toxic even at high dilutions. Toxin production and secretion is related to environmental
factors such as temperature, salt, pH, amino acids, iron etc.
Bacteria also produce by-products which can be toxic to human health. An example is histamine which
is produced by a number of spoilage bacteria and is often associated with cheese and fish.
TABLE 1: CONDITIONS FOR FUNGAL GROWTH AND MYCOTOXIN PRODUCTION
Mould
Mycotoxin
Conditions for growth
Conditions for mycotoxin
produced
production

Aspergillus
flavus

Aflatoxin B1, B2

Aspergillus
parasiticus

Aflatoxin B1, B2,


G1, G2

Fusarium
sporotrichioides

T2 toxin

Fusarium
graminearum
Fusarium
moniliforme

Deoxynivaleno
Zearaleone
Fumonisin B1

Penicillium
verrucosum

Ochratoxin A

Aspergillus
ochraceus

Ochratoxin A

Temp oC

Aw

Temp oC

Aw

10 (min)
~30 (opt)
43 (max)
10 (min)
30 (opt)
43 (max)
2 (min)
22.5 27.5
(opt)
35 (max)
24 26(opt)

0.82 (min)
0.99 (opt)
0.998 (max)
0.83 (min)
0.99 (opt)
0.998 (max)
0.88 - > 0.99

15 (min)
20 -30 (opt)
37 (max)
15 (min)
28 (opt)
37 (max)
-

0.87 (min)

0.9 - > 0.99

2.5 - 5 (min)
22.5 27.5
(opt)
32 -37 (max)
0-31

0.87 - > 0.99

0.80 (min)

0.86 (min)

8 (min)
25 - 31 (opt)
37 (max)

0.79 (min)

0 31
can get high
prod at 4
15 (min)
25 - 28 (opt)
37 (max)

0.87 (min)
-

0.88

- no information available
Reference: FAO/WHO. 2001 Manual on the application of the HACCP system in mycotoxin prevention
and control. Food and Nutrition paper 73
Marine biotoxins are produced by dinoflagellate algae. These toxins are secondary metabolites and it is
not clear why they are produced. The most important are shellfish toxins and ciguatoxins. To date, five
groups of shellfish toxins have been distinguished, namely:
i. paralytic shellfish toxins causing paralytic shellfish poisoning (PSP);
ii. diarrhoeic shellfish toxins causing diarrhoeic shellfish poisoning (DSP);
iii. amnesic shellfish toxins causing amnesic shellfish poisoning (ASP);
iv. neurotoxic shellfish toxins causing neurotoxic shellfish poisoning (NSP); and
v. azaspiracid shellfish toxins causing azaspiracid shellfish poisoning (AZP).
Ciguatoxins cause ciguatera fish poisoning (CFP). PSP, DSP, ASP, NSP and AZP are caused by human
consumption of contaminated shellfish products whereas CFP is caused by the consumption of

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81

subtropical and tropical marine carnivorous fish that have accumulated ciguatera toxins through the
marine food chain.
Natural substances that are toxic are produced by many plants that are staples in the human diet contain
substances. Among the best known naturally present food-borne hazards are cyanide in cassava,
alkaloids in potatoes, psilocybin in poisonous mushrooms. Generally, there are few cases of disease due
to poisoning since the hazards are well-known, and foods are avoided, or preparation or processing
techniques have been developed over the generations that make the food safe. Special plant breeding
programmes have reduced the level of toxic substances sufficiently to make the food safe. Outbreaks
tend to mainly occur in cases of extreme hunger or other emergency circumstances, when preparation is
compromised.
Plants such as cassava contain high levels of cyanogenic glucosides, which are substances that
decompose to release hydrogen cyanide that is highly toxic. Correct processing and cooking of cassava
eliminates this potential health problem. Solanine is an alkaloid found in the sprouts and green skin of
potatoes. Cooking potatoes does not eliminate the toxin, therefore these parts of potatoes should not be
consumed. The alkaloid causes gastrointestinal illness and neurological disorders. A range of other
substances may be found in what are commonly consumed foods. For example, legumes may contain
substances such as protease inhibitors and haemagglutinins that prevent growth, but cooking easily
destroys these substances.
We must recognize that our knowledge regarding natural toxins is still developing, and that we may
discover that substances are present in our food may which previously, as a pure chemical substance,
were classified as toxic. Not enough is known of the interaction of substance in the human body, of the
actual toxic effect of substances that hitherto were regarded as poisonous. Recently there was great
concern when it was discovered that acrylamide is being formed during the baking or frying of highcarbohydrate foods such as baked potatoes, biscuits, and bread. As a chemical substance, acrylamide is
classified as a probable human carcinogen, but at this stage the extent of the risk to humans of
acrylamide in food formed during baking or frying is still unknown. The advice most governments
therefore issued to the general public therefore tended to be that consumption of baked and fried foods
should be moderate, within a varied and healthy diet, until more is known about this substance and its
effects.
Improperly used agrochemicals
Pesticides are substances that are used prevent the destruction of crops by pests such as fungi
(fungicides), rodents (rodenticides), herbs (herbicides), insect (insecticides), etc. Pesticides are widely
applied in agriculture, horticulture, food processing, and food service establishments. Improper use may
results in residues being carried over into food and animal feedstuffs, and thus can affect the safety of
food. A wide range of pesticide formulations, such as organochlorine and organophosphorous
substances, methyl bromide, dithiocarbamates, etc. has been registered for agricultural usage, and in
many countries residue limits or tolerance levels have been established for pesticides in food. In order to
be registered, a pesticide is subjected to a review and approval process based upon intended use and
properties of the pesticide, including an assessment of risks to human health, domestic animals, wildlife,
plants, groundwater, beneficial insects and other environmental effects. A further issue is the potential
risk to humans when handling and preparing pesticides for use on crops and in premises. Pesticides are
highly toxic in concentrated form, and occupational exposure may result in serious risks to health.
Levels of pesticides found on fresh fruits are often alarmingly high. Some crops require extensive
intervention to control pests; hence residue problems may occur if good agricultural practices are not
applied to actively minimize the risks. This includes correct application of the appropriate dose.
Maximum residue limits (MRLs) have been set by the Codex Alimentarius Commission for pesticides
in food commodities. Foods listed shall not contain more than the MRL (in mg/kg) of the pesticide

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residue. MRLs are based upon public health, occupational health and environmental safety
considerations; and assist in ensuring the minimum amount of pesticide is used.
Veterinary drugs are used in animal husbandry to treat or prevent disease and infection in foodproducing animals, or included in animal diets as growth promoters. Poor management or improper use
may result in residues in meat after slaughter, or in milk, seafood, or other animal products. The
development of antibiotic resistance is a further concern, and has resulted in many countries banning the
use of those antibiotics that are also used for human medicine, to treat farm animals. All veterinary
drugs are approved for specific applications, and withholding periods (minimum time period between
treatment and slaughter) are set to enable the drug concentration to fall to an acceptable level before the
animal is slaughtered. By applying a withholding period, the food-producing animal has the opportunity
to reduce the drug level to below the approved MRL (maximum residue level).
Other agrochemicals that may contaminate food if used incorrectly include growth promoters,
fumigants, fertilizers, plant growth regulators
Improperly used additives.
Many additives are used in food production, processing and preservation. Evaluations have been
undertaken at national level and also by JECFA at the international level to provide the basis for
regulations to ensure that these are used correctly and do not pose a hazard to human health. Food
additives include colouring agents, flavouring agents and enhancers, antimicrobials, antioxidants,
stabilizers, anti caking agents, texturizing agents, thickeners, sweeteners, emulsifiers etc. to name but a
few. Incorrect or unauthorized use of additives can be a potential cause of food poisoning. A recent
example was the use of Sudan 1 dye in a batch of chilli powder produced in India. This is not a
permitted food additive as it can lead to an increase risk of cancer. The contaminated chilli powder was
subsequently used in the to manufacture of Worcester sauce which was subsequently used as an
ingredient in a wide range of products in the UK which were subsequently exported to a number of
markets mainly in Europe.
Other potential sources of contamination come from the cleaning agents, detergents, sanitizers, solvents,
processing aids, filter aide etc which may be used in the processing facility.
Contaminants produced during processing
In some cases the way in which a food is processed or preserved may lead to the production of toxic
agents. For example, during the curing of meat using nitrites, under certain conditions not yet fully
understood, the natural breakdown products of proteins known as amines can combine with nitrites to
form compounds known as nitrosamines. There are many different types of nitrosamines, most of which
are known carcinogens in test animals. Fortunately, not all cured meat products contain nitrosamines
and when present, they usually are in very minute amounts. Another example which has recently been
in the news is acrylamide. Acrylamide can be produced in certain starch-based foods, such as potato
chips and French fries when they have been cooked at high temperatures. Acrylamide has been
categorized as a probable cause of cancer in humans and studies and assessments are underway to better
categories the risk to human health. Other contaminants in this group include polynuclear aromatic
hydrocarbons which are produced during certain cooking practices e.g. charcoal grilling, smoking.
Nitropyrenes can also be produces during cooking. Another contaminant recently in the press was
chloropropanols. The exact conditions required for the formation of chloropropanols in foods are still
unclear although model systems suggest that they can form when glycerol reacts with hydrochloric acid
at high temperatures or with salt in the presence of other acids, such as citric and acetic acids, at high
temperatures. Studies to date indicate that in most cases the levels in food tend to be low but work is
ongoing to determine the public health risk associated with these contaminants.

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Agents

Infective agents
Infective agents are a major cause of food-borne disease. In developing countries it is estimated that
more than 1.5 billion episodes of diarrhoea occur per year in children under the age of 5 years, causing 3
million deaths per year. It is not clear to what extent contaminated local water supplies are responsible
for these diarrhoeal diseases, and to what extent food-borne disease contribute to the total incidence
figures. In industrialized countries, food-borne infections with for instance Salmonella, Campylobacter
or enterohaemorrhagic E. coli do show an increasing trend, and it is estimated that up to 10% of
population in these countries suffer annually from food-borne diseases.
Disease as the result of exposure to food-borne infective agents constitutes an often neglected public
health problem. Detection of food-borne disease, and subsequently the identification of the cause of that
disease, is often a difficult process. Underreporting is common, the symptoms are often perceived as
mild, as a normal occurrence, and most diseases tend to be self-limiting. The reported incidence of foodborne diseases worldwide is estimated to be only a very small proportion of the real incidence. The
presence of food-borne pathogens in a countrys food supply affects the health and well-being of the
local population, visitors and consumers of food imported from that country. Thus apart from the
physical suffering of the patients there generally are considerable economic consequences. These
include food losses, decreases in food exports, loss of time at work, cost of hospitalization, and
decreased revenues from tourism industry. These consequences seriously affect the local economy and
eventually public expenditure, thus perpetuating and aggravating the burden of the diseases.
The lengthening of food production chains, and the increase of international trade and travel give new
opportunities to pathogens to cause and spread diseases further. Despite our increased knowledge of the
sources of the organisms, and the factors contributing to the disease, there seems to be little decrease in
numbers affected, and the socio-economic impact of food-borne diseases remains very high. One reason
given for the fact that food control is under-budgeted is because surveillance is inadequate and thus the
extent of the burden of food-borne disease is not fully understood by policy makers. Another reason is
that a consistent and coordinated effort by industry and government is required, for instance by the
application of quality assurance mechanisms, and consistency and coordination regrettably are difficult
goals to attain.
Among the vast group of illnesses that are food-borne, gastroenteritis is the most frequent clinical
syndrome. Gastroenteritis can be attributed to a wide range of micro-organisms, including bacteria,
viruses and parasites. Usually, the incubation period is short, from 1or 2 days to one week. Different
degrees in severity are observed, from a mild disease which does not require medical treatment to the
more serious illness requiring hospitalization, long-term disability or death. The outcome of exposure to
food-borne diarrhoeal pathogens depends on a number of host factors including pre-existing immunity,
the ability to trigger an immune response, nutrition status, age and non-specific host factors such as
environment, climate etc. As a result, the incidence and severity of food-borne diarrhoea is much higher
in some particularly vulnerable segments of the population, including children under five years of age,
pregnant women, immuno-compromised people (i.e. patients undergoing organ transplantation or cancer
chemotherapy, AIDS...) and the elderly. Serious complications may result from these illnesses including
intestinal as well as systemic manifestations, like haemolytic uremic syndrome (HUS) (kidney failure
and neurological disorders) for 10% of all Escherichia coli O157:H7 infections with bloody diarrhoea,
Guillain-Barr syndrome (nerve degeneration, slow recovery and severe residual disability) after
Campylobacter jejuni infection, reactive arthritis after Salmonella infections. Several authors have
estimated that long-term complications may occur in 2% to 3% of all food-borne disease episodes.
While diarrhoea is the most common syndrome following the consumption of a contaminated food,
some diseases are more serious. Clinical manifestations of listeriosis include bacteraemia and central
nervous system infections, especially in patients with an impairment of T-cell mediated immunity

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FAO/WHO Regional Meeting on Food Safety for the Near East

(neonates, the elderly, immuno-compromised patients) and abortion in pregnant women, with an overall
case-fatality rate of 25%. Food-borne botulism is a result from the potent toxin by Clostridium
botulinum (bacteria)that causes paralysis of skeletal and respiratory muscles which, when severe, may
result in death in 8% of cases. In addition to the consequences of toxoplasmosis on the foetus (birth
defects), Toxoplasma gondii (parasite) is also the most frequent cause of lesion in the central nervous
system in patients with AIDS. Hepatitis A (virus) is an infectious disease for which age is the most
important determinant of morbidity and mortality, with severity of illness and its complications
increasing with age. The duration of illness varies, but most cases are symptomatic for three weeks.
The main reasons for the occurrence of food-borne diseases are the lack of scrupulous attention to food
hygiene from farm to table, and the lack of overall quality control systems. Most food-borne illness
agents enter the food chain via primary contamination from infected animal or plant foods or secondary
contamination from insects or rodents or any other animal; contact with polluted environment (water
air, soil, container, etc); and non-observance of good agricultural, good hygiene and good
manufacturing practices.
Food-borne infective agents include bacteria, viruses, parasites and more recently prions. More details
are provided in the following pages.
Bacteria
Bacteria are small unicellular organisms which can grow very quickly under suitable conditions (double
in 20mins). In terms of food bacteria can be divided into useful bacteria, spoilage bacteria and
pathogenic bacteria. Certain bacteria such as the lactic acid bacteria have long been used in food
preservation e.g. fermented foods. Spoilage bacteria dont normally cause disease although some are
opportunistic pathogens. Spoilage bacteria are not usually consumed in food in high enough numbers to
cause disease as they have generally caused sufficient organoleptic changes to the food to make it
unacceptable to the consumer. Controlling the growth of spoilage bacteria is used as a means of shelf
life extension and reduce loss of food. However, limiting their growth can in some situations leave niche
for pathogens to grow. In such cases the food can look okay but could be a potential cause of disease
e.g. vacuum packaged fish contaminated with Listeria.
Pathogenic bacteria cause disease in humans, animals, plants. They can be present in food in sufficient
numbers to cause disease without food being spoiled i.e. there are no visible indicators that the pathogen
is present. Pathogenic bacteria have different mechanisms of producing disease. Some cause an
infection by invading the cells. Others cause an intoxication by the production of either exotoxins
(Bacillus cereus, Clostridium botulinum) or endotoxins ( Salmonella, Escherichia coli). Other
pathogenic bacteria produce a toxin mediated infection in which case the toxin is produced inside
human body. More information on specific pathogenic bacteria is provided in the following pages.
Bacteria infection is caused by the ingestion of living bacteria. The number of bacterial cells required to
cause infection is different for different bacteria. Infection usually occurs following bacterial growth in
the food. Bacteria grow by dividing which is known as binary fission. The time taken for 1 bacterial cell
to become 2 depends on the bacterial species and the environmental conditions. In order to grow
bacteria need nutrients, water, a suitable pH and temperature, suitable atmospheric conditions and time.
An understanding of the conditions required for bacterial growth is critical to their control. There are 2
forms of bacterial cell a vegetative cell which is the normal form and a spore which is only produced
by some species of bacteria. Spores are usually very heat resistant and an important consideration in
food processing.

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BACILLUS
Important species: Bacillus cereus

Issues relating to control:

Why is it important? It causes two types of food


poisoning as a result of toxin production: an
emetic toxin (preformed in the food) that causes
vomiting; and an enterotoxin (produced in the
intestine) that causes diarrhoea. This toxin
producing bacteria is often associated with
reheated foods.

Survival: Vegetative cells readily killed by heat


(D value at 60C = ~1 min)
B. cereus cells die in yogurt when pH reaches 4.5
Spores are moderately heat resistant and can
survive pasteurization (D value at 100C = 2.7
3.1 mins). High fat/oil and low aw increase heat
resistance.
Spores survive for very long periods in dry foods.
Spores activated by a variety of treatments e.g.
heat shock (exposure to several hours of elevated
but sub-lethal temperatures)
Heat activation is reversible if spores then return
to lower temperature (i.e. unsuitable for growth)
Spores are hydrophobic difficult to remove
during cleaning Can allow contamination of
food during processing
Emetic toxins are very to heat and extremes of
pH. It can survive a pH of 2 11 and for 90 mins
at 126C.
Enterotoxin is less resistant and is inactivated
after 5 mins at 56C.

Ecological niche: Ubiquitous in nature. Normal


inhabitant of soil.
Foods with which it is most frequently
associated: Found in a wide range of foods
including meat, milk, dairy products, vegetables,
fish, rice dishes, sauces, pastas, dried mixes,
spices.
Characteristics and growth conditions:
Gram-positive rod shaped bacterium
Aerobic, but also grows well anaerobically lower toxin production under anaerobic
conditions
Spore former (central spores) heat resistant
spores are an important factor in food-borne
illness
Motile
Produces 2 types of toxin: an emetic toxin in
foods which is highly stable and survives high
temperatures, exposure to enzymes (trypsin,
pepsin) and pH extremes. An enterotoxin
which is produced in the intestine; this toxin
is acid and heat labile.
Growth temperature: 4 to 48C (optimal 28 35C).
Growth pH: 4.9 - 9.3 (optimum 6.8 - 7.2)
Growth aW 0.91
Illness: Rapid-onset emetic syndrome is
characterised by nausea and vomiting, which
begin one to five hours after contaminated food is
eaten. Slow-onset diarrhoeal syndrome is
characterised by diarrhoea and abdominal pain
which occurs 8 to 16 hours after consumption of
contaminated food.
Recovery from both is
usually rapid and all people are thought to be
susceptible. Symptoms may vary among
individuals.
Dose: Large numbers (>105/g of food) required to
produce toxin or cause infection. Small numbers
of B. cereus in foods are not a direct hazard to
health.

Inactivation: Effective prevention and control


measures depend on inhibiting spore germination
and preventing the growth of vegetative cells in
cooked, ready-to-eat foods.
Effect of temperature on spores varies according
to strain (D85 = 33.8 106 min) and environment
(D95 = 1.5 36.2 in distilled water an d 1.8 19.1
min in milk)
Inactivated by 0.1M acetic, formic and lactic acids
in broth.
Growth inhibited by >7.5% salt
Modified atmospheres can be used to control
growth of B. cereus
Nisin is commonly used in dairy products to
prevent outgrowth of spores.
Growth is inhibited by sorbic acid (0.26% at
pH5.5), potassium sorbate (0.39% at pH 6.6),
benzoate, EDTA and polyphosphates.
0.2% calcium propionate prevents spore
germination in bread.
Sensitive to most chemical disinfectants used in
food industry.
Spores are more resistant to radiation than
vegetative cells.
Note: Some strains capable of growing at
refrigerated temperatures have recently been
reported.

