WH WHO In Initia itiative to to Es Estim timate The he - - PowerPoint PPT Presentation

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WH WHO In Initia itiative to to Es Estim timate The he Global obal B Bur urden den Of F Foodbor oodborne ne Disease eases Claudi audia S a Stei ein, n, MD, , MSc, P , PhD hD, F , FFPH Depar epartment of of Food Food Saf

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SLIDE 1

WH WHO In Initia itiative to to Es Estim timate The he Global

  • bal B

Bur urden den Of F Foodbor

  • odborne

ne Disease eases

Claudi audia S a Stei ein, n, MD,

, MSc, P , PhD hD, F , FFPH

Depar epartment of

  • f Food

Food Saf afet ety & & Zoonos Zoonoses

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SLIDE 2

What are "Foodborne Diseases"?

  • NOT the nutritional disorders (deficiencies,

malnutrition and/or obesity)

  • Diseases transmitted through the ingestion
  • f contaminated food
  • Caused by bacteria, viruses, parasites, prions

and chemicals/toxins (in

incl.

  • cl. a

alle llergens)

  • …and they are everywhere
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SLIDE 3
  • Rapid spread of foodborne disease
  • utbreaks (trade, travel, migration,

social unrest)

  • Emergence of new foodborne

diseases (e.g. vCJD)

  • Use of food as a vehicle for

deliberate contamination (terrorist threats to food)

Myth No 1 – the obvious one:

'Foodborne disease problems are very localized' Foodborne diseases are a global health security issue

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SLIDE 4

Myth No 2:

'Foodborne diseases are mild, self-limited and and of short duration'

Danish Food Standards Agency

2.2 million deaths from diarrhoeal diseases each year world-wide

(World Health Organization, 2008)

Campylobacter: Guillain Barré Syndrome Reactive arthritis Salmonella spp: Guillai ain B n Barré Syndr drom

  • me

Reactive arthritis Septicaemia Meningitis Listeria: Meningitis Septicaemia Perinatal loss E.coli: Renal failure Pork tapeworm: Epilepsy Toxoplasma: Retinopathy Trichinella: Multi-organ failure Acrylamide: Cancer Arsenic: Cancer Aflatoxin: Cancer Lead: Mental retardation Dioxins: Cancer Allergens: Anaphylactic shock

USA: 5,000 deaths from foodborne illness from pathogens alone each year

(Mead et al, Emerg Infec Dis, 1999)

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SLIDE 5

Myth No 3:

'Foodborne diseases are becoming less & less frequent' 335 newly emerging infectious diseases:

  • 95 pathogens transmitted through food

(~27%)

  • 50 (15%) due to "changes in agricultural or

food industry"

  • many resistant to antibiotics

Compounded by effects of climate change

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SLIDE 6

Myth No 4 – the dangerous one:

'Food security is more important than food safety'

Food security without food safety can cause great harm

  • Malnourished people are more

vulnerable to foodborne diseases & more likely to die

  • Contaminated food is rarely

discarded in famine situations

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SLIDE 7

UN Millennium Development Goals (MDGs)

  • 4 out of 8 MDGs:

affected directly by progress with food safety

Myth No 5:

'Food safety is a luxury that rich countries can afford' Foodborne diseases are a global development issue

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SLIDE 8

UN Millennium Development Goals (MDGs)

Foodborne diseases – diseases of poverty:

  • Poor food regulatory

systems and enforcement

  • Poor food storage &

preparation  contamination

  • Foodborne diseases cause

high rates of work absenteeism and medical expenses  pov pover erty

  • Many foodbor
  • odborne di

diseas eases s ar are e zoonose

  • onoses,

s, henc hence r e ref eflect ction

  • n of
  • f

di disease ease i in n lives estock ck  pov pover erty y & trade de i issues ues

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SLIDE 9

UN Millennium Development Goals (MDGs)

Foodborne diseases – contributors to child mortality:

  • Children particularly vulnerable to

contaminated environments, incl. food

  • 1.9 million child deaths from

diarrhoeal diseases annually

  • Children living with HIV/AIDS

especially at risk – opportunistic infections

  • Pregnant women especially affected

by foodborne diseases (Toxoplasmosis, listeriosis)

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SLIDE 10

How big is the burden of foodborne diseases?