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FAO/WHO Regional Meeting on Food Safety for the Near East

BRUCELLA
Important species: Brucella abortus. Other
species include B. melitensis (sheep and goats), B.
suis (pigs), B. ovis (sheep), B. canis (dogs) and
B. neotomae
Why is it important? B. abortus is a costly and
contagious disease of cows and cattle that can also
infect humans. It is the causative agent of
brucellosis. It causes abortions in cows and
sterility in bulls among other symptoms and can
cause acute or chronic illness in humans.
B. melitensis
however
has
the
highest
pathogenicity of Brucella spp. B. melitensis and B.
suis are also considered as emerging pathogens in
cattle, thus extending their opportunities to infect
humans Brucella is also a bioweapons concern.
Ecological niche: The main reservoir for
B. abortus is cows and cattle. It is also found in
some wild animals;
Foods with which it is most frequently
associated: Unpasteurised (raw) milk or cheese or
other dairy products.
Characteristics and growth conditions:
Gram-negative, pleimorphic rods
Aerobic
Fastidious many strains of B. abortus
require increased CO2 for growth particularly
for primary isolation
Non motile
Facultative intracellular
Survive and replicate in host macrophages
Zoonotic
LPS endotoxin in the cell wall is the main
virulence factor.
Highly infectious
Illness: In the acute form (<8 weeks from illness
onset), nonspecific and "flu-like" symptoms
including fever, sweats, malaise, anorexia,
headache, myalgia, and back pain. In the undulant
form (<1 year from illness onset), symptoms
.

include undulant fevers, arthritis, and epididymoorchitis in males. Neurologic symptoms may
occur acutely in up to 5% of cases. In the chronic
form (>1 year from onset), symptoms may include
chronic fatigue syndrome, depression, and
arthritis.
Those working with animals and animal products
are at greatest risk and brucellosis is often found
to occur more frequently among slaughter house
workers, meat inspectors, farmers, animal
handlers, veterinarians, and laboratory workers.
Dose: Relatively few bacterial cells are needed to
cause infection (as few as 100 cells is a sufficient
number to cause disease) depending on the
species. B. melitensis is the most infectious to
man in that 1-10 colony forming units are thought
to cause disease followed by B. suis (100010,000), B. abortus (100,000), and finally B. canis
(>1,000,000
in
an
immuno-compromised
individual).
Issues relating to control
Survival: Stable during production;
Sensitive to direct sunlight and so it is destroyed
in the environment over time
B. abortus has been observed to survive in faeces
at ph 7.6 for 14 35 days and at pH7.2 for 56
days
B. abortus survives in soil in winter for 125 days
B. melitensis has been observed to survive in urine
for 3-4 days, moist faeces for >75 days and soil
for > 300 days depending on soil type.
B. suis has been observed to survive in cattle
faeces at room temperature for 120 days and soil
for 4 37 days depending on water content.
Inactivation:
D55oC = 60 minutes
D60oC = 3 minutes
D65.6oC = 0.0002 minutes
Z-value = 4.3 oC

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CAMPYLOBACTER
Important species: Campylobacter jejuni,
Campylobacter coli are most often associated
with disease but Arcobacter spp. can also be
important. Both pathogenic and non-pathogenic
strains exist and it is often difficult to differentiate
them.
Why is it important? Becoming one of the main
causes of food-borne disease. Usually causes
gastrointestinal illness Campylobacteriosis (diarrhoea) in humans. Can also cause systemic
illness, reactive arthritis, Guillain-Barr syndrome
(GBS). Death rarely occurs. Some species cause
abortions in animals. Children and young adults
most frequently affected.
Ecological niche: Intestines of wild animals,
Farm animals (cattle, sheep, pigs), Birds
(chickens), Domestic pets, sewage. Seasonal
variation in occurrence. Can also be found in
water supply
Foods with which it is most frequently
associated: Raw chicken, raw milk, nonchlorinated water

occasionally followed by arthritis or GBS (~1% of


cases). On rare occasions may cause non-enteric
disease such as invasion of bloodstream.
Dose: Infective dose thought to be small and
some studies suggest that 400-500 bacteria may
cause illness in some individuals. But usually
1000 to 10000 cells needed to cause illness.
Issues relating to control:
Survival: Relatively sensitive to environmental
stresses (e.g., 21% oxygen, drying, heating,
disinfectants, acidic conditions).
Can survive on hands and moist surfaces for up to
1 hour.
Numbers decline slowly at normal freezing
temperatures, but freezing does not instantly
inactivate cells.
Can survive in faeces, milk, water, urine for 3 5
weeks at 4oC
Survives well in modified atmosphere and
vacuum packaging but poorly at atmospheric
oxygen concentrations
Survives better at refrigeration than room
temperature.

Characteristics and growth conditions:


Gram negative, S curved spiral rods
Exists as vegetative cells only it is not a
spore former
Motile polar flagella
Reported to produce some toxins
Microaerophillic sensitive to high oxygen
conditions (C. jejuni: 3- 5% O2 and 2 10 %
CO2 )
o
Growth temperature >30 45 C (optimum 42
o
C
Growth pH 4.9 9 (optimum 6.5 7.5)
Growth aW: 0.987. Optimum aW is 0.997.
Will grow in 1.5% salt (NaCl) but not > 2%
Is slow growing compared to other bacteria
(generation time of 1 hour under optimum
conditions)

Inactivation: Easily inactivated by heat (D55 =


~1min; D60 = 0.2 0.3 mins)
Susceptible to low pH Die-off in foods < pH 4
Sensitive to oxygen
Appears to be sensitive to drying but under some
refrigeration conditions can remain viable for
weeks.
Reduced by freeze-thawing
Inactivated by frozen storage <-15oC over a
period of time
Sensitive to NaCl concentrations above 1% and
death occurs >2%
Sensitive to ascorbic acid and some spices
Susceptible to disinfectants such as chlorine.
Sensitive to gamma radiation and ultraviolet
radiation as used in water treatment units.

Illness: Campylobacteriosis occurs 1 10 days


after ingestion of bacteria. Symptoms include
muscle pain, headache and fever followed by
watery diarrhoea, abdominal pain and nausea. It
can last up to one week and is usually selflimiting. Can effect any age group but most often
found in infants and young adults. Infection

Note: Despite ease of heat inactivation and


oxygen sensitivity Campylobacter appears to be
able to survive environmental stresses as it is an
increasingly important cause of food-borne
illness. Under adverse conditions Campylobacter
is said to undergo a transition to a Viable but
non-culturable state.

The information provided here is a summary of the information available in the literature. It should be used as a guide only as many
variables impact on the survival and inactivation of pathogens in foods. The absence of certain information e.g. on impact of a
specific preservative, process etc. does not mean it does not exist.

88

FAO/WHO Regional Meeting on Food Safety for the Near East

CLOSTRIDIUM
Important

species:

Clostridium perfringens

Clostridium

botulinum,

Why is it important? Clostridium botulinum


causes botulism, recognized as a food-borne
disease since the late 1800s. There are 4 forms of
disease (food-borne, infant, wound and animal
botulism) caused by 7 types of botulism toxin.
While the incidence is low the disease is very
severe and can be fatal if not treated immediately
and properly. Two groups of C botulinum are
important in food: Group I-Types A, B, F
(proteolytic strains) and Group II-Types B, E, F
(non-proteolytic strains). Because they are
proteolytic Group I organisms generally cause
spoilage of contaminated food.
C. perfringens causes 2 types of food poisoning
a common form known as type A (diarrhoea and
abdominal cramps) and a rarer form called
necrotic enteritis which can be fatal.
C. perfringens poisoning occurs much more
frequently than botulism
Ecological niche: C. botulinum (esp. type A) is
widely found in soils faeces marine sediments (the
type varies from country to country) Types B, C,
D and E appear to be animal parasites. C.
perfringens is considered ubiquitous in the natural
environment.
Foods with which it is most frequently
associated: Canned corn, peppers, green beans,
soups, beets, asparagus, mushrooms, ripe olives,
spinach, tuna fish, chicken and chicken livers and
liver pate, and luncheon meats, ham, sausage,
stuffed eggplant, honey, lobster, and smoked and
salted fish. C. botulinum is often associated with
home canned foods. Meats, meat products, and
gravy are the foods most frequently implicated
with C. perfringens poisoning but it can occur in
any prepared foods that are then temperature
abused.
Characteristics and growth conditions:
Gram-positive rods
Anaerobic (but can grow in presence of low
levels of oxygen)
Sporeformers (spores are heat resistant)
Produce toxins. -C. botulinum produces a
potent neurotoxin. C. perfringens produces an
enterotoxin.
C. botulinum is motile
C. perfringens is nonmotile and encapsulated

Growth
T
pH
aW

C. botulinum Group
C. botulinum
I
Group II
12 - 50C (varies with 3.3 45C
strain type) optimum optimum 18 35 - 40C
25C
4.6 8.9 (varies with strain type)
0.95-

C. botulinum is produced at pH down to 5.2


and at a lower pH in certain foods e.g. pH
4.85 in potato
Growth
T
pH
aW

C. perfringens
12 50C (optimum
43-45C)
5.5 9 (optimum 6 7.5)
0.95

C. perfringens does not readily form spores in


food. These are mostly formed in the
intestine. It sporulates well at pH 6 8.
The enterotoxin is produced during spore
formation. Occasionally the toxin is produced
in food but large numbers of cells are required
and so food with toxin is usually spoiled.

Illness: C. botulinum. Classic symptoms of foodborne botulism include double vision, blurred
vision, drooping eyelids, slurred speech, difficulty
swallowing, dry mouth, and muscle weakness.
These are all symptoms of the muscle paralysis
caused by the toxin. If untreated, these symptoms
may progress to cause paralysis of the arms, legs,
trunk and respiratory muscles. In food-borne
botulism, symptoms generally begin 18 to 36
hours after eating a contaminated food, but they
can occur as early as 6 hours or as late as 10 days.
It is thought that all people are susceptible to
food-borne intoxication. Infants with botulism
appear lethargic, feed poorly, are constipated, and
have a weak cry and poor muscle tone. Muscle
weakness and loss of head control can reach a
point where infant appears "floppy." Infant
botulism occurs 3 30 days following ingestion
of spores which germinate and produce toxin in
the intestine.
C. perfringens. Symptoms occur 6 24 hours after
eating contaminated food and include profuse
watery diarrhoea and abdominal pain. Recovery
is usually rapid, within 24 hours. All people are
thought to be susceptible but the severity of
symptoms may vary among individuals.

FAO/WHO Regional Meeting on Food Safety for the Near East

Dose: C. botulinum. Botulism toxin is very potent


and low concentrations can cause illness. It is
estimated that the dose required to kill humans
ranges from 0.1 1.0 g. In cases of infant
botulism implicated honey samples have
contained 104 105 spores / kg.
C. perfringens. Large numbers are required to
cause illness, at least 106 / g food.
Issues relating to control:
C. botulinum:
Survival: Spores are resistant to freezing (not
defined for vegetative cells).
The vegetative cells are killed by a few minutes
exposure to 60C.
The spores survive drying and are very resistant to
heat
The toxin is stable at low pH but inactivates
quickly at pH 11.
Toxins may be slightly more heat stable at lower
pH values and are resistant to freezing.
Inactivation: For spores the D100 for Group I
C. botulinum is 25 min and for Group II is
<0.1mins, D121 for Group I is 0.1 0.2 mins and
for Group II is <0.001 mins.
A 12 D process, controlling group I spores, has
been adopted for the canning of low-acid (pH>
4.6) foods. This is the equivalent of heating to
121oC for 3 min.
Thermal death of spores
is accelerated at
extremes of pH (<5.0 and >9.0)
The toxin is inactivated by treatment at 85oC for 1
min, 80oC for 6 min or 65oC for 1.5 hours.
Nitrite is important in control of C. botulinum.
Lactic acid bacteria used in starter cultures inhibit
C. botulinum in meat products.
Nisin is widely used in dairy products
Liquid smoke appears to be effective for fish but
not meat.
A range of commonly used preservatives (e.g.
Sorbates, parabens, nisin, phenolic antioxidants,
polyphosphates, ascorbates) can be useful in the
control of C. botulinum as part of a hurdle
approach. However the interactions of various

89

preservatives when used in hurdle technology are


complex and combinations for food use need to be
validated.
Spores are inactivated by ozone and chlorine
(more effective at low pH), hydrogen peroxide
and iodophors. Normally chlorinated water should
inactivate the toxin.
C. botulinum spores are the most resistant
bacterial spores to radiation and doses used in
food preservation do not effectively eliminate the
toxin.
The toxin is not inactivated by irradiation.
C. perfringens
Survival: Vegetative cells are readily killed by
heating, are very susceptible to freezing and
decline slowly under refrigeration.
Vegetative cells are not very tolerant of low water
activity.
Spores are very heat resistant and some spores
survive boiling for 1 hour.
Spores very resistant to freezing, refrigeration and
desiccation.
Inactivation: D60 for vegetative cells = 5.4
14.5 mins
D100 for spores varies between strains from 0.31
min to >38 min.
Heating food to between 70 and 80oC followed by
cooling will induce germination of spores.
C. perfringens enterotoxin is inactivated by
heating for 5 min at 60oC.
C. perfringens will not grow at <12oC ( a very
important means of control)
Cells will die after several days below pH 5.0 and
above pH 8.3
6-8% NaCl inhibits growth.
While C. perfringens growth is inhibited by
sodium nitrite and sodium nitrate, the levels
required exceed those permitted in foods.
The application of several hurdles enables control
of growth of C. perfringens.
Susceptibility of spores to irradiation varies
according to strain.

The information provided here is a summary of the information available in the literature. It should be used as a guide only as many
variables impact on the survival and inactivation of pathogens in foods. The absence of certain information e.g. on impact of a
specific preservative, process etc. does not mean it does not exist.

90

FAO/WHO Regional Meeting on Food Safety for the Near East

ENTEROHAEMORRHAGIC ESCHERICHIA COLI


Important species: Escherichia coli O157:H7
and non-O157 shiga toxin producing Escherichia
coli (STEC)
Why is it important? E. coli are part of the
normal microflora of man and many strains are
non pathogenic. However, some are pathogenic
and these can be divided into 4 groups:
Enteropathogenic E. coli (EPEC);
Enteroinvasive E. coli (EIEC);
Enterotoxigenic E. coli (ETEC); and
Enterohaemorrhagic E. coli (EHEC).
In recent times the toxin producing forms of
E. coli have become an important cause of foodborne illness. They can cause severe illness such
as hemorrhagic colitis and haemolytic ureic
syndrome, which can be fatal particularly in
young children and the elderly. Non-O157 shiga
toxin producing Escherichia coli (STEC) are a
diverse group of organisms with varying
pathogenic potential. By definition all STEC
produce 1 or 2 toxins but might not possess other
factors critical for pathogenicity.
Ecological niche: Intestinal tracts of domesticated
and wild animals and their faeces.
Foods with which it is most frequently
associated: Beef (esp. ground beef), milk, leafy
green and salad vegetables, potatoes. May also be
transmitted via faecal-oral route person to person
or food handling.
Characteristics and growth conditions
Gram-negative
Rod shaped
Facultative - Can grow in presence or absence
of oxygen
Produce toxins
Most strains are motile
Growth temperature: 8 45oC (optimum 37
o
C).
Growth pH 4.4 9 ( optimum 6 - 7)
Aw 0.955 (optimum 0.995)

Illness: EPEC, which is rarely food-borne, causes


infant diarrhoea 1 3 days after ingestion. EIEC

causes a dysentery-like syndrome. 8 24 hours


after ingestion. ETEC is a cause of travellers
diarrhoea. It is caused by the production of a
cholera-like toxin and symptoms occur 8 44h
after ingestion. EHEC (STEC and E. coli
O157:H7) invades the gut and then produces a
toxin. This can lead to a bloody-diarrhoea
syndrome, kidney disease and even death.
Resulting conditions include Haemorrhagic colitis
(HC), Haemolytic Uraemic Syndrome (HUS).
Any age group can be affected but disease most
often occurs in young children and the elderly.
Dose: Foods with very low numbers of cells - 0.3
0.4 EHEC cells /g - have been implicated in
disease but it has been estimated that ingestion of
105 cells gives a 50% probability of disease. For
other pathogenic E. coli the minimal infective
dose for adults is probably 106 /g.
Issues relating to control:
Survival: E. coli O157:H7 survives well in chilled
and frozen foods. At low temperatures cells enter
a viable but non-culturable state.
It is more acid resistant than other E. coli. Prior
exposure to acidic conditions can increase acid
tolerance further. Has also been shown to survive
stomach pH (1.5) for longer than 3 hours.
Can survive for weeks under dry conditions and in
dried food products e.g. dried meat.
Inactivation: Rapidly inactivated by heating to
71oC so pasteurization is effective
D value at 60oC is 3045 seconds
Inactivated by proper cooking
Thermal resistance is higher in foods with a high
fat content.
Freeze thawing can reduce numbers but this effect
is strain dependent.
Inactivation by decreasing pH is dependent on the
acidulant and the temperature. Usually more
effective at warmer temperatures.
Sensitive to UV and gamma radiation.
While commonly used disinfectants such as
chlorine are effective, their efficacy may be
reduced in the presence of solids or organic
matter.

FAO/WHO Regional Meeting on Food Safety for the Near East

91

LISTERIA
Important species: Listeria monocytogenes is the
most important pathogenic strain. Not all strains
of Listeria are pathogenic.
Why is it important? Listeriosis is a relatively
rare but potentially fatal disease. Invasive
listeriosis is a life threatening systemic infection.
Those at risk include pregnant women and their
foetuses,
neonates,
the
elderly
and
immunocompromised people. There is also a noninvasive form gastroenteritis but there is little
available information on the occurrence of this
milder form. Most healthy people do not seem to
be affected by Listeria.
Ecological niche: widely distributed in the
environment and has been isolated from a variety
of sources, including soil, vegetation, silage,
faecal material, sewage and water. Ubiquitous in
the natural environment i.e. soil, water. Prevalent
in intensive animal/bird farming practices.
Foods with which it is most frequently
associated: Found in a wide range of foods. Milk,
semi-soft and soft mould-ripened cheeses, smoked
fish, modified atmosphere packaged vegetables,
hot dogs; pork tongue in jelly; processed meats;
pt; salami; butter; cooked shrimp; salads ; raw
vegetables; and cole slaw. Ready-to-eat food
products
Characteristics and growth conditions
Gram-positive
Facultative anaerobe growth is optimal
under microaerophilic conditions
Non-spore forming rod
A typical tumbling motility at 2025C, but
not at 35C
Psychrotrophic and grows over a temperature
range of 0 to 45C (37C). Some reports
indicate a minimum temperature of -1.5C
Growth pH 4.4 - 9.4
Growth aW 0.92

Illness: The invasive disease is normally


associated with people with weakened immune
systems and can occur 1 90 days after ingestion
of cells. Symptoms include flu like symptoms,
diarrhoea, vomiting, septicaemia, meningitis and

abortion. In most cases patients require


hospitalisation and the fatality rate is 20 30%.
There may be long term effects such as
neurological problems. Non-invasive listeriosis
can occur in anyone consuming a high number of
cells. Symptoms occur 12 h to 7 days after
ingestion and include diarrhoea, fever, muscle
pain, headache, cramps and vomiting.
Dose: The infective dose is not really known but
it seems that in most cases of invasive listeriosis
100 to 1000 cells are required. In cases of noninvasive listeriosis, a higher does has been
implicated, at least > 105 and more often around
1011 cells.
Issues relating to control
Survival: Resistant to various environmental
conditions, such as high salinity or acidity, which
allows it to survive longer under adverse
conditions than most other non-spore forming
bacteria of importance in food-borne disease and
contribute to its widespread distribution.
One of the most thermally resistant vegetative
cells -has caused some concern in terms of
effectiveness of pasteurization.
Listeria can survive in wet conditions for many
months and up to 2 years in dry soil or dust.
Inactivation: Listeria are killed by the heat
treatments in most normal processing operations
but its heat resistance varies according to strain
type and food matrix. The commonly reported
D60C is 2.6 mins but it may be greater e.g. D60C of
strain Scott A is 5.29 min in chicken slurry, 8.32
mins in beef slurry and 5.02 mins in carrot slurry
Can grow at low temperatures (3C) and survive
down to 0C or just below.
Listeria can survive and grow at a pH down to 4.4
but it seems that the type of acid and the storage
temperature influence the effect of pH
Sensitive to commonly used disinfectants in
absence of organic matter. In presence of organic
matter many disinfectants are ineffective.
Similar resistance as other Gram positive bacteria
to gamma radiation but more sensitive than other
Gram positive bacteria to UV radiation.
Recent evidence suggests that L. monocytogenes
may have a viable but non-culturable state

The information provided here is a summary of the information available in the literature. It should be used as a guide only as many
variables impact on the survival and inactivation of pathogens in foods. The absence of certain information e.g. on impact of a
specific preservative, process etc. does not mean it does not exist.

92

FAO/WHO Regional Meeting on Food Safety for the Near East

MYCOBACTERIUM
Important species: Mycobacterium bovis
Why is it important? M. bovis is the cause of
tuberculosis in cows, cattle and other animals
(bovine tuberculosis). However it can also infect
humans and can be transmitted via raw milk and
meat. Humans can also be a reservoir for this
bacteria. Note: The primary cause of tuberculosis
in humans is M. tuberculosis. Humans are the
only reservoir for this latter bacterium. The
proportion of human cases caused by M. bovis
compared to M tuberculosis is not well
documented.
Ecological niche: The main reservoir is cattle;
however humans and a wide range of mammals
are susceptible to the bacterium e.g. farmed deer,
farmed wild boar, goats, llamas, alpacas, pigs,
dogs and cats. number of wild animals (European
badger, the brush-tailed possum, buffalo, bison
and several species of wild deer) can also act as
reservoirs.

develop symptoms as their immune system can


usually control the bacterium, sometimes
throughout life. However inactive bacteria can
become active again later in life, particularly if the
immune system is weakened.
In airborne
infections and in immunocompetent people the
incubation period can be years, while in
immunosuppressed people it may be months.
Cases of the gastrointestinal form can occur after
reactivation of infections that must have occurred
many years earlier. Symptoms include chills,
weight loss, abdominal pain, diarrhoea or
constipation. Other symptoms depend on the
organs infected. Symptoms may last for months or
years.
Immunosuppressed or immunocompromised
people are thought to be particularly at risk e.g.
HIV/AIDS patients. Children also appear to have
a higher risk of infection.
The course of the disease is long term and may
result in death.

Foods with which it is most frequently


associated: Unpasteurised milk and raw meat and
raw meat products.

Dose: Need high numbers need to be ingested to


cause infection millions of cells. In contrast as
few as 10 cells can cause infection when inhaled.

Characteristics and growth conditions:


Gram-positive slightly curved rods
Aerobic
Very slow growing as the foods it is
associated with generally have a short shelf
life there is unlikely to be any significant
growth in the food and
Non spore forming
Non motile
Does not produce toxins.
Fatty coat or capsule which protects it from
digestive juices
Zoonotic

Issues relating to control


Survival:
Relatively susceptible to high temperatures.
Inactivated by sunlight
Can persist and remain infective in the
environment for long periods.
Survival is better under cool conditions e.g.
survived in cow faeces for 5 months in winter and
2 months in summer
Survives well in dry conditions

Illness: Tuberculosis is the general name for a


group of diseases associated with the presence of
Mycobacterium spp. - pulmonary (lung)
tuberculosis is the most important but almost any
organ can be affected. Infection is generally
acquired by inhalation from dust, aerosols.
Gastrointestinal infection occurs as a result of
ingesting M. bovis and is called intestinal
tuberculosis or tuberculosis enteritis The bacteria
can migrate fro the intestine and infect other
organs in the body. Infected people may not

Inactivation: Inactivated by normal pasteurization


temperatures i.e. 63.5oC for 30 mins and 71.7oC
for 15 secs. In milk (Major factor in the
establishment of milk pasteurization standards).
Pasteurization has been very effective in many
countries in eliminating this as a human health
problem. It has been used in conjunction with an
animal disease control program.
In meat products the D61oC = 1 minute, while
D55oC = approx 10 minutes. Treatment at 65oC
for 1 minute gave a 5 D kill.

FAO/WHO Regional Meeting on Food Safety for the Near East

93

SALMONELLA
Important species: Salmonella enterica many
different serotypes that can be divided into two
groups i) non-typhoid and ii) typhoid
Most food-borne Salmonella are non-typhoid
strains. Names usually written as Species
Serotype. The enterica is often left out e.g.
Salmonella Enteritidis
Why is it important? Salmonellosis, caused by
non-typhoid S. enterica is one of the most
frequently reported food-borne diseases in the
world. S. enterica comprises a large number of
different serotypes although a few dominate in
terms of causing disease e.g. S. Enteritidis,
S. Typhimurium. The typhoid fever causing
serotypes are S. Typhi and S. Paratyphi produce
typhoid (enteric) fever or typhoid-like fever in
humans, which is a much more series form of
Salmonella infection..
Ecological niche: Non- typhoid Salmonella is
ubiquitous in the natural environment i.e. soil,
water. Prevalent in intensive animal/bird farming
practices. Man is the reservoir for S. Typhi and S.
Paratyphi. Water may become contaminated via
human faecal waste.
Foods with which it is most frequently
associated: Non-typhoid salmonellae are found in
a wide range of foods as they are prevalent in
many sectors of the food chain. Associated in
particular with foods of animal origin e.g. poultry
meat, eggs, poultry and egg products, meat and
meat products, cakes and ice cream, milk and
dairy products, fish and shrimp, peanut butter,
cocoa, chocolate. Contamination of foods with S.
Typhi and S. Paratyphi is usually via food
handlers or faecally contaminated water.
Characteristics and growth conditions
Gram negative rod
Non-spore forming
Motile peritrichous flagella
Facultative anaerobic (i.e. can grow in the
presence or absence of air)
Growth temperature 8 45oC ( optimum
37oC)
Growth pH 4 8 (optimum 6.5 7.5)
Growth aW 0.93

Illness:
Non-typhoid
salmonella
causes
Salmonellosis - a gastrointestinal illness which
occurs 648h after ingestion. Symptoms include
nausea, vomiting, cramps, diarrhoea, fever and
abdominal pain and last 17 days. Can have long
term effects (e.g. septicaemia may occur) and
chronic consequences (e.g. arthritic symptoms in
34 weeks). All age groups are susceptible, but
symptoms are most severe in the elderly, infants,
and the immunocompromised.
Typhoid occurs 7 28 days after ingestion of S.
Typhi cells. Symptoms include fever, malaise,
anorexia, diarrhoea or constipation, delirium.
Recovery is slow and may take up to 2 months.
Hospitalization is often required. S. Typhi is not a
problem in industrialized countries. Those at risk
include people living in conditions of poor
sanitation and international travellers.
Dose: The dose required to cause non-typhoid
salmonellosis varies with many factors. While in
general 105 106 cells are required to cause illness,
doses as low as 445 cells have been reported to
cause illness. As with non-typhoid salmonellosis
the infectious dose to cause typhoid fever also
appears to be variable.
Issues relating to control:
Survival: Can survive well in foods and on
surfaces, for long periods at room temperature or
below and for long periods in animal sewage
applied to land ( up to 8 months). Can survive in
dried foods. Has survived in broth with 12% salt
(22 days at 20oC and 55 days at 5oC)
Inactivation: One of the most heat resistant
vegetative cells. D value at 60oC = 2 6 mins
Varying heat resistance - Increased heat resistance
following heat shock and also at a lower aW values
(e.g. milk concentrate and chocolate)
Freezing usually kills Salmonella but some foods
e.g. meat appear to be protective of Salmonella so
freezing does not ensure inactivation.
Inactivated by radiation (D value around 0.5 kGy,
up to 0.8.) but effectiveness depends on food type
e.g. D times are higher in drier foods such as
desiccated coconut.
Effect of pH is related to other factors such as
acid type and temperature e.g. inactivation is
more rapid in commercial mayonnaise at 20oC
than it is at 4oC.
Sensitive to disinfectants used in food industry.

The information provided here is a summary of the information available in the literature. It should be used as a guide only as many
variables impact on the survival and inactivation of pathogens in foods. The absence of certain information e.g. on impact of a
specific preservative, process etc. does not mean it does not exist.

94

FAO/WHO Regional Meeting on Food Safety for the Near East

SHIGELLA
Important species: Shigella dysenteriae, Shigella
flexneri, Shigella boydii and Shigella sonnei
Why is it important? Causes bacillary dysentery
or shigellosis. It is painful and incapacitating and
may require hospitalization. Not usually fatal but
can be in undernourished children,
immunocompromised individuals and the elderly.
Ecological niche: The primary reservoir is
humans and other primates.
Foods with which it is most frequently
associated: Not associated with any particular
foods but outbreaks have been associated with
salad, raw vegetables, milk, dairy products,
chicken and shellfish. Contamination of foods is
usually via the faecal-oral route. Can be
introduced into food by an infected food handler.
Often regarded as waterborne.
Characteristics and growth conditions:
Gram-negative rod
Non spore forming
Non motile
Can grow in the presence of absence of
oxygen.
Growth temperature 6 47oC
Growth pH 4.8 9.3
Aw >0.95
5.2% NaCl
Some strains produce enterotoxin and Shiga
toxin
Illness: Bacillary dysentery or shigellosis can
occur within 12 hours to 4 days if ingestion of
Shigella. Symptoms include abdominal pain,
profuse watery or bloody diarrhoea, fever and
malaise. It can last from 3 to 14 days. Everyone is
susceptible to some degree but some groups in the
population are more at risk such as young children
in day-care centres, people in nursing homes,
prisons, and those lining in places with poor
sanitary facilities. Infants, the elderly, and the

immunocompromised are susceptible to the


severest symptoms of disease. Shigellosis is
common AIDS and non-AIDS homosexual men.
In severe cases of diarrhoea/dehydration
hospitalization may be required. Sequelae may
occur such as Reiters disease, reactive arthritis,
haemolytic uremic syndrome.
Dose: The dose required to cause illness is low
with 10 200 cells capable of causing illness.
Issues relating to control
Survival: Shigella spp have not been widely
studied in foods and very little is known about the
growth and survival of the organism in food.
S. sonnei is more robust than S. flexneri and it has
been shown to be able to grow on foods (e.g.
parsley).
Usually introduced by a food handler so often
difficult to control.
Survive well at low temperatures e.g. up to 100
days on butter
Survives heating to 63oC for 2-3 min.
Among the most acid resistant food-borne
pathogens
Can survive up to 15% salt and survival is better
in low moisture foods
Inactivation: Rapidly inactivated above 65 oC
Inactivated at pH values <4 but die-off can be
slow
Decline slowly at 6% NaCl
Susceptibility to preservatives can vary among
strains e.g. S flexneri is inhibited by 450ppm
nitrite at pH 5.5 while S. sonnei requires 700ppm
for inhibition
Inactivated by chlorine
Sensitive to gamma radiation.
Good personal hygiene of food handlers is critical
for control as in some cases carriers of Shigella
may not exhibit any symptoms.

FAO/WHO Regional Meeting on Food Safety for the Near East

95

STAPHYLOCOCCUS
Important species: Staphylococcus aureus

Why is it
important? S.
aureus produces a
toxin which
causes food
poisoning.
Growth and toxin
production are greatest in aerobic conditions but it
can also grow anaerobically. Although numbers of
staphylococcal poisoning are difficult to estimate
it is thought to be relatively common especially in
areas where there are deficiencies in food
handling.
Ecological niche: Ubiquitous in man and animals
(skin, nose, and throat) which are the primary
reservoirs. Carried by a large proportion of the
healthy population. Also exists in air, dust,
sewage, water, milk, and food or on food
equipment, environmental surfaces.
Foods with which it is most frequently
associated: Fish, meat, poultry and egg products,
salads, cream, confectionary products, milk and
cheese. Any food contaminated by a food handler.
Characteristics and growth conditions:
Gram-positive cocci
(characteristic grape
like clusters of cells)
Aerobe but capable
of growing
anaerobically
Non motile
Non spore forming
Some strains produce toxins (5 types of toxins
produces by S. aureus).
o
o
Growth temperature 6.5 50 C (37 C).
o
o
Toxin production 10 48 C (35 - 40 C)
Growth pH 4 9.3 (6-7) Toxin Production 4.8
9 (5.3 - 7)
Aw 0.83 0.99 (0.98) Toxin production 0.85
0.99 (0.98) (Ability to grow at such low water
activity gives it as competitive advantage in
foods with low water activity / high salt
(grows at up to 25% NaCl)
In general it does not compete well with other
bacteria
Toxin production is greater in the presence of
oxygen.

Illness: Staphylococcal food poisoning is acute


with symptoms occurring within 30 mins to 7
hours after eating contaminated foods. They
include nausea, vomiting, abdominal cramps,
sometimes followed by diarrhoea. Recovery is
usually rapid, within 2 days. All people are
thought to be susceptible but severity of
symptoms varies among individuals.
Dose: Need high numbers of cells before
sufficient toxin to cause illness is produced.
Toxin production begins when there105 to 106
cells. Sufficient toxin to cause illness is produced
when there are 5 x106. A toxin dose of about 1.0
mg in contaminated food will produce symptoms
of staphylococcal intoxication. Compared to other
exotoxins a large amount is needed to cause
illness potent but not as potent as other
exotoxins.
Issues relating to control
Survival:
Relatively susceptible to high temperatures.
Survives frozen storage.
Resistant to drying and can grow and produce
toxin in foods of low Aw
Can grow in up to 25% NaCl
Can survive in foods at pH down to 4.2 but this is
dependent on type of acid.
Toxins are very resistant to heat (e.g. D value of
enterotoxin B at 149oC is 100 min at
an aw of 0.99)
Inactivation: Usually readily killed at cooking
and pasteurization temperatures. D60 = ~2 mins
Heat resistance is increased in dry, high-fat and
high-salt foods.
High resistance is reduced at high and low pH
Lemon and lime juice and lactic acid bacteria
inhibit S aureus
Toxin production is inhibited at low pH (lactic
acid) and in the absence of oxygen
Commonly used preservatives, with the exception
of NaCl, are effective against S. aureus.
The effectiveness of some preservatives towards
S. aureus increases with decreasing pH.
Sensitive to most chemical disinfectants routinely
used in the food industry.
Relatively resistant to ionizing radiation but not
UV radiation compared to other non-spore
formers.

The information provided here is a summary of the information available in the literature. It should be used as a guide only as many
variables impact on the survival and inactivation of pathogens in foods. The absence of certain information e.g. on impact of a
specific preservative, process etc. does not mean it does not exist.

96

FAO/WHO Regional Meeting on Food Safety for the Near East

VIBRIO
Important species: Vibrio parahaemolyticus,
Vibrio vulnificus, Vibrio cholerae
Why is it important? V. parahaemolyticus and
V. cholerae cause gastrointestinal illness while
V. vulnificus causes non-intestinal illnesses such
as septicaemia. Important cause of gastroenteritis
where large amounts of undercooked or raw
seafood is consumed. Toxigenic V. cholerae O1
and O139 cause water- and food-borne cholera
outbreaks with epidemic and pandemic potential.
Ecological niche: Marine, coastal and estuarine
waters and marine organisms. Pathogenic vibrios
sometimes found in fresh water reaches of
estuaries.
Foods with which it is most frequently
associated: Fish and seafood. Can be a big
problem when seafood products are eaten raw
(sushi, sashimi) V. cholerae in particular is
associated with inadequate sanitary conditions and
faecal contamination of water and foods.
Characteristics
and
growth conditions
Gram-negative curved
rods
Facultatively
anaerobic
Non-sporeforming
Curved rod shape
Motile
Mildly Halophilic (except V. cholerae - does
not require presence of salt to grow)
V. cholerae produces cholera toxin in the
small intestine.

V.
parahaemolyticus
5 45C (37C)

pH

4.8 11 (7.8 8.6)

aW

> 0.94 (0.98)

NaCl

0.5 10%
(3%)

Growth

V.
cholerae
10
43C
(37C)
5 9.6
(7.6)
> 0.97
(0.984)
0.1 4%

V.
vulnificus
8 43C
(37C)
5 10
(7.8)
> 0.96
(0.98)
0.5 5%
(2.5%)

Illness: V. cholerae: Cholera, caused by serotypes


O1 and O139 which produce a toxin in the small
intestine, occurs within 12 72 hours of ingesting
cells. Symptoms include initially mild diarrhoea
progressing to rice water stools, nausea,
abdominal cramps and low blood pressure.

Dehydration, if not treated, may cause death.


Otherwise recovery occurs within 1 week.
Children up to 9 years in endemic countries are
most at risk. More prevalent in the developing
world. There have been up to 8 cholera
pandemics.
Non O1/O139 types (do not produce toxin) can
also cause a milder illness with diarrhoea, cramps
and fever. Everyone seems to be susceptible.
V. parahaemolyticus: Symptoms occur 4 72
hours after ingestion and include abdominal
cramps, watery diarrhoea, nausea, vomiting and
fever. It can last for up to a week but usually self
limiting. Produces a haemolysin and shiga-like
toxin. Sequelae such as reactive arthritis have
been reported.
All people appear to be
susceptible.
V. vulnificus. Illness can occur within 12 hours to
3 days after consumption. Illness can take the
form of gastroenteritis (vomiting, diarrhoea,
abdominal pain) or more often primary
septicaemia. Initial symptoms include fever,
malaise and chills and death can occur rapidly in
50% of cases. There is a high case fatality rate.
The at risk people are those with impaired liver
function and those that are immunosuppressed.
Dose: V. cholera: Around 106 cells when ingested
in food by healthy adults. Lower numbers will
cause illness in those taking antacids.
V. parahaemolyticus: 2 x 10 5 to 107 cells
required to cause illness in healthy adults but also
may be lower in those taking antacids.
V. vulnificus: Dose for healthy adults unknown
but could be less than 100 for at risk people.
Issues relating to control
V. cholerae
Survival: Survives better under refrigeration than
ambient temperature and can survive freezing.
Variation in survival during refrigerated and
frozen storage (up to 3 weeks at 7C and up to 5
months of frozen storage)
Highly sensitive to acidic environments and
desiccation
V cholerae has been shown to undergo a transition
into a Viable but Non-Culturable state.
Inactivation: D60 = 2.7 mins D71 = 0.30 mins
Rapidly inactivated at pH values<4.5 at room
temperature.
Freshly squeezed lemon juice inactivates
organism after 5 minutes exposure.
Depuration is not a reliable way to remove vibrios
from shellfish.

FAO/WHO Regional Meeting on Food Safety for the Near East

Sensitive to disinfectants routinely used in the


food industry.
Sensitive to irradiation
V. parahaemolyticus
Survival: Can survive refrigeration temperatures
for several weeks and freezing for up to 7 weeks
Normally starts to die off at <5C
Inactivation: Sensitive to heating
D65C = <1 min
D55C = 2.5 mins
A low temperature pasteurization (50oC) for 10
mins is effective in inactivating the organism in
oysters (outbreaks are often associated with
oysters).
Very sensitive to drying.
Fresh water inactivates the organism
Growth inhibited by 0/1% acetic acid (pH 5.1)
Very sensitive to preservatives
Very sensitive to chlorine and iodophors
Depuration is not effective for removal from
shellfish
V. vulnificus
Survival: More sensitive to environmental
conditions than other Vibrio spp.

97

Can survive well under refrigeration by entering


Viable but non culturable (VBNC) state
Survives quite well in oysters at 0 4oC
Survives to pH 5 at low salinity
Inactivation:
Inactivated by mild heat treatment and low pH
D45C = 50 mins
D51C = 10 mins
A low temperature pasteurization (50oC) for 10
mins is effective in inactivating the organism in
oysters
Freezing reduces the organism in oysters by 95
99% but survivors remain fairly stable during
frozen storage.
Inactivation at low pH is slower at lower
temperatures.
Inhibited by some but not all preservatives.
Depuration is ineffective
Relaying shellfish to higher salinity environments
can reduce pathogen numbers
Irradiation is effective and the irradiation dose can
be reduced if used at higher temperatures e.g.
increasing from 25 to 40oC means that
approximately half the dose has the same killing
effect.

The information provided here is a summary of the information available in the literature. It should be used as a guide only as many
variables impact on the survival and inactivation of pathogens in foods. The absence of certain information e.g. on impact of a
specific preservative, process etc. does not mean it does not exist.

98

FAO/WHO Regional Meeting on Food Safety for the Near East

YERSINIA
Important species: Yersinia enterocolitica.
There are two other pathogenic species
Y. pseudotuberculosis and Y. pestis (the causative
agent of the plague) but these are not foodborne.
Why is it important? It causes yersiniosis which
is frequently characterized by gastroenteritis
Yersinia infections mimic appendicitis and often a
major "complication" is the performance of
unnecessary appendectomies. Yersinia is capable
of growing at refrigeration temperatures.
Ecological niche: Intestinal tracts of many
mammalian species and birds. Soil, vegetation,
lakes, rivers, wells, streams.
Foods with which it is most frequently
associated: Meats (pork, beef, lamb, etc.),
oysters, fish, and raw milk. Mostly associated
with pig and pig meat products. Poor sanitation
and improper sterilization techniques by food
handlers, including improper storage, can
contribute to contamination of food.
Characteristics and growth conditions:
Gram-negative rod shaped bacterium
Aerobe but capable of growing anaerobically
Non spore forming
Non toxin producing
Growth temperature 0 44oC (28-29 oC).
Growth pH 4.2 10 (7.2 7.4)
Aw: 0.945 (5% NaCl)
Not all strains are pathogenic
Geographical variation of pathogenic strains
worldwide
A good competitor with other bacteria.

Illness: Occurs between 1 and 11 days after


ingestion. Symptoms include abdominal pain
(sometimes
confused
with
appendicitis),
headache, fever, diarrhoea, nausea and vomiting.
The disease is self limiting with recovery within
about 1 week. In rare cases bacteraemia may
occur. Person to person it usually affects the very
young
and
very
old
as
well
as
immunocompromised and debilitated. In some
cases enterocolitis may persist for several months.
Dose: This is not known.
Issues relating to control:
Survival: Can readily withstand freezing and
refrigeration
Survived for 64 weeks in water stored at 4oC.
At low pH (below pH value for growth) survival
is better at lower temperatures
Survives well in water and moist soil but declines
as soil dries out.
Inactivation: Easily inactivated by heat. D value
at 60oC = ~30 secs at 65oC D value = 2 secs so
pasteurization is an effective heat treatment.
Impact of pH varies according to acidulant
Susceptible to drying
5 7 % NaCl inhibits growth
Its presence often indicates a failure in the
processing system
Preservatives retard growth to varying degrees
e.g. sodium nitrite is more effective than sodium
nitrate.
It is thought to be somewhat resistant to chlorine
Sensitive to radiation and commercial UV water
radiation systems are considered to be effective.