Reported human cases

What we know from surveillance data What we need to know

Actual human disease burden Reported human cases

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SLIDE 11

Myth No 6 – the understandable one:

'We can never estimate the burden of foodborne diseases' Yes, , we c e can. an. And w nd we e ar are e doi doing i ng it

"What hat does esn't n't get meas asur ured, ed, doe doesn't get get done" ne" Recom

  • mmendat

ndation

  • n:

WHO to

  • lead

ead ef effor

  • rts

& appo appoint Foodbor dborne ne Diseas ease e Burden den Epidem demiol

  • logy
  • gy

Refer erenc ence e Group up (FERG) "How

  • w el

else to

  • as

assess effectiveness of food saf afety pol policies & inter ervent entions

  • ns?"

?"

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SLIDE 12

What is the FERG?

FERG = scientific expert group appointed by & advising the WHO Director General

  • representing all regions of the world (North & South)
  • representing all areas of foodborne diseases, economics, policy etc.
  • To provide epidemiological estimates on the global burden of all

relevant foodborne diseases (according to age, sex and WHO regions)

  • To assist WHO to strengthen the capacity of countries to conduct

burden of foodborne diseases and cost of illness studies

  • To assist WHO in bridging the gap between collection of scientific

evidence and food safety policy making.

What are the objectives of FERG?

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SLIDE 13

FBD Burden - Action framework FERG strategic framework

Assem embling g ex exist sting ng ev evidenc dence

(syst (systematic c re revi views) s)

Count

  • untry

y studi udies es

Coun

  • untry

y BoD capaci apacity y built Too

  • ols

s for

  • r cou
  • untries

s to

  • asse

sess e ss effect ctive veness ss

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SLIDE 14

Bur urden den of

  • f FBD

Countr

  • untry

y Study tudy P Protoco

  • tocols

Food S

  • od Safety

afety Pol

  • licy

Situa tuation A n Anal nalyses es

Tools for systema matic bur burden of

  • f FBD studi

udies Tools & mechanisms ms facilitatin ing res esear earch h up-take ke Collabor aborat ation

  • n

How to bridge the gap between researchers and policy-makers ?

  • Launched in June 2009
  • Aiming for 3 studies in each WHO region
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SLIDE 15

Alliance of collaborators & funding partners

  • Centers for Disease Control, CDC, Atlanta, USA (technical & financial)
  • Dutch Ministry of Health, Sports & Welfare (technical & financial)
  • Government of the Federal Republic of Germany (human resources)
  • Japanese Ministry of Health, Labour and Welfare (financial)
  • Government of the UK, Department of Health (human resources)
  • Government of Sri Lanka (human resources)
  • US Department of Agriculture (technical & financial)
  • Government of the Republic of Ireland (human resources)
  • US Food and Drug Administration (technical & financial)
  • UN & other internationals (FAO, OIE, IARC, UNEP, WTO, World Bank)
  • ECDC (29 European country studies for 49 diseases, incl. 20 FBD)
  • Institute for Health Metrics and Evaluation
  • Multiple topic-relevant networks (e.g GSS, Med-Vet-Net, Int Collab of Ent BoI

studies)

Who are the multi-sectoral stakeholders?

  • WHO member states
  • Bi/multi-lateral donors
  • NGOs
  • Consumer groups
  • Industry
  • Public & scientific media
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SLIDE 16

On the occasion of the third meeting of The Foodborne Disease Burden Epidemiology Reference Group (FERG)

Thursday, 29 October 2009

10:00 – 18:00 hrs, followed by a reception WHO Headquarters, Executive Board Room, Geneva

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SLIDE 17

Extending the alliance of partners – Get involved!

  • Consider whether and how the Initiative is relevant to

your work

  • Consider how and to what extent you wish to engage

with WHO and contribute to the outcome of the Initiative

  • Expert scientific input into Initiative (policy/economics/epi)
  • Expansion of expert network & raising awareness of FERG
  • Other practical inputs:
  • Human resources to Initiative
  • Funding for Initiative – help sponsoring a country

study

What kind of input could be provided?