FAO/WHO Regional Meeting on Food Safety for the Near East

99

AEROMONAS and PLESIOMONAS


Important species: Aeromonas hydrophila,
Plesiomonas shigelloides
Why is it important? A. hydrophila may cause
gastroenteritis in healthy individuals or
septicaemia in individuals with impaired immune
systems or various malignancies. Plesiomonas can
cause gastroenteritis. While there is still
controversy as to the enteropathogenicity of these
bacteria, they may be considered emerging
pathogens. Certainly, not all strains cause human
illness. Plesiomonas can also grow at low
refrigeration temperatures so it could be a
potential problem in chilled foods.
Ecological niche: A. hydrophila is found in
brackish, fresh, estuarine, marine, chlorinated and
unchlorinated
water
supplies
worldwide.
P. shigelloides mainly occurs in freshwater and
fresh water fish and shellfish but also many
animals.
Foods with which it is most frequently
associated: A. hydrophila is frequently found in
fish and shellfish but sometimes is associated with
red meat and poultry. P. shigelloides is mainly
associated with water and raw freshwater fish and
shellfish
Characteristics
and
growth
conditions
Gramnegative
Rod shaped
Facultatively anaerobic
Motile (polar flagella)
Non sporeformer
Produces a toxin which is preformed in the
food
Usually encapsulated
Unlikely to grow at salt levels greater than 3
3.5%
Growth
T
pH

A. hydrophila
P. shigelloides
5 - 45C (28C) 0 45C (3839C)
5.5 10
58

Illness: Two types of gastroenteritis have been


associated with A. hydrophila: a cholera-like
illness with a watery diarrhoea and a dysenteric
illness characterized by loose stools containing
blood and mucus. Septicaemia has been observed
in individuals with underlying illness.
P. shigelloides has been implicated in cases of
gastroenteritis. P. shigelloides infection may
cause diarrhoea of 1-2 days duration in healthy
adults. However, there may be high fever and
chills and protracted dysenteric symptoms in
infants and children under 15 years of age.
Complications (septicaemia and death) may occur
in people who are immunocompromised or have
an underlying illness. Most cases reported have
occurred in people living in tropical and
subtropical areas.
All people may be susceptible to infection.
Infants, children and chronically ill people are
more likely to experience protracted illness and
complications.
Dose: The infectious dose of A. hydrophilia is
unknown, but it is thought to be high, ranging
from 104 to 109. For P. shigelloides the infective
dose is also presumed to be quite high - > 106
cells.
Issues relating to control
Aeromonas contribute to spoilage of many foods
but can reach high numbers (108) in some foods
such as milk without detectable organoleptic
changes
Survival: Quite resistant to freezing.
Some strains of both Aeromonas and Plesiomonas
can grow at refrigeration temperatures
While Aeromonas can grow in modified
atmospheres Plesiomonas are very susceptible to
modified atmosphere storage
Inactivation: Research on methods of destruction
is relatively limited but appears to be readily
killed by heat or radiation
Aeromonas and Palestinians spp. are sensitive to
low pH and > 4%NaCl
Susceptible to disinfectants including chlorine.
However, recovery of Aeromonas from
chlorinated water has commonly been reported
(post treatment contamination, inactivation of
chlorine by organic matter, high initial cell
numbers, viable but non-culturable state.

The information provided here is a summary of the information available in the literature. It should be used as a guide only as many
variables impact on the survival and inactivation of pathogens in foods. The absence of certain information e.g. on impact of a
specific preservative, process etc. does not mean it does not exist.

100

FAO/WHO Regional Meeting on Food Safety for the Near East

Viruses
Viruses are now recognized as among the top causes of food-borne disease. Some studies suggest that
between 30-60% of the total number of cases of food-borne illness may be attributable to viruses. They
are very simple organisms that require a living host (a human, animal, insect or bacteria) in order to
grow and multiply. Hence viruses do not multiply in food or water, but they can be spread via both these
routes. Viruses can be transmitted from person to person. They are shed with faeces and so can be
transmitted to humans via water and food due to faecal contamination. Once consumed, these viruses
may infect the gastrointestinal tract and cause a range of illnesses. Examples of some important foodborne viruses include hepatitis A and noroviruses. Outbreaks of illness due to these viruses arise from
contaminated raw foods such as shellfish, and through secondary contamination by food handlers
carrying the virus. Other foods typically implicated in outbreaks are those eaten raw such as salads and
fruit, or foods not cooked after handling. Viral gastroenteritis is usually a relatively mild disease and
most people do not consult a doctor, hence the majority of cases are not reported or investigated.
Therefore the importance of viral food-borne illness has been widely underestimated.
Hepatitis A
Many food associated outbreaks recorded
Source: human faeces is primary reservoir.
Also in some animals
It will not grow in food and water
It is associated with water, raw foods e.g.
strawberries, raspberries, green onions,
(irrigation with contaminated water),
shellfish (harvested from contaminated
water), and frequently handled foods e.g.
bakery products, (handling by person
infected with hepatitis)
Infective dose not known
Illness can last weeks ( symptoms include
jaundice, anorexia, vomiting, malaise)
Patient can be more susceptible to other
illnesses
No established methodology for detection
or routine surveillance except for shellfish
Issues relating to control
Can survive in the environment for long
periods (3 months)
Shows high resistance to chemical and
physical agents
Stable at acid pH
More temperature resistant in foods (e.g.
only partially inactivated after 10 12 h
at 56oC
As humans are carriers personal hygiene is
very important in control of the virus
Noroviruses

Also known as Small round structured


viruses / Norwalk like viruses /
caliciviruses
Acute gastroenteritis (stomach flu)
Illness sudden, usually brief (common
problem on cruise ships)
Found in faeces or vomit of infected
people.
Infection via contaminated food/drinks,
contaminated surfaces, person-to-person
(very contagious)
Cannot be grown in cell culture so
difficult to study
Will not grow in food
Only known reservoir is human faeces
Outbreaks associated with shellfish, water,
bakery goods, sandwiches, salads.
1- 10 virus particles can cause illness

Issues relating to control


Little information on stability in food
Food handlers should not be in contact
with food during infection or for 3 days
later
Available information indicates virus is
stable and resistant to heat, acid and
solvents
Appears to survive refrigeration and
freezing
Not eliminated by pasteurization
Resistant to drying

Other viruses that can be transmitted via food and cause gastroenteritis include enteric adenovirus,
rotavirus, coronovirus, astrovirus and aichivirus.
Enterovirus (e.g. poliovirus) can also be transmitted by food but causes a range of different symptoms
including neurological symptoms.

FAO/WHO Regional Meeting on Food Safety for the Near East

101

Parasites
The parasites of primary concern in terms of food-borne disease include the protozoa and the helminths
or intestinal parasites (tapeworms, round worms and flat worms). They are complex organisms capable
of causing a range of illnesses, including diarrhoea and even liver-cancer. may spend time in the tissues
of an animal host before infecting a human, using a range of vectors or carriers. Helminths are primarily
associated with meat and fish and usually have complex lifecycles. They are usually easily killed by
heating and freezing but this means they can be a problem when meat or fish are eaten undercooked or
raw. They do not multiply in foods and critical control points include control in animals and during
food preparation. Protozoan parasites have lifecycles that vary from simple to complex depending on
the species. They produce cysts which are passed in faeces and contaminate water and food (often
irrigated fruit and vegetables. They can also be transmitted via food handlers. Many protozoan parasites
are resistant to chlorine and other disinfectants/chemicals as well as many environmental stresses.
Oocysts can survive for prolonged periods under moist conditions and are susceptible to high
temperatures, freezing, desiccation. These parasites can be controlled by water filtration and some
chemicals e.g. hydrogen peroxide, ozone
Helminths
Trichinella

Five species - T.spiralis, T. nativa, T. britovi, T.


nelsoni and T. pseudospirals. (nematodes)
Most human infections caused by T.spiralis
Illness associated with raw or improperly cooked
meats containing the larvae of the parasite
Causes Trichinellosis / trichinosis
First symptoms: Nausea, diarrhoea,
vomiting, fatigue, fever, abdominal
discomfort.
Headaches, fevers, chills, cough, eye
swelling, aching joints and muscle pains,
itchy skin, diarrhoea, or constipation
follow.
A heavy infection may cause coordination
difficulties, heart and breathing problems.
Recovery takes several months
In severe cases, death can occur

Reference: CDC
www.dpd.cdc.gov/dpdx

The information provided here is a summary of the information available in the literature. It should be used as a guide only as many
variables impact on the survival and inactivation of pathogens in foods. The absence of certain information e.g. on impact of a
specific preservative, process etc. does not mean it does not exist.

102

FAO/WHO Regional Meeting on Food Safety for the Near East

Taenia

Taenia saginata (beef tapeworm)


and T. solium (pork tapeworm)
(cestodes)
Humans are the only definitive
hosts
Humans become infected by
ingesting raw or undercooked
infected meat, contaminated water
or food
T. saginata taeniasis
only mild abdominal
symptoms, passage (active
and passive) of proglottids,
occasionally causing
appendicitis or cholangitis
T. solium taeniasis
main symptom is the
passage (passive) of
proglottids.
But risk of development of
cysticercosis cysts
developing in different parts of the body

Anisakis

Anisakis simplex (herring worm),


Pseudoterranova decipiens (cod or seal worm),
Contracaecum spp., and Hysterothylacium
(Thynnascaris) spp. (nematodes)
Human infections caused by the consumption
of raw or undercooked seafood.
Symptoms
tingling or tickling sensation in the
throat
acute abdominal pain and nausea
Burrow into the wall of the digestive
tract to the level of the muscularis
mucosae
Anisakids rarely reach full maturity in
humans and usually are eliminated
spontaneously within 3 weeks of
infection.

Taenia lifecycle
Reference: CDC
www.dpd.cdc.gov/dpdx

Anisakis lifecycle
Reference: CDC
www.dpd.cdc.gov/dpdx

FAO/WHO Regional Meeting on Food Safety for the Near East

103

Protozoa
Toxoplasma gondii

Obligate intracellular parasite does not grow


outside host
Complex lifecycle
Only infected cats shed oocysts in faeces
Environmental survival
Up to 400 days in faeces, water at 4
37oC
Gradually inactivated by drying
Inactivation
Meat cooked to 80oC for several mins
Freezing
Curing agents used in meat
Source: cats, meat containing oocysts
Symptoms of toxoplasmosis
flu like symptoms, rash,
malaise, fever, swollen lymph
nodes
In healthy people infection can be
asymptomatic
Congenital infections
Brain and eye lesions, visual
impairment, death (up to 10%
cases)
At risk groups: Pregnant women/ foetus,
Immunocompromised people
Dose not established likely to be less than 10,000

Reference: CDC
www.dpd.cdc.gov/dpdx

Cryptosporidium parvum

Does not grow outside animal reservoir.


Environmental survival
Long periods under moist/wet conditions
Often a problem in water
Susceptible to drying
Inactivation
Milk pasteurization insufficient
Dies off over time when frozen at < Reference: CDC
15oC
www.dpd.cdc.gov/dpdx
Very resistant to chlorine
Source: Farm and domestic animals, humans, (personto-person secondary transmission occurs)
Food vehicles include raw mild, raw fruit and veg,
salad,
Symptoms of cryptosporidiosis
Watery diarrhoea, vomiting, anorexia, malaise,
cramping, weight loss
Usually self-limiting 2- 4 days
At risk groups: anyone can be infected but children <5
years and immunocompromised are most prone to the
disease
Dose: Less than 10, possibly 1 Can be higher depends on strain

The information provided here is a summary of the information available in the literature. It should be used as a guide only as many
variables impact on the survival and inactivation of pathogens in foods. The absence of certain information e.g. on impact of a
specific preservative, process etc. does not mean it does not exist.

104

FAO/WHO Regional Meeting on Food Safety for the Near East

Cyclospora

All human cases caused by Cyclospora cayetanensis


Reference: CDC
www.dpd.cdc.gov/dpdx
Human may be only host
Cyclospora is spread by ingesting contaminated water or
food
Outbreaks linked to various types of fresh produce.
Not infectious immediately after excretion - needs time (days or
weeks) to sporulate!
Many unanswered questions re its survival in environment
Oocysty sometimes confused with Cryptosporidium
Symptoms of cyclosporiasis:
prolonged watery diarrhoea, abdominal cramping, weight
loss, anorexia, myalgia, and occasionally vomiting and/or
fever
Can last a month or more
At risk group: People of all ages are at risk for infection.
Dose: Unknown but presumed to be low

Giardia

Giardia intestinalis (aka Giardia lamblia)


After infection parasite lives in the intestine and is
passed in faeces.
Protected by an outer shell so it can survive outside the
body and in the environment for long periods of time.
Giardia infection one of the most common causes of
waterborne disease in humans
Inactivation
Boiling for 3 mins
Frozen in water for long periods
Symptoms of giardiasis
Asymptomatic or gastrointestinal disease in
immuno competent people
Severe diarrhoea, weight loss, dehydration
inimmunocompromised people
At risk groups:
anyone can become infected
Children and infants more susceptible than adults
Disease more serious in immunocompromised
people
Dose as few as 10 cysts can cause infection

Reference: CDC
www.dpd.cdc.gov/dpdx

FAO/WHO Regional Meeting on Food Safety for the Near East

105

References and Resources


Books:
Food Microbiology: Fundamentals and Frontiers. 1997. Doyle, M.P., Beuchat, L.R. and Montville, T.J.
eds. ASM Press Washington D.C.
Basic Food Microbiology. 2nd Edition. Banwart, G.J. 1989. Chapman and Hall, New York
Principles and Practices for the safe Processing of Food, 1998, Shapton, D. A. and Shapton, N. F.
Woodhead Publishing Limited Cambridge.
Listeria, Listeriosis and Food Safety, 2nd Edition, Ryser, E.T. and Marth, W.H. 1999. Marcel Dekker
Inc. New York.
Risk assessments of Salmonella in eggs and broiler chickens, 2002. FAO/WHO. Microbiological Risk
Assessment Series 2.
Risk assessment of Listeria monocytogenes in ready-to-eat foods: Technical Report, 2004. FAO/WHO.
Microbiological Risk Assessment Series 4.
Vibrio cholerae and cholera: Molecular to Global Perspectives, 1994. Wachsmuth, I.K., Blake, P.E. and
Olsevik, O. ASM Press Washington DC
Weblinks: (All Accessed October 2004)
Todar'
s Online Textbook of Bacteriology
http://www.textbookofbacteriology.net/
U.S. Food & Drug Administration, Center for Food Safety & Applied Nutrition Food-borne Pathogenic
Microorganisms and Natural Toxins Handbook. The "Bad Bug Book"
http://vm.cfsan.fda.gov/~mow/intro.html
CDC disease information
http://www.cdc.gov/ncidod/dbmd/diseaseinfo/
Food-borne Parasites: A review of the scientific literature. UW-FRI Briefing October 2003.
http://www.wisc.edu/fri/briefs/parasites.pdf
Infectious diseases; eMedicine Instant access to the minds of Medicine
http://www.emedicine.com/med/INFECTIOUS_DISEASES.htm
Microbial Pathogen Data Sheets, New Zealand Food Safety Authority. 2001.
http://www.nzfsa.govt.nz/science-technology/data-sheets/
Aeromonas
http://www.who.int/water_sanitation_health/dwq/en/admicrob2.pdf
Marine Biotoxins. Food and Nutrition Paper 80. FAO 2004
http://www.fao.org/documents/show_cdr.asp?url_file=/docrep/007/y5486e/y5486e00.htm

The information provided here is a summary of the information available in the literature. It should be used as a guide only as many
variables impact on the survival and inactivation of pathogens in foods. The absence of certain information e.g. on impact of a
specific preservative, process etc. does not mean it does not exist.

106

FAO/WHO Regional Meeting on Food Safety for the Near East

Manual on the application of the HACCP system in mycotoxin prevention and control. Food and
Nutrition paper 73. FAO/WHO. 2001
CHLOROPROPANOLS IN FOOD. An Analysis of the Public Health Risk. Technical report series no.
15 . Food Standards Australia New Zealand
http://www.foodstandards.gov.au/_srcfiles/Chloropropanol%20Report%20(no%20appendices)%2011%20Sep%2003b-2.pdf

FAO/WHO Regional Meeting on Food Safety for the Near East

107

Conference Room Document 4

English only

FAO/WHO Regional Meeting on Food Safety for the Near East


A m m an, Jordan, 5-6 M arch 2005

LITERATURE REVIEW OF FOOD-BORNE DISEASES AND THEIR CAUSES


IN THE NEAR EAST REGION
(provided by an FAO consultant as a background document)
This paper is intended to serve as a background document to the working papers for the Meeting to
provide a general overview of some available literature relevant to food-borne diseases in countries of the
Near East region. These data have been collected from presentations at (regional) meetings, publications
and research papers. It should be noted that the data presented have not been verified nor validated, and that
their intended use is to demonstrate general trends rather than specific issues. The sections are in
alphabetical order according to the name of the country concerned. Absence or inclusion of information
about any given country does not imply a lack of systems, facilities, resources, interest, nor a quality
indication, but merely reflects the information available to the author at the time of writing. The abstracts
have been collected to demonstrate the utility of methodical collection of food-borne disease- related
information and its application in the decision making process. Complete information on each case can be
found in the indicated reference.
Availability of data on the incidence of food-borne disease
Determining the incidence of food-borne disease is dependent on the availability of data. Collection
of appropriate data requires that a public health surveillance system is in place, diseases are notifiable and
there is compliance with this requirement. However surveillance systems do not yet exist in many countries
in the world and when they do exist they vary widely among countries, in the diseases they collect
information on and in their level of implementation and compliance. Recent initiatives mean that
surveillance systems have or are currently being established in a number of countries in the Near East
region. To date, data is only available for a few countries in such a manner that the data can be presented for
comparison, or recalculated to serve as such. This data is presented in Table 1; however, it should be
viewed with great caution, since the calculation of the figures has not been verified, and thus comparability
is not assured, nor has the classification of diseases as used been harmonized. The values in the table
indicate, in general, the incidence of disease per 100,000 people.
Table 1: Incidence of disease per 100,000 people in some countries in the Near East Region.
Disease

Country
Syria
(2002)

Lebanon
(2001)

viral hepatitis
Hepatitis A
Brucellosis
non-bloody diarrhoea

23.9

7.7

66.3
871

6.4

Jordan1
(2002)

Palestine
(2002)

Egypt
(2002)

10.4
4.9

40.4
4.8

18

Data from 2002 incidence per 100,000 calculated with population figure (5,611,202) for 2004 from
www.cia.gov/cia/publications/factbook/geos/jo.html

108

bloody diarrhoea
Dysentery
hydatic cyst
food poisoning
Shigella
Amoebiasis
Chemical
Salmonella typhi and
S. paratyphi
Typhoid and
paratyphoid fever
Typhoid fever

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67.2

51.5
0.2
2.1

9.5

10.4 Gaza
19.2 West
Bank
0.4
299
17.6
8.1

0.8
26.9

13.7

13

The information presented above is relatively sparse and does not give a good indication of the
incidence of food-borne disease in the region. Data from other countries in the world however indicate that
food-borne disease is an important and growing public health problem in many countries. In order to try and
get a better understanding as to whether the same statement can be applied to countries of the Near East
region the remainder of this paper reviews data available from other sources such as outbreak
investigations, food monitoring activities and research. Data on the level of contamination in foods can be
used to indicate the potential for food-borne disease within the region.
Microbiological contamination
British medical researchers have described the case of a patient who became ill with Salmonella
Blockley food poisoning while working in Cyprus2 in August 1994. Salmonella Blockley is associated with
chickens, and chicken meal was identified as the probable source of infection in the patient. This case is of
interest since it demonstrates the emergence of this serovar outside of South East Asia where it is common.
It may be an indicator of the role of international trade in food and feedstuffs on the spread of disease.
In June 1992, 19 cases of typhoid fever were reported in the town of Al-Mudhnab (population
10,000) in the Qassim region of central Saudi Arabia3. Cake with cream topping from a school potluck
dinner was kept overnight at room temperature and served to girls on the bus the next day. The rate of
eating leftover cake on the school bus and becoming ill was 11.04. The localization of this outbreak by
time, place and by the age groups affected supports the conclusion that the outbreak was food-borne.
Accordingly, lessons on proper food handling and storage should regularly be included in home economics
classes. While the national incidence of food-borne disease associated with a particular pathogen cannot be
determined from a single outbreak, outbreak investigations can provide useful information on disease
severity, at risk groups in the population, the dose required to cause illness and be an impetus to modify
and/or update food handling and preparation practices to minimise the potential for future outbreaks.
The source and prevalence of pathogenic Salmonella serovars among poultry farms in Saudi
Arabia4 were studied. Samples were collected from poultry, including broilers, layers, broiler breeders and
layer breeders as well as the poultry environments such as box liner, litter, droppings, mice and feed. A total
2

Long-term post-Salmonella reactive arthritis due to Salmonella Blockley.Wilson IG, Whitehead E. Jpn J Infect
Dis. 2004 Oct;57(5):210-1.
3
An outbreak of typhoid fever occurred among children who attended a potluck dinner at Al-Mudhnab, Saudi
Arabia. al-Zubaidy AA, el Bushra HE, Mawlawi MY. East Afr Med J. 1995 Jun;72(6):373-5
4
Representative Salmonella serovars isolated from poultry and poultry environments in Saudi Arabia. H.M. AlNakhli, Z.H. Al-Ogaily & T.J. Nassar. Rev. sci. tech. Off. int. Epiz., 1999, 18 (3), 700-709

FAO/WHO Regional Meeting on Food Safety for the Near East

109

of 1,052 (4%) Salmonella isolates were recovered from 25,759 samples. The majority of the 276 isolates
(26.2%) of Salmonella typed were recovered from the liver, heart and intestines of the broilers and layers.
The most prominent Salmonella serogroups isolated were as follows: serogroup C1 (392 isolates, 37.26%),
B (289 isolates, 27.47%) and D1 (269 isolates, 25.69%). Such data can be useful in an assessment to
determine the level of exposure of the population to a food-borne pathogen such as Salmonella.
In Yemen the number of samples analyzed for Salmonella in the laboratories has reduced from 127
in 1999 to 67 in 2000; however, this is not due to an actual decrease in Salmonella cases but rather to the
following factors: 1) doctors tend to prescribe medicines without culture-confirmation of their diagnosis; 2)
patients will not submit samples when they realize that the results will not be returned immediately (will
take 2-3 days); 3) a number of patients start using antibiotics before giving their stool specimens which
inhibits Salmonella growth. This study indicates some of the problems which have to be overcome in terms
of implementing a successful surveillance system and also highlights why in many countries there is a high
degree of underreporting of food-borne disease.
Chemical contamination
In Cyprus5, aflatoxins B1, B2, G1, and G2 in locally produced and imported foodstuffs such as
nuts, cereals, oily seeds, and pulses were monitored and controlled systematically and effectively from 1992
till 1996. The portion of samples with total aflatoxins above 10 micrograms/kg (the maximum level allowed
in Cyprus) fluctuated between 0.7 and 6.9%, and was mainly found in peanut and pistachio samples. The
results indicate the effectiveness of monitoring, as well as the need for constant surveillance and control to
prevent unfit products from entering the Cyprus market. The highest incidence (56.7%) of aflatoxin
contamination was observed in peanut butter and the highest level of aflatoxin B1 was found in peanuts
(700 micrograms/kg). Levels of aflatoxin M1 in raw and pasteurized milk analyzed in 1993, 1995, and 1996
were within both the Cyprus maximum level (0.5 microgram/L) and the lower European maximum level
(0.05 microgram/L). Only 12% of samples had detectable levels of aflatoxin M1.
Ochratoxin A is a widespread mycotoxin that contaminates food such as cereals, beer, coffee and
wine. Ochratoxin A is known for its nephrotoxic, immunotoxic and carcinogenic properties. The prevalence
of Ochratoxin A in human blood and foodstuffs has been investigated in many countries, including
Lebanon6. Ochratoxin A was detectable in 33% of the 250 tested plasma samples, with a concentration
ranging from 0.1 to 0.87 ng/mL and a mean of 0.17+/-0.01ng/mL. The frequency of Ochratoxin A -positive
plasma samples obtained in the South of Lebanon and in the Bekaa Valley (50 and 47%, respectively) was
significantly higher compared to plasma samples obtained in the Beirut/Mount Lebanon region (19%). Food
analyses showed that wheat, burghul and beer were contaminated with a mean value of 0.15+/-0.03
microg/kg, 0.21+/-0.04 microg/kg and 0.19+/-0.12 ng/mL, respectively. These data suggest that the
Lebanese population is exposed to Ochratoxin A through food ingestion at concentrations lower than the
tolerable daily intake.
An assessment7 of marine contamination due to heavy metals was made in the Persian Gulf and
Gulf of Oman on marine fish and various bivalves and in coastal sediment collected in Bahrain, Oman,
Qatar, and the United Arab Emirates during 2000 and 2001. Sediment metal loads were generally not
5

Surveillance and control of aflatoxins B1, B2, G1, G2, and M1 in foodstuffs in the Republic of Cyprus: 1992-1996.
Ioannou-Kakouri E, Aletrari M, Christou E, Hadjioannou-Ralli A, Koliou A, Akkelidou D. J AOAC Int. 1999 JulAug;82(4):883-92.
6
Ochratoxin A levels in human plasma and foods in Lebanon. Assaf H, Betbeder AM, Creppy EE, Pallardy M,
Azouri H.Hum Exp Toxicol. 2004 Oct;23(10):495-501.
7
Distribution of heavy metals in marine bivalves, fish and coastal sediments in the Gulf and Gulf of Oman. de Mora
S, Fowler SW, Wyse E, Azemard S. Mar Pollut Bull. 2004 Sep;49(5-6):410-24.

110

FAO/WHO Regional Meeting on Food Safety for the Near East

remarkable, although hot spots were noted in Bahrain (copper (Cu), mercury (Hg), Lead (Pb), Zinc (Zn))
and on the east coast of the UAE (arsenic (As), cobalt (Co), chromium (Cr), nickel (Ni)). Concentrations of
As and Hg were typically low in sediments and the total Hg levels in the top predator fish commonly
consumed in the region were < 0.5 microg g(-1) and posed no threat to public health. Very high Cd
concentrations (up to 195 microg g(-1)) in the liver of some fish from southern Oman may result from foodchain bioaccumulation of elevated Cd levels brought into the productive surface waters by up-welling in the
region. Very high As concentrations (up to 156 microg g(-1)) were measured in certain bivalve species from
the region. Although it is not certain, the As is probably derived from natural origins rather than
anthropogenic contamination.
A survey was carried out in Qatar8 for the presence of benzo( )pyrene in olive oils, following
reports that some batches of Spanish olive-pomace oil and its products contained high levels of
benzo( )pyrene. Three types of olive oils, originating from France, Greece, Italy, the Lebanon, Spain,
Tunisia and Turkey, and available on the Qatar market, were analyzed for benzo( )pyrene. Benzo( )pyrene
was detected in amounts below the permitted level of 2 microg/kg in all 31 virgin olive oil samples and in
13 refined olive oil samples.
Ochratoxin A is a nephrotoxic mycotoxin considered to be the causal agent of the Balkan endemic
nephropathy. In Tunisia9, Ochratoxin A has been cited as a possible causative agent of a chronic interstitial
nephropathy resembling Balkan endemic nephropathy. However, despite the considerable number of
investigations conducted so far, the role of Ochratoxin A in the outcome of this human nephropathy is still
uncertain.
Antimicrobial resistance
In one study in Iran10, almost 17% of all acute diarrhoea cases were caused by Shigella spp., most of
which were (multi)drug resistant. Of 734 stool samples collected from patients with acute diarrhoea and
analyzed for Shigella spp., 123 (16.8%) yielded Shigella spp. (7.5% Shigella flexneri, 5.2% Shigella sonnei,
2.6% Shigella dysenteriae, and 1.5% Shigella boydii). Of the Shigella isolates, 90.8% were resistant to one
or more antimicrobial agent(s), and 87.8% were multidrug resistant. The most common resistance was to
tetracycline (73.5%), trimethoprim-sulphamethoxazole (70.4%), and amoxicillin-clavulanic acid (50.0%).
Resistance to cefixime, ciprofloxacin, ceftriaxone, and nalidixic acid was observed in 6.1%, 3.1%, 2.0%,
and 1.0% of the isolates respectively. These findings suggest that Shigella spp. may be an important
aetiological agent of diarrhoea with a high rate of drug resistance in this region, which requires further
study. The level of antimicrobial resistance among Shigella spp. also highlights the importance of
prevention of Shigella infections, especially among vulnerable groups in the population as treatment options
are limited.
The first emergence of Salmonella Enteritidis outbreaks among chickens in Lebanon11 was reported
in 1999, with the epidemiological markers of selected recovered Enteritidis strains identified. A total of 112
8

Determination of benzo(a)pyrene by GC/MS/MS in retail olive oil samples available in Qatar. Abdulkadar AH,
Kunhi AA, Jassim AJ, Abdulla AA.Food Addit Contam. 2003 Dec;20(12):1164-9.
9
Ochratoxin A and beta2-microglobulinuria in healthy individuals and in chronic interstitial nephropathy patients in
the centre of Tunisia: a hot spot of Ochratoxin A exposure.
Hassen W, Abid S, Achour A, Creppy E, Bacha H. Toxicology. 2004 Jul 1;199(2-3):185-93.
10
Prevalence and pattern of antimicrobial resistance of Shigella species among patients with acute diarrhoea in Karaj,
Tehran, Iran. MoezArdalan K, Zali MR, Dallal MM, Hemami MR, Salmanzadeh-Ahrabi S. J Health Popul Nutr. 2003
Jun;21(2):96-102.
11
Emergence of Salmonella Enteritidis outbreaks in broiler chickens in the Lebanon: epidemiological markers and
competitive exclusion control. E.K. Barbour, L.H. Jurdi, R. Talhouk, M. Qatanani, A. Eid, W. Sakr, M. Bouljihad & R.
Spasojevic. Rev. Sci. Tech. Off. int. Epiz., 1999, 18 (3), 710-718

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111

invasive Salmonella Enteritidis strains were recovered on 11 farms from individual organs of broiler
chickens with typical signs and lesions of salmonellosis. The prevalent resistance to drugs in such strains
was to furaltadone and gentamycin, a marker identified in 93 strains (83%), recovered from nine out of
eleven farms. The same resistance pattern was present in Salmonella Enteritidis strains recovered from
breeders on one out of four farms.
A review of the use of antibiotics in veterinary medicine for animals reared for human consumption
was conducted in Tunisia12. Antibiotics are often abused, both by practitioners as well as by breeders.
Specific recommendations on the use of antibiotics are suggested to Tunisian sectors such as the
pharmaceutical industry, the veterinarians and the breeders, each of which are expected to contribute to the
preservation of this valuable therapeutic tool.
A study 13 was done during the year 2001 on Yemeni children aged 1-60 months with diarrhoea.
Out of a total of 561 stool cultures, 33.9% were positive for bacterial culture, 58% of which were from
children aged 1-12 months. The majority of the positive cultures were Enteropathogenic Escherichia coli
(58.4%), with the remainder Salmonella sp.(20%), Shigella spp.(20%) and Campylobacter spp. (1.6%).
Two-thirds of the salmonella isolates were resistant to nalidixic acid.
Zoonoses
The excellent results achieved in the control of animal diseases in Cyprus14 have allowed the
Veterinary Services to take a leading role in the elimination, surveillance and investigation of important
zoonoses. Public awareness of the risks posed by the presence of zoonoses and the efficient and effective
intersectoral co-operation achieved between the veterinary, medical, public health and other government
services and non-governmental organizations are considered to be the key to the successful control of
zoonoses in Cyprus.
Although a case of human listeriosis has recently been reported in Saudi Arabia15, the disease had
not been reported until an outbreak of septicaemia listeriosis occurred in sheep. Adult animals and pregnant
ewes were principally affected, with a morbidity rate of 7.1% and a mortality rate of 2.4%; no abortions
were recorded during the outbreak. Listeria monocytogenes was isolated in pure culture from affected
sheep. Hygienic measures and antibiotics were successful in treating the rest of the flock.
A review of the epidemiological status of brucellosis in cattle and small ruminants in Syria16 from
1990 to 1996, based on laboratory findings at the Brucellosis Centre, Damascus, revealed an overall herd
seroprevalence rate of 3.14% in cattle herds and 2.94% in small ruminant flocks for 1990 and 1991.
Although partially biased by previous vaccination of young female cattle, these figures indicate that
brucellosis in cattle is widespread, particularly in the urban governorates of Damascus, Aleppo and
Suwaydah. Brucellosis seroprevalence in sheep and goats was relatively high in the governorates of
Damascus, Aleppo and Dara'
a.
12

Use of antibiotics in food animals (article in French). Gharbi M, Messadi L, Benzarti M, Bouzghaia H. Arch Inst
Pasteur Tunis.1999 Jan-Apr;76(1-4):3-10.
13
Bacterial aetiology and antimicrobial resistance of childhood diarrhoea in Yemen. Salem M Banajeh, Nadia H S
Ba-oum, Raja M N al-Sarabani. J Trop Pediatr, Oct 2001; 47; 301-302.
14
Control of zoonoses in Cyprus. Economides P. Rev Sci Tech. 2000 Dec;19(3):725-34.
15
First report of an outbreak of ovine septicaemic listeriosis in Saudi Arabia. A.M. Al-Dughaym, A. Fadl Elmula,
G.E. Mohamed, A.A. Hegazy, Y.A. Radwan, F.M.T. Housawi & A.A. Gameel. Rev. sci. tech. Off. int. Epiz., 2001, 20 (3),
777-783 pdf
16
Field investigations of brucellosis in cattle and small ruminants in Syria, 1990-1996. M.A. Darwesh & A.
Benkirane. Rev. sci. tech. Off. int. Epiz., 2001, 20 (3), 769-775 pdf

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FAO/WHO Regional Meeting on Food Safety for the Near East

While the information provided above does not allow us to determine the incidence of food-borne
disease in the region it does allow identification of some of the problem areas in terms of food safety and
some of the issues that have to be addressed in the establishment of a disease surveillance system. It
indicates that like many other regions of the world this region has to face emerging problems such as that of
antimicrobial resistance. This type of information also helps us to identify the types of actions that we need
to take. For example humans are a primary reservoir for Shigella spp. which is transmitted via the faecaloral route. In areas where this pathogen is identified as an important cause of disease, a reduction in disease
incidence can be achieved the implementation of proper sanitation and good hygienic practices.

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Conference Room Document 5


English only

FAO/WHO Regional Meeting on Food Safety for the Near East


Amman, Jordan, 5-6 March 2005

THE ROLE OF VETERINARY SERVICES IN THE FOOD CHAIN


from the Stable to the Table

(prepared by Pavlos A. Economides, D.V.M, FRSH, Food Safety Consultant,


Member of the O.I.E. Permanent Working Group on Food Safety
35, Aesop str., 2113 Nicosia, Cyprus)

Summary
Food-borne diseases affect hundreds of millions of people around the world. The globalization of
trade in animals and food has made food safety an international issue. Consumer pressure and the
responsibilities of Competent Authorities have forced the control of risks in every stage of the food chain,
i.e. from the stable-to-the-table. O.I.E. F.A.O. W.T.O. and Codex Standards and Guidelines require
an objective and transparent scientific analysis and assessment of risks from foods. Veterinary Services and
Veterinarians should adapt their role and activities, in close collaboration with other sectors and
professionals in a risk-based approach to cope with hazards and risks to human health from foods.
Veterinary activities at the farm level, aiming at protection of Public Health from food-borne
hazards, are implemented mainly by state veterinarians, and to a lesser degree by private veterinarians and
those of food safety agencies. At the same level, programmes of good hygienic practices are implemented
mainly by state veterinarians with some assistance from veterinarians employed in industry and private
veterinarians.
It is concluded that present developments in food safety issues at International Level, create new
responsibilities to Veterinarians and the State Veterinary Services.
1.

INTRODUCTION

Food is a potential vehicle for exposing consumers to different agents capable of causing disease or
injury. At all stages of production, transport, storage, distribution and preparation for consumption, food can
be contaminated with biological, chemical or physical agents.
Hundreds of millions of people are affected by food-borne diseases each year and the problem is
more widespread in developing countries. (1, 26)
During the last decade a number of extremely serious outbreaks of food-borne diseases have
occurred in all Continents. In Europe, hormones, dioxins, Bovine Spongiform Encephalopathy, Listeria,
antibiotic resistance and chemical residues in foods, have made consumers increasingly concerned about the
health risks from hazards in foods. (21, 24, 25).
The globalization of trade has made food safety an international issue, as food contaminated in a
producing country may cause food-borne outbreaks in an importing country. (13)

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FAO/WHO Regional Meeting on Food Safety for the Near East

In the past, food control was concentrated on the examination of samples from the end products and
the inspection of processing and catering establishments to monitor hygienic practices. Unsafe foods found
during inspections were detained and removed from the market and those responsible for their production
and placing on the market were prosecuted. These traditional systems have not been efficient and could not
respond to existing and emerging challenges to food safety because they do not provide a preventive
approach. (2, 26, 27)
During the last decade food scares and consumer pressure contributed to a change of Food Safety
Programmes towards a holistic approach for the control of food risks in every stage of the food production,
from raw material to food consumption, from the farm-to-the-fork - from the stable-to-the-table. Many
food safety problems originate from the farms and their environment. Now there is a greater emphasis on
measures to prevent biological and chemical contamination at source both at the pre-harvest and postharvest stages of food production. Prevention of hazards requires attention through the chain of production
and the responsibility for safe foods should be shared by all involved, i.e. farmers, processors, distributors,
retail markets, consumers and Competent Authorities (CA) for the control of Food Safety. (12, 26, 36, 39)
Food safety risk management must be developed on the basis of risk analysis and risk assessment.
Between risk assessment and management there should be a functional separation.
The O.I.E., F.A.O., W.H.O., Codex Guidelines and the new European Regulations on Food Safety
which were adopted by the European Parliament and the European Council (Regulations 178/2002,
852/2004, 853/2004, 854/2004), are based on an integrated approach from the farm to the final consumer.
These Guidelines and Regulations require also that the scientific analysis and assessment of risks from
foods to be undertaken in an independent, objective and transparent manner based on the best available
science. It establishes the rights of the consumers for safe foods, accurate and honest information, so that
they can choose their diet. (7)
The spectrum and the prevalence of hazards in foods are under continuous change. Recent
epidemiological surveys have shown that bacteria in foods of animal origin are the most important causes of
food-borne diseases. Most of these are transmitted by animals, which do not show any clinical symptoms.
(24)
Under these circumstances Veterinary Services and veterinarians must adapt their activities, their
role and work in close collaboration with other professionals and sectors for the effective management,
control and prevention of hazards and risks for human health from foods.
The scope of this report is to point out the new role and responsibilities of the State Veterinary
Services for food safety.
2.

CURRENT ASPECTS OF FOOD-BORNE HAZARDS

During the last few decades, countries with surveillance on food-borne diseases have reported
significant increases in the incidence of diseases due to biological hazards in food of animal origin. Some of
these pathogens were not even recognized as causes of such diseases and some are carried by animals not
showing clinical symptoms. (3, 6, 20) The factors which contribute to the increase of biological hazards in
foods are related to:
Changes in farm practices
Intensive rearing of animals
Increase in consumption of meat

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Globalization of food trade


Urbanization
Changes in lifestyles
International travel
Preference for fresh and undercooked foods
Eating food prepared outside the home
Demographic changes with increased proportion of old and immunosuppressed people
Environmental pollution from unsafe disposal of animal manure
Most of the biological hazards have been recognized as emerging17 or re-emerging18, the most
important of which are:
Enterohaemorragic E.coli 0157:H7
Salmonella enteritidis
Salmonella typhimurium DT104, which is resistant to five antibiotics used in human medicine
Campylobacter jejuni
Listeria monocytogenes
Cryptosporidia
Cyclospora
Trematodes
Bovine Spongiform Encephalopathy (BSE)
Chemical contaminants in food may be naturally occurring or may be added during the processing
of food. They include chemical compounds that, when consumed in sufficient quantities, can inhibit
absorption or destroy essential nutrients from the diet of the consumer. They can be carcinogenic,
mutagenic or teratogenic, or can be toxic and can cause severe illness and possibly death. (30, 33, 41)
Chemical contamination in food may be classified into the following categories:
Direct food additives, i.e. preservatives, flavorings, anticaking agents, vitamins, minerals, etc.
Indirect food additives, i.e. detergents, disinfectants, lubricants
Heavy metals, i.e. lead, mercury, copper, cadmium, radioactive isotopes
Pesticides, insecticides, fungicides, herbicides
Veterinary drugs residues
Persistent organic pollutants (dioxins)
Natural toxic substances, cyanogens, solanine
Natural toxins: paralytic, diarrhoeic, newrotoxic and amnesic shellfish poisonings
Allergens
Monitoring and surveillance for food-borne diseases and hazards are necessary at all stages of the
production-to-consumption continuum in order to overview food safety and consumers health. Monitoring
should also be directed to detect hazards in food supplies, water and the environment at the level of farm
production.