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SLIDE 18

Global Programme on Evidence for Health Policy

Thank hank you you

Int ntest stines es hangi hanging out ng out to

  • dr

dry, Cam ambo bodi dia

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SLIDE 19

FERG Documents:

www.who.int/foodsafety/foodborne_disease/ferg Summary documents FERG & Stakeholder reports

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SLIDE 20

Extra slides

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SLIDE 21

In summary: WHO Initiative to Estimate the

Global Burden of Foodborne Diseases (FBD)

  • Why?

– Because information on burden of FBD from all causes is poor – Policy makers require information to assess effectiveness of prevention and interventions (incl. Codex) – Foster international development and global health security

  • What?

– Estimation of morbidity, disability and mortality of FBD, leading to cost of illness assessments – Development of tools for countries to conduct BoD studies

  • How?

– Foodborne Disease Burden Epidemiology Reference Group (FERG) – Time frame of at least 5 years

  • Outcome?

– Global report and global atlas – Country Burden of Disease studies

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SLIDE 22

Foodborne diseases maim and kill

  • Food safety concerns everyone, everywhere
  • Foodborne diseases affect global development &

global health security

  • Everyone has a role to play

in making our food safer

  • Estimating the burden of foodborne diseases

is a critical element in the improvement of food safety

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SLIDE 23

Myth No 5:

'Foodborne diseases are mild, self-limited and and of short duration'

Danish Food Standards Agency

Campylobacter: Guillain Barré Syndrome Reactive arthritis Salmonella spp: Guillai ain B n Barré Syndr drom

  • me

Reactive arthritis Septicaemia Meningitis Listeria: Meningitis Septicaemia Perinatal loss E.coli: Renal failure Pork tapeworm: Epilepsy Toxoplasma: Retinopathy Trichinella: Multi-organ failure Acrylamide: Cancer Arsenic: Cancer Aflatoxin: Cancer Lead: Mental retardation Dioxins: Cancer Allergens: Anaphylactic shock

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SLIDE 24

FER ERG – composi positio ion n & proce cess ss

WHO Secret ecretariat

Cor

  • re

e or

  • r

Steer teering gr g group

  • up Them

Thematic c Tas Task k For Forces es

1. 1. Bur urde den of

  • f Disease

ease ex exper pert (Chai hair) 2. 2. Epi pide demiolog

  • gist

sts s & ex exper pert scien entist sts s in: n: Microb

  • biol
  • logy/

gy/en enteric c di disease eases Chemica cals/ s/Toxi xico cology Par arasi asitic c di disease eases Zoono

  • onotic

c di disease eases s Cause e attribut bution

  • n

Disea ease se m model

  • deling

Ad-hoc resource experts

  • 1. Enteric diseases
  • 2. Parasitic diseases
  • 3. Chemicals & toxins
  • 4. Source attribution
  • 5. Country Studies

External al ex exper perts

Pict ctur ures es aw awai aited: ed: Dr Jo John C n C Lar arss ssen en Dr Jo Josef ef Sch chlat atter Prof

  • f Rol
  • laf

af va van n Le Leeuw euwen en

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SLIDE 25

Myth No 1:

'Foodborne diseases are mostly a problem in developing countries' USA: 76 million cases

  • f foodborne illness

from pathogens alone each year

(Mead et al, Emerg Infec Dis, 1999)

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SLIDE 26

Myth No 2:

'Foodborne diseases in rich countries are mostly travel-related'

United States and EU: In most countries majority of cases is domestically acquired

(CDC & European Food Standards Agency)

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SLIDE 27

Myth No 6 – the hopeful one:

' As a vegetarian I am less likely to get foodborne diseases'

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SLIDE 28

Myth No 7 – the easy one:

'Governments hold the sole responsibility for making food safer'

Processing Storage Cooking Livestock Crops Seafood

Distribution Retail

Industrial emissions and effluents Sewage Vehicle emission Agricultural practices