17
18

Infections that have newly appeared in a population


Infections that have previously existed but due to various factors (ecological, environmental, food production, or
demographic) are rapidly increasing in incidence or geographical range

116

3.

FAO/WHO Regional Meeting on Food Safety for the Near East

THE RISK-BASED APPROACH

Food safety issues are known to be complex. Therefore, in order to take into account the full picture
of the existing situation in the whole food chain, a Science-based methodology, with appropriate structure,
is of particular importance. This can be achieved through the risk-based approach, which is the result of
international concern and increasing consumer interest in public health problems associated with foodborne diseases. (26, 39)
3.1.

Risk Assessment

The Codex Alimentarius Commission (CAC), the provisions of the Sanitary and Phytosanitary
Agreement of the World Trade Organization (WTO), the Ems new basic Food Regulations and the CA of a
continuously increasing number of countries require an independent, science-based risk assessment,
undertaken in an objective and transparent way, to determine the risks associated with hazard in foods and
the factors that influence them. (4, 15, 16)
In the development of appropriate food safety controls, it is important to understand the association
between a reduction in hazards in food and the reduction in the risk to consumer health.
However, a distinction between the terms hazard and risk should be made. Hazard is a
biological, chemical or physical agent in food with the potential to cause harm. In contrast, risk is an
estimate of the probability and severity of the adverse health effects in exposed populations, consequential
to hazards in food. (39)
When they take decisions, risk managers must consider the results of the risk assessment, the
feasibility of controlling the risk, the most cost-effective risk reduction actions, the practical arrangements
needed, the socio-economic effect and their environmental impact.
Risk assessment can be a qualitative or quantitative estimation of a risk to a group of people. It is
based on a four-step procedure: hazard identification, hazard characterization (dose/response), exposure
assessment, risk characterization and estimation of an overall probability of consumption and the severity of
health effects in a given population of consumers. (16, 39, 41)
Quantitative risk assessment is the basis of the new food safety control systems and is becoming
very important for the international trade of foods.
3.2.

Risk Management

Risk management is strongly linked into the food safety policy and the definition of the appropriate
level of consumer protection. It involves the development of strategies, and the selection and
implementation of appropriate control actions necessary to prevent, reduce or eliminate the risk to ensure
the decided level of health protection. (10, 15)
When there is evidence that the accepted level of consumer protection is not achieved, all safety
programmes and actions should be reviewed and redesigned. The CA for the management of risks are
obliged, by the provisions of the International Guidelines, to take into account the results of risk assessment.
In circumstances where, following an assessment of available information, the possibility of harmful effects
on health has been identified but, however, scientific uncertainty persists, all the necessary provisional risk
management measures may be taken pending further scientific information for a more comprehensive risk

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assessment. Measures implemented on the basis of the precautionary principle shall be proportionate and
no more restrictive of trade than is required to achieve the level of health protection.
The implementation of risk management decisions requires Regulatory measures and Food Safety
Programmes.
4.

THE STABLE-TO-TABLE APPROACH TO FOOD SAFETY

To guarantee a high level protection of consumers from food-borne diseases there is an urgent need
to integrate the feed production, farming, transport of animals and slaughtering, primary and secondary
processing, storage, distribution, sale, cooking and serving of foods in a Quality Assurance System, which
will link the entire chain of food production from animal breeding and feeding until the time the food is
placed on the table of the consumer. (14, 28, 38)
This concept can be easily adapted to all kinds of food: meat, milk, fish and even food of vegetable
origin.
The food production chain is becoming increasingly complex and every link in this chain must be as
strong as the other. Wholesome and safe food can be produced only from healthy animals kept in hygienic
conditions and under husbandry systems that cause them minimal stress. The stable-to-table approach can
become a success only if animal health and welfare are fully integrated into it. (2, 28, 29)
WHO, OIE, FAO, the CAC and the EU have endorsed the farm-to-table approach and promote the
development of structures and systems for the surveillance of food-borne diseases, the risk assessment and
implementation of risk management programmes like the Hazard Analysis Critical Control Points
(HACCP) systems, to be implemented at all stages of food production, preparation and use. (18, 31)
The HACCP system is known to be a science-based analytical tool that enables management to
introduce and maintain a cost-effective, on going food safety programme. It involves the systematic
assessment of all steps involved in each stage of food production: (farm, food establishment, storage, etc)
and the identification of those steps that are critical to the safety of the product. (31, 32, 40)
Food producers, by endorsing the HACCP concept, are enabled to move away from the old
philosophy, which was based primarily on end product testing for the detection of failures, to a preventative
approach whereby all potential hazards at all stages of production are identified and controlled for the
prevention of product failures. This preventative approach has been promoted worldwide as a cost-effective
measure, which can, in principle, be used throughout the food chain. (2, 28, 38)
5.

THE ROLE OF VETERINARY SERVICES IN FOOD SAFETY

Food safety is recognized as a widely shared responsibility, which requires strong co-ordination
between the CA for risk assessment and management and effective collaboration with all other interested
parties such as consumers, industry, traders and farmers. To achieve the required objectives and regain the
confidence of the consumers, high levels of transparency and communication are needed.
Veterinary Services and their veterinarians, in many countries of the world, have a leading role in
the safety of foods of animal origin. The adoption of the integrated approach from the stable-to-table, and
the introduction of quality assurance systems, through the entire production process, provide a new
challenge for the Veterinary Services and the veterinary profession in general. Veterinarians should seek
and accept responsibilities for developing a new quality-oriented procedure. This process must cover the

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FAO/WHO Regional Meeting on Food Safety for the Near East

entire food chain from farm-to-table and must be designed to deliver the highest levels of food safety
guarantee for animal production, the food industry and the consumer. (14, 18, 29)
The principles of the risk-based approach, HACCP programmes and the ISO Quality Control
Standards should be adopted to ensure the delivery, at the final point of consumption, of high quality safe
food.
The identification of the origin of animal feed, food ingredients and food sources is important for
the protection of consumers. Traceability is also a new requirement useful for the facilitation of withdrawal
or recall of foods unsuitable for human consumption.
All adopted systems should be implemented in a transparent, easily audited, cost-effective and
quality driven approach. The aim shall be to deliver affordable and fully accountable inspection systems
that will help to regain the confidence of the consumers. Since the primary responsibility for the production
of safe foods and feeds is going back to the producers, the veterinary inspection should undertake the
assessment of the control systems and apply the monitoring of their correct implementation by the
producers. The monitoring and auditing should be used for the development of co-operation with producers
to identify non-compliances, reduce inconsistencies and improve standards. (10, 11, 38)
6.

THE ROLE OF VETERINARIANS


HAZARDS AT THE FARM LEVEL

IN THE

PREVENTION

AND

MANAGEMENT

OF

FOOD-BORNE

The basic training of Veterinarians covers nearly all aspects of food hygiene, food processing,
pharmaceuticals and pathogenic agents which may be present in foods of animal origin. These, together
with their speciality in animal health and welfare, place veterinarians in a unique position to provide expert
advice and establish specific programmes on the farm, in order to prevent and control the presence of
biological and chemical hazards which may be carried by animals, milk or other animal products to primary
processing.
The presence of a Veterinarian on the farm is the key to an integrated approach and will ensure that
animals and animal products sent to slaughterhouses or dairies are free from disease.
The role of Veterinarians at the farm level will focus on good hygienic practices, on safe use of
veterinary drugs, disinfectants, insecticides, and herbicides and on safe waste disposal. They should also be
involved in the epidemiological surveillance programmes for zoonotic diseases and food-borne pathogens,
the protection of animal health and welfare, the residue control programmes, the registration, identification
of animals and in the issue of certificates for animals which will be moved from the farm. (2, 25)
Monitoring and reporting of the animal health situation in the farm by the national Veterinary
Services is an essential tool in the context of an epidemiological surveillance programme. Early detection of
zoonotic diseases can prevent transmission to humans at slaughter or introduction of pathogens into the
food chain. It is evident that the effectiveness of monitoring and reporting is directly dependent on the
cooperation of veterinarians and farmers with the State Veterinary Services. (2, 9, 18, 35)
The Veterinarian at the farm will also supervise the record keeping of all the activities at the farm,
including the feed quality control and the recording of the batches of feeds received and the name and
address of their suppliers. All this information must be made available to the Veterinarian of the abattoir
where the animals are sent for slaughter or to the manager of the food establishment where the animal
products are sent for processing.

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119

THE ROLE OF THE VETERINARIAN AT THE PRIMARY PROCESSING LEVEL (SLAUGHTERHOUSES)

The movement of animals causes stress to them, which consequently affects the safety and the
quality of the meat. For this reason only healthy animals must be transported and their health and welfare
must be monitored during their transport from the farm to the slaughterhouse.
The Veterinarian upon arrival of the animals at the slaughterhouse will carry out the following
checks and assessments:
The effects of the transport on the animals
The health data from the farm of origin
The identification of the animals
Any previous treatments they have received or which were given to other animals on the farm of
origin
The level of cleanliness at time of arrival
The clinical examination for any symptoms which the animals may show.
During post-mortem inspection, the Veterinarian will carry-out examinations for the detection of
macroscopically visible pathological changes or other abnormalities. Wherever it is absolutely necessary,
palpation and incisions for removal of any lesions, which may be present, may be carried out.
The Veterinarian will also supervise the implementation of Good Hygienic Practice (GHP), Good
Manufacturing Practice (GMP), the HACCP and the samplings for the residues control, the microbiological
testing of carcasses and the general hygiene of the slaughterhouse.
He will be responsible for record keeping and the communication of his findings to the farm
veterinarian, to the Veterinary Services for any necessary actions and to meat processing establishments,
cold stores and traders, as well as any information required for the traceability of the products they will
produce or distribute. (17, 23)
Veterinarians and Veterinary Services are also involved in the primary processing of milk, fish,
eggs and farmed and wild game.
8.

ROLE OF VETERINARIANS AND THE VETERINARY SERVICES IN SECONDARY PROCESSING


ESTABLISHMENTS

Veterinarians employed in food safety are involved in the design and implementation of GHP,
HACCP Plans and quality assurance systems in Secondary Processing Establishments for meat, milk and
fish products in many countries.
The role of the Veterinary Services with the change of the legislation will be confined to assessment
of the HACCP food safety programmes and their auditing to verify that they are correctly implemented by
the industry. It should be noted that the management of food establishments now has the primary
responsibility for the production of safe food. (18, 32, 40)
9.

DISCUSSION

The implementation of the risk-based approaches for food safety will require veterinarians to
include in their epidemiological surveillance programmes, pathogens which do not cause clinical disease to
animals but which contribute to the contamination of animal products with biological hazards which may

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FAO/WHO Regional Meeting on Food Safety for the Near East

affect the health of consumers, i.e. E.coli 0157:H7, Listeria, Campylobacter, Salmonella and antibiotic drug
resistance. (3, 5, 6, 12)
Veterinary activities are reported at all stages of milk and fish production and other sectors of food
production. Veterinarians are present in every stage of food production and have the scientific background
and experience to develop standards on animal health, animal welfare, food safety and to undertake a
leading role in the implementation of the stable-to-table approach for all foods of animal origin.
Although food producers will have the primary responsibility for the production and planning on the
market of safe foods of animal origin, the protection of public health and consumers will continue to be a
public task. The Veterinary Services will have to take the leadership and all the necessary responsibilities to
fulfill the requirements of the Guidelines and Codes of the International Organizations, such as O.I.E.,
WHO, FAO and Codex Alimentarius and the provisions of the Sanitary and Phytosanitary and Technical
Barriers to Trade Agreements of the WTO. To achieve this, the Veterinary Services urgently need to change
to a risk-based approach to food safety and to focus their veterinary public health activities primarily on the
protection of the health of the consumer. (4, 7, 38)
The Veterinary Services must harmonize their legislation with the International requirements and
seek adequate legal power to get the chains of command and control of food production from the stable-totable.
The change from traditional programmes of food safety control to risk-based approaches will create
new responsibilities for veterinarians, which will require their involvement in the development and
implementation of HACCP-based control systems at farm level and in food processing establishments.The
Veterinary Authorities will have to develop services for the Assessment, Verification and Auditing of
HACCP implemented by food producing establishments.
There is a need to regulate and audit the services of veterinarians to which Veterinary Services may
delegate responsibilities for official inspections. The veterinarians must be professionally competent, fully
accountable and regularly audited by the Competent Authority. They must attend programmes of
continuous training and further professional development which must be closely followed and encouraged
so that there is a continuous progress and adaptation in the increasing demands for high levels of food
safety.
10.

CONCLUSIONS

Food safety has become an international issue of major concern. The reality of millions of people
around the world suffering from food-borne diseases of different origins has made food security a sector
under continuous development. In this changing environment Veterinary Services and veterinarians should
be integrated so that, in close collaboration with other disciplines and professionals, they can fulfill their
tasks and responsibilities in the context of modern requirements and prerequisites for food safety.
It is important that Veterinary and other control Services make continuous efforts for the
establishment of hygienic norms at the farm level, the verification of food producers'compliance with
official standards and regulations and for the application of sound processes at all stages of the food chain.

FAO/WHO Regional Meeting on Food Safety for the Near East

121

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FAO/WHO Regional Meeting on Food Safety for the Near East


Amman, Jordan, 5-6 March 2005

O.I.E. ACTIVITIES

FOR

SAFETY

IN

FOOD

OF

ANIMAL ORIGIN

(Prepared by Dr. Pavlos Economides, DVM, FRSH


Food Safety Consultant, Member of the O.I.E. Permanent Working Group on Food Safety
35, Aesop str., 2113 Nicosia, Cyprus)

Due to the demand from consumers worldwide for improved Food Safety, the O.I.E. is working
with other relevant organizations in reducing food-borne risks to human health due to hazards arising from
animals. In this context, a hazard is defined as a biological, chemical or physical agent in food with the
potential to cause an adverse health effect in humans, whether or not it causes disease in animals.
The O.I.E.s work programme for 2001 2005 recommends that O.I.E. should be more active in
the area of Public Health and consumer protection and notes that this should include zoonoses and
diseases transmissible to humans through food, whether or not animals are affected by such diseases. This
will help to improve the production to consumption food safety continuum worldwide.
The Director General of the O.I.E. has established a permanent Working Group on Animal
Production - Food Safety to coordinate the Food Safety activities of the O.I.E. The Working Group includes
in its membership experts from the W.H.O., Codex Alimentarius Commission and Codex Committees, and
reflects a broad geographical base.
The Working Group has drawn up a detailed work programme for the development of Standards on
Animal Production - Food Safety covering pre-slaughter issues and those prior to the first transformation of
animal products, with a primary focus on food safety measures applicable at the farm level.
The Working Group recognized that the O.I.E.s goals can only be achieved in collaboration with
the W.H.O., the F.A.O. and their subsidiary bodies, particularly the Codex Alimentarius. This is essential to
avoid contradictory standards, to address gaps which may exist among current standards and to ensure the
most effective utilization of available expertise. To this end, the O.I.E. has already moved to strengthen
formal and informal relationships with such International Organizations and with relevant expert groups.
The Working Group identified, as priorities, the joint review of O.I.E. and Codex standards to
identify gaps and duplication, and the development of procedures for common and linked standards and for
their mutual recognition. Work has started on the Code Chapters on Tuberculosis and Brucellosis (to better
address Animal Production - Food Safety aspects).
As an observer organization the O.I.E. contributes to the work of several Codex Committees,
including the Codex Committee on Meat Hygiene and the Codex Ad Hoc Intergovernmental Task Force on
Animal Feeding. To avoid gaps and duplications between the standards of the O.I.E. and Codex, the
Working Group is progressing its work on cross-referencing O.I.E. and Codex texts. In parallel the Working
Group has drafted for Member Countries comments, a Guide to Good Farming Practices in order to
address Public Health Risks arising from hazards at the farm level.

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FAO/WHO Regional Meeting on Food Safety for the Near East

A paper on the Role and Functionality of Veterinary Services in Food Safety throughout the Food
Chain has been produced to assist Veterinary Services in addressing both public health and animal health
issues.
Associated with this paper is the Control of hazards of public health and animal health importance
through ant- and post- mortem meat inspection. This paper, currently under development, will provide
more detailed guidance in the use and development of a risk based approach to ante- and post- mortem
inspection.
The Working Group of the O.I.E. will act as a Steering Committee to coordinate Animal Production
- Food Safety Activities with W.H.O., F.A.O., W.T.O. and the Codex Alimentarius Commission to develop
standards and practices on the basis of risk based approach in all stages of production of foods of animal
origin from the stable to the table.
The Standards, Practices and Guidelines which will be developed by this group and the provisions
of the O.I.E. International Terrestrial and Aquatic Animal Health Codes will provide very useful guide to
the Veterinary Authorities of all O.I.E. Member Countries in facing the challenge and the changes required
for the upgrading of Food Safety.

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Conference Room Document 7


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FAO/WHO Regional Meeting on Food Safety for the Near East


Amman, Jordan, 5-6 March 2005

Food Safety in Jordan - Overview and Resources


(Prepared by the Hashemite Kingdom of Jordan)
Introduction:
The Hashemite Kingdom of Jordan is located in a strategic spot on the world map, linking the
Americas, Africa and Europe continents with Asia and the Far East with a total surface area of 89342km2 of
which 2% crops field area, 1% fruit area and 0.4% vegetable area (statistics 2000). The country is governed
by 12 different governorates with six border entry points. 20 health directorates are distributed throughout
the country mandating over 3000 food activities (statistics 2000)
Jordan imports large quantities of different types of food from a number of countries. Imported food
products enter the Jordanian food supply market either directly for consumer use; indirectly by being
incorporated as raw material in manufactured foods; or, by being further processed before being offered for
local marketing. Some of these food products are in turn sold for export marketing. At the present time
approximately one-quarter of the total imports into Jordan are foodstuffs. Food imports were valued of
3434.5 million Jordanian Dinars, whereas domestic food exports were valued of 116.3 million Jordanian
Dinars (statistics 2001).
The Jordanian food sector is governed by multi-official authorities in Jordan, namely:
-

Ministry of Health MoH Now Food & Drug Administration; responsible according to the Food
law no. 79/2001 and Public Health Law no. 54/2002 (Departments involved: Food Control, Disease
Control, Health Safety Education, Food laboratories and border control committees) as well as
district Health Directorates
Ministry of Agriculture according to the Agriculture law no. 44/2002 (Departments involved:
Veterinary, Plant protection, Pesticide residues center, Veterinary laboratories and border
agricultural centers)
Ministry of Industry and Trade (Registration and licensing)
Ministry of Municipalities according to Municipal law and Slaughterhouses by-law no.1/1985
(Departments involved: Public health, Slaughterhouse, Food and Meat laboratories)
Jordanian Institute of Standards and Metrology according to their JISM Law no. 22/2000

In January 2001, the geographical area surrounding the Port of Aqaba (where about 75% of food
imports occurs), became the Aqaba Special Economic Zone (ASEZ) of an area 375km2, administered by a
legal independent Authority, which has complete mandate over the administration of the activities within
the zone.

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The Aqaba Special Economic Zone (ASEZ) offers businesses and residents a planned environment
consisting of high quality infrastructure, facilities, and support services, as well as an attractive package of
incentives and liberal policy environment to help increase your operating efficiency.
The Aqaba Special Economic Zone (ASEZ) is a private sector-driven development initiative that
maximizes private sector participation in a duty free, tax-advantaged and flexible regulatory operations
environment with a vision to make the zone a leisure destination and trade hub in the region.
The Authority has jurisdiction over all common areas of responsibility associated with law and
order, security, trade and development, public health, and public administration, among other
responsibilities. For this purpose, ASEZA law no. 32/2000 came very powerful and thus memorandums of
understandings were signed to submit responsibilities on phases to the zone authority avoiding duplication
and redundancy of work done between the official government authorities.
Currently, ASEZA is responsible on the whole process of registration and permitting using the MoH
as technical arm of pre operation inspections, whereas, responsibilities were identified and separated
between ASEZA and MoH on the food imports control at borders of entry. By February 2004; ASEZA will
take over the control of Domestic food compliance and preoperational inspections, whereas MoH will carry
on the pharmaceuticals and medical services mandate in the zone with close coordination until capacity
building is achieved within ASEZA
As a member of the WTO, Jordan has accepted the responsibility of the terms of Membership. This
means that the measures imposed in protecting the public health against hazards associated with food from
imported sources must not be trade restrictive, arbitrary, or disguised technical barriers to trade. Measures
are also to be scientifically justified using risk assessment methods acceptable at the international level.
Human Resources
Total number of the workers for the Health Directorates is approximately (700) health controllers
(statistics 2001) after deducting the number of the workers for the center, the customs centers and the
laboratories. Additional 40 qualified laboratories technicians. At Aqaba Health Directorate; over 65 staff
members are involved in food safety activities (shown in organizational structure below) and; at Aqaba
Special Economic Zone Authority- Health Control Directorate; currently 25 staff members are involved in
food safety activities (shown in organizational structure below). Imported food activities are performed
within National agencies staff (FDA- MoH Aqaba, MoA, JISM) of around 20 staff members available at
Aqaba Port
Physical Resources
Kindly refer to detailed papers on Food Imports, Food Compliance and Food Safety major issues
and challenge.

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128

Aqaba Health Directorate -Ministry of Health:

FAO/WHO Regional Meeting on Food Safety for the Near East

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FAO/WHO Regional Meeting on Food Safety for the Near East


Amman, Jordan, 5-6 March 2005

Surveillance of Food-borne Diseases in Jordan


(Prepared by the Hashemite Kingdom of Jordan)
General information

Major statistics of Jordan:


Indicator
Mid year population estimate (.000)
Population growth rate (%)
Crude birth rate (%)
Crude death rate (%)
Total fertility rate (%)
Infant mortality rate (%)
Life expectancy at birth- Males
Life expectancy at birth- Females
Urban population (%)
No. of hospitals
No. of hospital beds
Population/bed ratio
Population/ physician ration
No. of comprehensive health centers
No. of primary health centers
Adult literacy- Males (%)
Adult literacy- Females (%)
Age group (% of population)
0 to 4
0 to 14
15 to 64
65+

Value
5039.0
2.8
28.0
5.0
3.6
29.0
68.6
71.0
78.7
86
8705
579
526
47
333
94.3
83.6
14.4
39.6
57.7
2.7

Jordan Health care centers and hospitals are distributed throughout the country eleven districts;
The surveillance of food-borne infections and intoxications in Jordan is based on two systems by which
data are collected:
1. The notification system
2. The outbreak reporting system

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FAO/WHO Regional Meeting on Food Safety for the Near East

Notification system
42 communicable diseases, including cholera, bloody diarrhea, food poisoning, hepatitis A,
brucellosis typhoid and paratyphoid fever are modifiable in Jordan.
Diseases to be notified urgently: Cholera, Plague, Yellow fever, Meningitis, Typhus, AIDS,
Poliomyelitis, A.F.P., Diphtheria, Tetanus neo., Rabies, Food and Chemical poisoning, outbreaks and
epidemics.
District Heath Authorities (DHA) receives notifications on individual cases and outbreaks from
physicians working in the Ministry of Health (MoH) health centers and hospitals, and sometimes from
the general public.
The attending physician must notify the District Medical officer of any patient suffering from these
diseases.
The notification may be based on clinical diagnosis only or on clinical diagnosis supported by
laboratory confirmation.
The Disease Control Directorate (DCD) in the MoH collect the data reported to the 20 DHA s in the
country on regular basis. The data are compiled weekly, monthly and on an annual basis and
disseminated to the DHA all over the country
NOTIFICATION SYSTEM IN JORDAN
Patient

Attending Physician

District Health Directorate

Undertakes epidemiological
Investigations and Control Activities

Reports weekly (No. of cases only,


no epidemiological details and
monthly epidemiological details.
Details of Information on outbreaks

Food-safety Directorate

Disease-control Directorate (Central


public health authority)

The Outbreak reporting system


District Medical officer reports outbreaks Disease Control Directorate which occurred in their
districts, even if no laboratory results have proved positive.

FAO/WHO Regional Meeting on Food Safety for the Near East

131

Details include the place of the outbreak, the number of people infected, symptoms, suspected foods
and description of food handling.
Epidemiological investigation of the outbreak also includes examination of feces, vomit, throat or
skin of persons involved in the preparation and serving of the food, as well as bacteriological
examination of the incriminated food or water.
The District Medical Officer for public health, usually carries out the investigation, in order to find
out the vehicle, the source of infection and the possible contributing factors and to recommend
adequate control measures. Outbreak in institution and community at large rather than family
outbreaks are targeted.
Limitations of the surveillance system in Jordan

Underreporting form the private medical sector.


Laboratory diagnostic capabilities are limited do not fully allow for the definite identification of the
whole range of microbial causative agents.
Questionable quality of food poisoning outbreaks investigations.

Major Food-borne illness indicators:


Hereunder are some statistical information demonstrating the major food born indicators and their incidence
rate*:
Total cases and IR of certain food-borne diseases during the period (1998 2001) and its average
incidence rate during the period 1993-1997,1994-1998,1995-1999-2000
Notified cases of food-borne diseases during 2001 and average incidence during the period (1996
2000)
Distribution of stool samples tested in relation to the causative agent during the period (1996
2000)
Cases of Hepatitis A during the period (1991- 2001)
Cases of Brucellosis during the period (1991- 2001)
Cases of Typhoid and Para Typhoid during the period (1991- 2001)

* Statistics obtained from the DCD Disease Control Directorate within Ministry of Health- Food and Drug
Administration. More information can be obtained based on district level, sex and age groups

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FAO/WHO Regional Meeting on Food Safety for the Near East

Total cases and IR of certain Food-borne diseases for the years 1998,1999,2000 and 2001 and its AIR for the years 19931997,1994-1998,1995-1999-2000.
1998

1999

Disease

AIR
19931997

Total
cases

IR

Diarrhea

27.1

100095

Bloody Diarrhea

15.27

Typhoid + Para Typhoid

2000

AIR
19941998

Total
cases

IR

21.3

24.84

106114

772

16.3

16.71

4.7

97

Hepatitis A

31.8

1083

Brucellosis

20.7

Food Poisoning with


pesticide
Food poisoning
Remarks:

2001

AIR
19951999

Total
cases

IR

21.69

23.74

102768

963

19.68

18.11

2.98

96

1.96

22.9

28.51

969

684

14.5

19.46

1.2

73

1.52

5.4

379

5.9

Diarrhea IR/1000 population


ALL others IR/100.000population

IR

AIR
19962000

Total
cases

20.4

22.9

105433

20.35

448

8.91

17.1

504

10.00

2.61

46

0.9

2.0

69

1.3

19.81

25.0

947

18.8

26.0

754

15

432

8.8

17.35

268

5.33

12.3

275

5.5

198

4.83

244

4.85

3.9

290

5.8

FAO/WHO Regional Meeting on Food Safety for the Near East

133

Notified Cases of food-borne diseases Jordan


Number of cases and incidence rate per 100 000 inhabitants
Diagnosis

1996 Cases

Brucellosis

3281

2000
Average
Incidence %
13.9

2001
Cases

Typhoid & paratyphoid

489

2.07

69

1.33

Hepatitis A

6097

25.77

754

14.56

Incidence %

257

5.3

Distribution of Stool samples tested in relation to the causative agent


Period 1996-2000 Jordan

Years

Number of samples
tested

Causative Agent
Amoeba

Giardia

E-coli

Salmonella

Shigella

1996

37811

3298

1986

204

30

79

1997

34628

3541

1608

21

35

37

1998

36292

4377

1729

25

55

54

1999

41416

4738

1944

15

30

23

2000

40515

4373

1469

12

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FAO/WHO Regional Meeting on Food Safety for the Near East

Cases of Hepatitis A By month


Period 1991 2001 Jordan
Years Month

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

January

89

69

93

271

70

65

179

135

36

112

51

February

86

64

74

276

41

70

105

77

58

122

49

March

67

49

41

134

25

69

129

140

79

93

55

April

64

40

48

130

43

54

135

62

62

57

41

May

44

39

49

110

39

69

127

77

54

80

52

June

29

32

40

87

27

36

81

65

54

56

48

July

49

23

69

114

38

102

109

96

43

57

107

August

64

44

86

88

41

98

97

82

48

97

101

September

69

23

162

86

49

151

178

92

119

71

80

October

106

63

201

97

69

233

165

98

141

95

53

November

108

90

280

86

50

278

138

72

143

64

66

December

93

147

375

77

79

261

169

77

132

43

51

Total

868

683

1518

1556

571

1486

1612

1083

969

947

754

I.R/100.000

24.3

18.5

37.5

36.8

13.5

33.6

35.2

22.9

19.8

18.8

14.6

FAO/WHO Regional Meeting on Food Safety for the Near East

135

Cases of Brucellosis by month


Period 1991 2001/ Jordan

Years Month

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

January

13

15

22

20

32

57

34

17

10

February

32

42

25

50

58

41

56

27

20

March

39

120

60

101

57

110

99

91

27

18

20

April

67

122

109

120

144

112

125

86

86

40

23

May

145

110

116

116

171

157

142

84

63

48

54

June

156

91

103

103

137

99

152

77

60

30

52

July

217

53

122

102

87

119

145

94

40

36

42

August

113

57

68

66

89

61

73

66

36

29

21

September

89

27

50

51

46

63

62

49

43

15

13

October

30

40

26

32

38

40

31

41

19

22

16

November

38

26

19

28

44

33

30

15

16

December

20

23

13

61

35

19

Total

933

716

750

770

956

944

953

684

432

268

275

I.R/100.000

62.1

19.4

18.5

18.2

22.6

21.3

20.8

14.5

8.8

5.3

5.3

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FAO/WHO Regional Meeting on Food Safety for the Near East

Cases of Typhoid & Para Typhoid


Period 1991-2001 Jordan
Years Month

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

January

12

February

March

10

12

12

April

17

10

11

May

16

28

12

14

June

26

11

14

17

12

22

July

17

16

25

16

20

30

11

13

August

24

19

97

18

15

18

10

September

18

17

226

40

25

25

18

16

October

17

14

23

24

11

14

14

10

20

November

13

10

17

19

December

10

16

10

Total

132

159

439

157

155

141

109

97

96

46

69

I.R/100.000

3.7

4.3

10.8

3.7

3.7

3.2

2.4

2.0

2.0

0.9

1.3

FAO/WHO Regional Meeting on Food Safety for the Near East

137

Recommendations

The establishment of a regional priority list of Food-borne Diseases to be monitored


within a regional surveillance system;
Private laboratories and physicians should be identified as a potential source of
information;
Agencies involved are requested to advice for the process of accreditation and quality
assurance system in the laboratories;
Food traceability for proved contamination food.

Currently, the Government of Jordan is undergoing a joint programme with the World Health
Organization and the CDC Department following the WHO/FAO consultation conference held in
Germany (18-20 March 2002), on: Global Salmonella Surveillance and; Food-borne disease
Surveillance where Jordan was chosen as the sentinel point for the Middle East region.

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FAO/WHO Regional Meeting on Food Safety for the Near East

Conference Room Document 9


English only

FAO/WHO Regional Meeting on Food Safety for the Near East


Amman, Jordan, 5-6 March 2005

Major Issues and Challenges in Food Safety


(Five-Year record)
(Prepared by the Hashemite Kingdom of Jordan)
Background:
The Ministry of Health (Currently Food and Drug Administration) has the largest share of the
imported food control burden in Jordan with Ministry of Agriculture and the Jordanian Institute of
Standards and Metrology also having some responsibility. These grievances have been the subject of
complaints since before 1999. Complaints have also been directed to the Jordanian Government, at the
Prime Ministers level. An international Consultant (Mr. Anthony Whitehead) served as a technical
advisor to a High Ministerial Council Special Committee appointed to review the MOH policy on frozen
food shipping and clearances procedures.
These activities included the review of MOH instructions related to sampling, sampling
procedures, frozen food shipping controls, sample handling procedures, laboratory procedures, and a
review of the major concerns of clearance delays, handling requirements, etc. A number of
recommendations were made to MOH, which included among others:
-

Discontinue the use of a committee of 5 or more people to do the work of one person in
collecting samples. Hire fully qualified personnel to perform these duties or provide the training
needed to present employees to qualify for these duties
Discontinue the 100% sampling program and concentrate sampling on those products most
likely to be hazardous and those products that routinely have poor compliance performance in
past entries. Establish a rational approach to sampling and inspecting food consignments for
clearance without the costly sampling and analysis process currently in place, and use methods
that permit rational decisions on clearing or rejecting imported food products.
Establish a system to track the food entries for compliance performance data to provide the
necessary information on which to make sampling decisions and to make the control system
more effective and efficient.
Strengthen the laboratory capacity and capability by establishing Laboratory Quality Assurances
Program, providing training to personnel, replacing existing methods with modern up-to-date
methods, including instrumental analysis and equipment.
Strengthening the laboratory control by improving the rational for testing. Testing samples for
the right things and testing them right rather then just testing samples for the sake of testing.
Use Risk Analysis as bases for developing a risk based system to control imported food

The creation of Aqaba Special Economic Zone Authority (ASEZA) in year 2000 as a role model
to modern governance and fundamental reforms as well serving as a world class business hub and
leisure destination and investment friendly environment, gave major boost to incubate and embarked on
many of the modern- science based systems in the food sector where risk based system of imported food
control was the first success story since then.

FAO/WHO Regional Meeting on Food Safety for the Near East

1.

139

Previous Import Control System in Jordan until 2002:

All imported food products were subjected to 100% control (full sampling and testing) by MOH
even when other agencies are also collecting samples. For food safety, each sample is subjected to four
or more different analytical tests, including chemical, physical and microbiological hazards. Other tests,
which are usually performed, include tests on standards conformity, quality tests, and labeling
conformity by JISM. Frozen and refrigerated products are tested in the field for conformity with
required shipping temperatures. Each of the agencies collects separate samples for their own purposes.
Samples are collected from each production day code, each batch code within the production
day and for each brand name of the same product or for each species of animal in a consignment of meat
or meat products, including hanging carcasses. The number of samples collected from a single
consignment can be considerable. For example, in a consignment from one producer of frozen meat in
five-kilogram packages with three production code dates, and with three batch codes within each
production code date and representing buffalo, beef, and lamb meat, 18 samples would be required.
If the same production date codes with the same three batch codes of the same three species of
animals are represented in a consignment received in few days later from the same country and
producer, MOH will sample the consignment as a new shipment again in the same manner and to the
same amounts and test again for the same hygienic factors, regardless of the test results for the previous
samples of the same products and codes received a few days earlier. Sample information including
results of analysis are not captured into a database but are kept in a paper file system by custom entry
number; consequently tracing samples is difficult and time consuming. Records are kept only for
samples that do not meet Jordanian requirements. Only statistical (counting) information is kept on
products, which are released for entry (i.e., number of shipments, products, entry points, exporting
countries, etc.).
Jordan collects between 43,000 and 53,000 import samples per year, with a rejection rate of
about 200 consignments or 0.65%. At the same time, MOH monitoring of Jordanian domestic food
production results in approximately 24,000 samples per year (about 1/2 the number of samples collected
from imported food products), which result in about 720 rejections or a defect rates of 3.0% or nearly 5
times higher than imported foods. The number of samples collected from domestic food control was not
related to the total annual production volume, however the 24,000 samples collected per year is
estimated to represent about 10% of production. If this is the case, then domestic food control is
represented at the 10% level while imported food products is represented by 100% level of control
violating the principle of equal treatment for import and domestic food control measure under the WTO,
SPS Agreement.
Each product that is sampled undergoes 3-4 different individual test procedures. This amounts to
nearly 200,000 different tests annually at a cost estimated to be 3-4 million USD or more per year.
Remedy:
When the concept of a risk-based system (RBS) of food control was introduced in June 2000,
edited and revised to bring into consideration a number of changes, which addressed specifics to the
Jordanian context, of which:
-

Proper expenditure of resources on those foods that really matter to consumer health. All foods
are divided into three categories of risk, High, Moderate, and low based on a limited risk
assessment process. In Jordan, low risk products comprise about 40% to the total entries,
moderate 10% and high 50% based on the current estimate of risk for imported food. (At the
present time, the MOH has made the decisions related to risk and the current scheme is heavily
weighted in favor of high risk).

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2.

FAO/WHO Regional Meeting on Food Safety for the Near East

Introduce the concept of Cargo Examination applied to 25% of the moderate risk products.
Cargo examination consists of an inspection of the cargo and if no visual or sensual evidence of
defective product is encountered, the product is released.
Clearance time is considerably decreased to about 50% (1-2 days) and 10% (3-5 days), while the
remaining 40% (5-10 days)
Introduce the concept of Portion Sampling, in which samples are drawn from the individual
packages exceeding 2 Kg of the food rather that collecting the entire package when the
packages.
Introduce data tracking of all samples, acceptances and releases and the problems identified with
each shipment for historical and reporting purposes, permitting trend analysis and the
identification of poor performers in the import business. Based on historic and retrospective
review, products may be targeted for higher levels of control. Re-sampling of previously cleared
shipments of the same product lot numbers can be prevented when not necessary, preventing
duplication of effort. Products that are banned can automatically be screened out and rejected
without further processing. Products can be placed in an automatic detention category;
preventing entry for food safety reasons without further process
Creates incentives for those importers that consistently import high quality and safe foods, based
on the sampling and compliance levels of the food being imported. When this level of
compliance is routinely achieved, control of the products from this importer can be reduced to
lower levels providing faster clearance of their consignments.
Official staff is totally responsible for the sampling process and transport the samples to the
laboratory.
Sample Size:

A main issue especially with importers of meat products. As many as 36 animal carcasses could
be collected as a sample from one frozen meat container. If three bottles of Cognac are imported, the
MOH will collect two bottles for a sample, leaving one to sell.
Remedy:
The Risk based system establishes portion sampling. Food of any type in package size in
excess of 2 Kg, a portion of the food is taken from the necessary number of units, using special tools
and trained personnel for the sample collection. Special training was provided to the inspectors in
collecting portion samples and in aseptic sampling techniques. ASEZA/USAID funds were used to
construct a refrigerated Food Inspection Center with high efficiency refrigeration capacity to maintain
food at appropriate temperatures, for use to examine containerized foods and to collect clean portions
samples under controlled environmental conditions. Additionally, New revised Sampling regulations are
underway to be issued by end of year 2003 covering all types of samples and for the use of all official
agencies representatives

3.

Slow Processing Time for Imported Food Products:

Importers and brokers have expressed their concern as early as 1997 (perhaps even earlier) that
the processing time for imported food is much too long, resulting in loss of profits, increased cost of
goods and services and higher prices for consumers.
The World Bank/FIAS and USAID/AMIR conducted an Investor Road Map study in Jordan in
1998. The study identified a number of obstacles to investments resulting from government policies and
procedural requirements associated with the food safety inspection program. One key issued identified
was the length of time for processing entries, 20-30 days for food products that comply with Jordanian
requirements, and even longer to be informed that a product does not comply and must be re-exported.
The causes were not addressed and no positive strategy formulated to resolve the problems.

FAO/WHO Regional Meeting on Food Safety for the Near East

141

All correspondence was done by mail. Electronic communications were nearly non-existent in
some official agencies which resulted in adding several more days to the process. The streamlining of
import food entry process has been going on for two years at a very slow pace. Change is reluctantly
accepted but always with suspicion and lack of confidence in the process.
Remedy:
Through RBS implementation and the introduction of the electronic systems of selection and
reporting as well as customer complaints immediate action, concluded in major shuffling on time frames
measured now by days- hours- minutes and statistically analyzed on SPSS, resulting in better
knowledge of liability and responsibility and accountability on both the government as well as the
private sector

4.

Lack of Confidence in Laboratory Results:

The private sector had very little confidence in the laboratories to do accurate and precise food
analysis and distrusts the laboratory results. They have no other options since private laboratory testing
is not considered in any official decision by MOH food control. Not one MOH food laboratory has a
fully functioning Laboratory Quality Assurance Program, which assures proper laboratory practices and
procedures. The private sector was concerned about the laboratory personnel not being provided the
equipment and training to perform the test appropriately and testing takes longer by the use of out-dated
testing method. When test results are close to the limits between accepted and rejected, any request for
retesting is usually denied by the MOH food control.
The MOH policy is not to permit any tolerances in the limits, consequently a product found to
be over the established limits of a requirement, is rejected even if it is within the sensitivity of the
method for that analysis and the result could be Plus or Minus a given amount above or below the limit.
The concern is further complicated by the lack of an appeal process of decisions made based on
laboratory analysis and the ridged policy on sample retesting.
Remedy:
Since that time, a USAID-AMIR Consultant for Laboratory Operations has conducted training
in development and implementation of a Laboratory QAP, has provided training in food testing
methods, and developed recommendations for establishing a sampling retesting procedure. New
Laboratory equipment was also provided for the Aqaba Laboratory to modernize sample-testing
methods using instrumental analysis, and training was provided in the use of these instruments.
Review the Sampling instructions and include the portion sampling and aseptic sampling
techniques and other changes being introduced by the RBS is another task on continuous basis. With
review the sampling methods to include the more practical approaches to sampling bulk, packaged, raw
and processed food, and specialty items requiring unique sampling methods.
Additionally, review sample sizes against the sample quantity needs for the specific analyses to
be performed and to meet statistical approaches of probability to increase assurance of accepting
acceptable consignments and rejecting unacceptable consignments.
EU Commission has granted ASEZA six million euro to establish state-of-art food and
environment laboratory, fully equipped along training and international accreditation to be achieved by
year 2006 which shall serve both the imported and domestic food laboratory analyses.

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5.

FAO/WHO Regional Meeting on Food Safety for the Near East

Lack of Clear Criteria and Procedures for Control of Imported Food:

The private sector has complained since 1999 the absences of clear statements of criteria,
requirements, and procedures. There is no official office available to independently provide official
policy or procedural, operational or technical requirement or criteria to the private sector.
The MOH maintains about 100 different instructions and regulations. There is a tendency for the
introduction of an instruction to deal with each problem as they arise. The documents are all stand alone
documents and prepared and maintained as separate independent documents. There is no codification of
these documents.
Remedy:
The MOH/FDA should accelerate the process of reviewing existing instructions and applicable
regulations to assure their compliance with WTO guidelines and to eliminate any trade barriers. Current
policies and procedures of the Ministry still reflect unnecessary, excessive, and discriminatory trade
practices. The MOH should also consider the codification of the instructions and regulations to assure
their availability to the private sector, which have more than a need to know, but an obligation to
comply with these requirements.
ASEZA has taken the initiative to document all related food import procedures at Aqaba Port
into a formal standard operating procedures and Food Importers Guide is under design and print for
interested stakeholders by early year 2004 where it shall be available on its website
(www.aqabazone.com)

6.

Rejection of Frozen Food on the Basis of Manual Temperature Readings:

The Policy of the MOH/FDA, prior to the most recent revision (2/2001) of the Instructions for
the Transport, Storage & Exhibition of Foodstuffs, was all frozen and refrigerated shipments of food
must meet international standards of shipping temperature and that this requirement was measured by
manual temperature readings of the cargo when the product was offered for entry into Jordan. For this
purpose, the Codex Alimentarius Commissions Standard on Frozen Foods was used as the temperature
criteria. The Standard requires shipping temperature for frozen food to be -18C, with a variance
allowed of 0.5C due to recording device differences. Shipments of frozen blocks and carcasses of
meat of various food animals are routinely imported by Jordan. Shipments from distant shippers are
from 20-30 days in shipment, are shipped in refrigerated/freezer reefer containers, and most are
equipped with computer controlled time and temperature recorders, documenting the temperature
throughout the vessel journey.
The MOH policy required the Sampling Committee MOH member, using an electronic probe
thermometer, to measure the temperature manually. If the temperature was above 17.5C, the entire
consignment was to be rejected, without further sampling or testing safety of the frozen food. Evidence
was obtained from the Codex Alimentarius Commission, that confirmed the Standard for Frozen Food
should not be applied to meat products, (it is intended to be used for frozen vegetables-however the
standard does not clearly make this distinction a matter which is being rectified by Codex). Codex also
confirmed that the temperature criteria alone should not be the sole reason for rejecting any
consignments, a practice routinely carried out by MOH. Additional information was obtained from the
International Institute of Refrigeration (a standard setting body for refrigeration and freezer devices) that
confirmed that studies conducted of meat safety and quality at different storage and shipping
temperatures and at temperatures that were in continuous fluctuation, does not increase the risk of food
safety or quality when maintained at temperatures higher than -10C for periods of time less than 22
days. After 22 days, the only measurable impact was a slight sensorial detection of quality loss in
texture or taste and no impact on safety of the meat.

FAO/WHO Regional Meeting on Food Safety for the Near East

143

Remedy:
Instructions for the Transport, Storage & Exhibition of Foodstuffs were considerably changed
adding more reasonable criteria on electrical failure in reefer vessels according to the compliance with
ISO shipping standards. Manual temperature measurement was eliminated from use except in very rare
cases; since a one-time temperature measurement is not a measure of the food quality or safety.
Automatic shipment rejection is done only when the product temperature was higher than -12C.

7.

Domestic food traders refuse selling products released under the RBS without Analyses:

A new issue has arisen since the implementation of the RBS. Local merchants were refusing to
purchase food products that have not been sampled and tested for clearance. They fear being at risk of
penalty of the food law, particularly the present Jordanian Food Law, which carries severe penalties for
violations of selling products that do not meet Jordanian safety standards. This notion is based on false
premises that clearance by the MOH assures the product is safe and meets quality standards. The reality
is that the MOH clearance only pertains to those tests performed and that even that is not a guarantee
that if the product was safe at the time of testing it will be safe when delivered into the hands of the
local merchant for further sale.
The local merchants are not aware of these facts and have the notion that once declared safe by
the MOH, the food will remain safe from that point on, a notion that needs to be dispelled with
information, facts and education. The RBS allows for low (virtually no risk) foods to be cleared without
examination, sampling or testing on the basis that these foods are not subject to hazards that would
cause harm to consumers. Business enterprises with a long history of the food products complying with
Jordanian requirements, may also obtain releases for food consignments under these conditions.
At the present time, greater protection is provided under RBS due to the 100% sampling of all
high-risk foods, and the classification of many foods that may have some minor potential for high risk
being included in the high-risk category. Many countries classify food listed as high-risk food in Jordan
as moderate risk food. Consequently, the Jordan system is heavily skewed in favor of over protection.
As more experiences are gained in the sampling and analysis of these high-risk foods, the list may be
adjusted simply by re-defining and moving the food into a more appropriate category for future
handling.
Remedy:
Heavy education and awareness meetings were held since the launch of RBS with all
stakeholders on the concept of the system and dispel the notion that once cleared, the food is guarantee
to be safe from that time on. Routine meetings with key industry members of the private sector, the
associations and chambers with health officials held at regular intervals to identify problems and deal
with issues in a positive manner.
Educational programs such as food handlers, or food establishment operators training, workshop
and seminars shall be implemented once the new Food compliance system in place.
8.

Incentive-Penalty scheme for Food Importers - CHALLENGE

Create incentives for those importers that consistently import high quality and safe foods even
on high risk category, based on the sampling and compliance levels of the food being imported. When
this level of compliance is routinely achieved, control of the products from this importer can be reduced
to lower levels providing faster clearance of their consignments.
This must apply as well on traders importing low risk food products, yet have records of
noncompliance with food safety and quality standards

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FAO/WHO Regional Meeting on Food Safety for the Near East

Remedy:
ASEZA is undergoing the complete checking on the acquired data since the implementation of
RBS and shall design the criteria linking the product with importer and country of origin to be processed
electronically on the ASYCUDA module during selection and channeling of food imported via Aqaba
port to Jordan.
9.

Domestic Food Control- CHALLENGE

In most countries, food control is applied within the national borders across the entire food chain
from the farm to the consumer. This may involve a host of different official control agencies, each with
their specific authority and specialized expertise. The measures that are applied may vary depending on
the authority granted in law or directives for each control agency and their ability to carry out these
responsibilities. The effectiveness of these internal controls are largely dependent on the available
resources, the available equipment, technical capability and capacity, knowledge, skills and abilities of
the staff, and access to technically up-to-date information and methods. The measures are usually
applied to all food products produced by domestic producers, and sold in the domestic marketing system
to the public.
Food, which is subsequently prepared in public eating places and fast food business for direct
consumption by consumers, is also monitored for appropriate handling, preparation and service to
consumers. Food-borne disease outbreaks are usually monitored by most countries and are investigated
to determine the causative agent(s), the cause and effect circumstances and the potential for continued
risk to consumers, if proper actions are not taken by officials and the private sector.
The control measures for domestically produced food in most countries consist of sampling and
testing/analysis for the hazards most likely to be associated with the food being produced. For
domestically produced food, factory and food handling inspections are also made that compliment the
sampling program and serve to monitor the performance of the factories in complying with national
food safety and quality standards and health requirements. All food products being manufactured,
stored, transported and sold at the wholesale and retail market levels are generally subject to this
control. The degree of sampling of food in the markets is however, a very low percentage of the total
food produced or available at any given time. The monitoring serves as a measurement of the
performance of the food industry in producing quality and safe food.
Jordan has such a system in place. In each of the directorates, a medical officer is responsible for
public health and there is a staff available to inspect food establishments and to collect food samples for
monitoring purposes from these factories. The samples are collected from stored inventory of products
that are ready to be distributed to the marketing system. They also collect samples of food periodically
from wholesale, retail and fresh markets to monitor the level of compliance for food products entering
the marketing system.
Until today, Jordans inspection system on domestic products is rather scattered, random efforts
based on reaction to a complaint or suspicion. Current inspection program was not standardized, in that
no specific procedures were established for the conduct of an inspection, no forms were used in
reporting the results of the inspections and no historical files of past performance by the enterprise was
maintained. The inspections resulted in a pass or fail category in which minor failure were treated as
warnings and more serious violations resulted in citation or closure for prescribed periods of time and
destruction of offending food products, if any are involved.
This is imposing major challenge on the official level to think strategically on the appropriate
mechanisms on creating a proactive, practical, science-based and sustainable system of food compliance
and inspection on food activities applying the equivalence concept of SPS agreement

FAO/WHO Regional Meeting on Food Safety for the Near East

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ASEZA is working on launching the Risk based system of Food Compliance on enterprises
located within the zone, where one-stop-shop of enterprises registration and permitting is carried out
and the investor will receive full documentation of all pre licensing requirements to comply with before
operation (i.e. Health, public safety, environment, zoning, etc.)
Food Compliance system classified food activities into three categories within clear grading
system and scoring weight sheet of each inspection carried out, utilizing proper inspection equipment
and documenting violations via digital and video cameras. The system will be launched early year 2004
throughout heavy awareness campaign to various sectors of the community, providing brochures and
pamphlets in both Arabic and English on basics of food safety. The system will be fully automated in a
year time and data will be collected via hand held computers and downloaded into ASEZA central
databank
10.

Liability of Officials - CHALLENGE

In most countries, the basic principle of law is that violations of law must be witnessed or
evidence must be obtained to prove that the violation has been committed. In the case of food, it is not
difficult to prove violations since food is a highly regulated product and standards and rules/regulations
are establish which define the level of safety and quality required.
When food does not meet these standards or other requirements, it is considered in violation and
is subject to appropriate disposition under official control. In addition, in most countries, the law meters
out penalties to those persons or business establishments that are responsible for the causes of the
violations.
Since it is not possible for food control officials to be in every food facility at all times, the
approach taken as described above is considered acceptable practice and procedures. In addition, since it
is not possible for the food control officials to assure or certify that every batch of every food produced
or sold in the market meets safety and quality requirement, the food control officials do not guarantee
these products to meet all requirements. Consequently, food control officials, responsible for consumer
health protection are not considered libel for their actions or lack of action in most countries as long as
they are carrying out their duties in a due diligent manner. Executing control and monitoring
programs, similar to that explained above are considered as meeting the due diligent standard. Only in
situations where staff or leadership personnel within control agencies are found to be negligent or
derelict in their duties, are they likely to be subject to punishment, usually from the government
personnel administration rather than from the courts. Many government officials have protection against
personal suites by the public based on the overall government immunity from civil suits for carrying out
their duties (good or bad).
Further, when the activities of the food control officials meet the due diligence standard, they
are not considered to be negligent in their duties and not liable for any injury or sickness caused by any
food product subsequent to the official release for sale to consumers.
It is however, more prudent for control agencies to assess the most likely hazards associated
with various food products, types and groups. An assessment of the health risks to consumers can be
made from knowledge and experience, available and shared information from all reputable sources,
results of scientific research and studies, technical meetings and papers, etc. A carefully developed and
implemented risk based program of control of the specific hazard(s) associated with the different types
of food (i.e. HACCP), as identified in the risk assessment process, permits more effective consumer
protection against those food risks that present the greatest threat to human health. Consequently, risk
based systems is being developed in many countries to improve existing control programs and more
effective consumer protection.

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11.

FAO/WHO Regional Meeting on Food Safety for the Near East

Liability of the Food Industry (Private Sector): CHALLENGE

From an historical view, the primary responsibility to protect consumer health was vested in the
national public health officials with food control authority. Consumers were conditioned to expect a
maximum level of protection from the government. The private sector has since developed improved
quality control and safety assurance production procedures. This allows the private sector to be more
accountable and to accept a greater responsibility in assuring food safety and quality of their products.
The private sector has also developed an increased level of dependency on brand name
recognition and reputation. Brand name recognition is generally rewarded by higher sales and greater
market share over less known brands. Protecting this image is an important marketing strategy for most
business. In many cases, the industry will take extraordinary precautions to protect this status. In the
food industry, assure the highest level of public safety and quality for their products is an essential
element in this protection process, since a single incident of food-borne disease associated with their
product can destroy consumer confidence and impact on business prospects.
In modern food law, the responsibility for meeting the requirements for safety and quality
standards, hygienic and other requirements, rests with the private sector. It means that the food
industries all along the food chain, and the people involved in this business, are responsible for meeting
the requirements of food law and regulations issued pursuant to the law to assure food safety and quality
and appropriate representation in its labeling or advertisement. The industry bears the ultimate
responsibility for the safety of the products they make and sell regardless of the governments efforts to
regulate the products for consumer protection The food industry is liable and accountable for all
violations of the law and regulations.
12.

Automation of all food imports and domestic food control processes: CHALLENGE

All activities within food sector must be automated using PDAs and linked to data warehouse
to be able to link all data, analyze statistically to enable for concrete management decisions and policy
thinking as well as serving a transparent and easy mean of issuing reports and notifications to all
international concerned organizations
Remedy:
After the system has been reengineered manually, ASEZA has already created the electronic
Food Import management Information system in year 2002 provided by USAID grant, which is half
automated system to capture all data and detailed information on every food consignment and tracking
all procedures, personnel and results
The next phase of automation shall entail linking to the laboratories to pool their results
electronically, followed by the full automation where paperless procedure will be in place between all
officials on their various levels will be able to document the procedures on their PDAs linked to the
central system for downloading and process of further actions
Additionally, ASEZA e-permitting and registration system will be followed by an automated
food compliance system where all food inspectors in the zone will be provided with PDAs to record
their observations and results where it can be downloaded directly on the data warehouse. For this
purpose, the zone was granted 350 000 euro from the EU grant (2003-2005) for such tailored automated
system design and deliverance of hardware for this purpose
The road of Thousand miles start with a step Jordan is leading the road of improvement
vigorously

FAO/WHO Regional Meeting on Food Safety for the Near East

147

Conference Room Document 11


Arabic only

FAO/WHO Regional Meeting on Food Safety for the Near East


Amman, Jordan, 5-6 March 2005

Knowledge, Attitude and Practice of Food Handling among


Housewives in the Amman Area
(Prepared by the Hashemite Kingdom of Jordan)
The study is an investigation of knowledge and trends in handling of food by Jordanian
housewives, including the preparation of the food, its storage at home and personal hygiene, etc, with
the purpose of identifying issues that would be addressed in educational and extension programmes to
improve food safety at household level.
The full text of this document can be found in the Arabic version of the report.

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FAO/WHO Regional Meeting on Food Safety for the Near East

Agenda Item 5

Conference Room Document 12


English only

FAO/WHO Regional Meeting on Food Safety for the Near East


Amman, Jordan, 5-6 March 2005

Human Health Outcome as the Focus of Food Control System


The need for a conceptual change
(Prepared by the Hashemite Kingdom of Jordan)
Introduction
The main objective of any food control system is to protect human health through activities that
ensure the safety of foods made available to consumers. Nevertheless, the actual food control systems in
most Middle East countries are still traditional systems that adopt a punitive approach to food control,
and depend heavily on inspection and rejection activities at the final stage of the food chain. It is
possible to provide adequate protection to the consumer by merely sampling and analysis of the final
product.
The increasing burden of food-borne diseases and the emerging food-borne hazards are major
challenges for food control authorities. Linking food-borne disease surveillance data with food
surveillance data, and taking preventive measures at all stages of the food chain are necessary for
reversing the increasing trend in food-borne diseases.
Traditional Food Control Systems
In most countries of the Middle East food control activities mainly emphasize the routine
inspection of the structural aspects of food businesses and the collection of samples for laboratory
analysis from end products. During a standard inspection, the food inspector would look at the structure
of the food facility (defective floors, ceilings and machinery), and he would ask for the facility license
and the health certificate of employees. By the end of the inspection visit, the inspector would collect an
unrepresentative sample from the end product for laboratory analysis. Process assessment is not always
done, and if done it is most probably of poor quality.
In general, food inspectors are not properly trained to inspect the different types of food
businesses, and in most cases they learn from the more senior inspectors experience which is not
always optimal.
Food samples are analyzed in food laboratories of variable quality, and tested for compliance
with specific standards and technical regulations. In many instances the tests are not focused on relevant
pathogens.
Data generated from inspection activities and food laboratories are of descriptive nature showing
the number of inspection visits, violative businesses, laboratory analysis performed, court actions,
closures, etc. The data is rarely analyzed, and by its nature is not indicative of the impact of control
activities on human health. It is mainly used to produce reports required for administrative purposes.
The present food control system in Jordan faces the following challenges:
1.
2.
3.

Gaps and overlaps across the food chain


Communication between relevant agencies
The use of risk assessment to provide a scientific basis for management decisions

FAO/WHO Regional Meeting on Food Safety for the Near East

4.
5.
6.
7.
8.
9.

149

The dilemma of Urgent versus Important


Lack of disciplinary inspection teams
Staff unevenly distributed across the food chain
Microbiological criteria to support classification of analytical results
Regulatory impact assessment
Hiding behind the regulations

Jordan Food and Drug Administration JFDA was established under the JFDA Act No.
31/2003, which came into effect on 16 April 2003. JFDA is responsible for the integration and
coordination of food controls, and for the development of a modern effective food control system that is
scientifically based with focus on human health.
Food-borne diseases Surveillance
Usually, food-borne diseases surveillance is part of the national disease control system, and in
most ME countries it is not linked to the food control systems. Epidemiological data related to foodborne diseases is not communicated to food control authorities, and even if communicated, it is not used
for risk assessment and risk management, partly due to the traditional thinking of food control
managers, and due to the incompleteness and poor quality of the epidemiological data.
In Jordan, the disease surveillance system suffers from the following shortcomings:
1)
2)
3)
4)

Underreporting from the private medical sector


Laboratory diagnostic capabilities are limited, and do not fully allow for the definite
identification of the whole range of microbial causative agents
Questionable quality of food poisoning outbreaks investigations
Only few food-borne diseases are included in the list of notifiable diseases.

The Changes Needed


Revising inefficient traditional food control measures with low disease reduction is an important
prerequisite for reversing the increasing trend in food-borne disease and for optimizing the present food
control systems. Conceptual changes are needed to focus the management or control measures in new
directions, redirecting old inspection and control routines to focus on the relevant pathogens. Important
changes necessary for that purpose are:
1. New emphasis on the human health outcome, linking the hazards in the foods with the actual
human health risk through the scientific risk assessment process.
2. The use of risk assessment to provide a scientific basis for management decisions.
3. Monitoring and reviewing the effect of risk management efforts
4. Including effective risk communication in all food safety activities.
The implementation of such changes is not an easy undertaking. A new food safety culture has
to be developed among food control staff along the food chain. It is essential that a competent and
qualified workforce staffs the food control authorities, and multidisciplinary teams including public
health practitioners, veterinarians, food scientists, microbiologists, etc. should be established.
Food laboratories should be developed in parallel with the inspection services, to be able to
produce dependable analysis results. Consequently, quality assurance programmes should be established
in all food laboratories, and national or international accreditation for food laboratories should be
sought.

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FAO/WHO Regional Meeting on Food Safety for the Near East

For most developing countries, assistance from international organizations and from
experienced food safety authorities in developed countries is needed to go ahead with the reform of their
food control systems. In Jordan, the JFDA is embarking on a twinning project with the Danish
Veterinary and Food Administration. The two-year duration project started in February 2005, and will
focus on three components:
1.
2.
3.

Coordination and strategic planning


Reforming of the Jordanian food inspection services
Reforming of the food chain laboratories

Conclusion
Traditional food control systems practice inspection and testing activities in isolation from food
safety-related health problems. The results of such practice are inefficient control measures that have
little or no impact on human health.
Human health should be the core of food control activities, and therefore links between food
contamination and food-borne diseases should be established and analyzed. Effective linkage between
food control authorities and the public health system will rationalize the food control system by leading
to appropriate risk-based food control policies.
In Jordan, the establishment of JFDA comes as a major step towards the optimization of food
safety system with the understanding that the ultimate goal of food control activities is to protect the
health of the consumer. To be able to achieve this goal, JFDA works on the basis that food safety is a
shared responsibility.
References
1.

WHO, Regional Office for Europe, Improved Coordination and Harmonization of National
Food Control Services. Report on a joint WHO/EURO-FSAI meeting, Dublin, Ireland 19-20
June 2001.

2.

FAO/WHO. Assuring Food Safety and Quality: Guidelines for Strengthening National Food
Control Systems. Joint FAO/WHO Publication.