Global Foodborne Disease Surveillance System Faces Hurdles

Last February, the World Health Organization, as part of its development of a strategic plan for food safety, proposed a system to detect “global hazards” of supranational interest in the food supply, using combined epidemiologic and laboratory surveillance (see Food Technology, May 2001, p. 22).

There seem to be many impediments to such a system, including several centered on national interests. In “Impediments to Global Surveillance of Infectious Diseases: Consequences of Open Reporting in a Global Economy,” published last year in Dairy, Food and Environmental Sanitation (volume 21, pp. 123-131), R.A. Cash and V. Narasimhan examined the situation, especially with regard to developing countries that “often derive little benefit, and may suffer disproportionately heavy social and economic consequences.”

They pointed out that to overcome the hurdles they face in instituting surveillance and reporting systems, developing countries need access to better and more affordable diagnostic capabilities to allow for real-time reporting; accurate, non-sensational news reporting of outbreaks; adherence by other countries to international regulations (e.g., those of the World Trade Organization); and financial support for countries that are economically damaged.

In the context of foodborne disease, there is evidence that a finding of an infectious agent in the food supply of a developing (or even developed) nation could lead to social and economic consequences. For example, the Food and Drug Administration has block-listed countries that have exported raw shrimp containing Salmonella. More recently, raspberries from Guatemala were denied entry into the United States for fear of Cyclospora. What would have been the incentive for these countries to volunteer information to the importing country? What would be the incentive for a developing country to develop the infrastructure for rapid detection of foodborne disease agents in its citizens or its food chain? Who would want to travel to any nation if its food supply was suspect? There would be a social stigma and economic consequences. For example, the 1991 cholera epidemic in Peru resulted in an estimated loss of $770 million in trade revenue and $150 million in tourism revenue that year.

In the aftermath of the events of September 11, 2001, concern has arisen that the food chain is a likely target for terrorism. Since then, countless articles have examined the vulnerability of the food chain, from the farm sector through to finished product. Terrorism could take more than one form. Agents could be introduced into the food chain to harm humans or crops (and thus the economy and national psyche). Peter Chalk, a policy analyst with RAND Corp., has said that “Agriculture and the general food industry are absolutely critical to the social, economic, and political stability of the U.S., and any deliberate act of sabotage/destruction to this highly valuable industry would be enormous.”

This concern, shared by many within and outside of government, has spawned numerous legislative initiatives to bolster food safety. Imported food is a particular concern, and it has been proposed that FDA hire more inspectors to better cover U.S. ports of entry for food. Other bills push for increased enforcement authority for food safety/regulatory agencies, and for better labeling of foods, such as country-of-origin labeling. There has even been a renewed call for a single food safety agency (see Food Technology, December 2001, p. 32), an idea that has surfaced from time to time but now, with the specter of terrorism, may have a chance of becoming reality.

Thus, there is a tremendous focus of concern on the food supply, including a great deal of focus on imports. What would be the incentive for a developing (or developed, for that matter) country to implement surveillance and reporting now, knowing full well that their export foods, if even suspected of containing a harmful agent, would face detention and perhaps destruction? After the initial action, they would have no export markets.

Ironically, a global surveillance system for foodborne disease is needed now more than ever. No one doubts that the U.S. food supply is vulnerable to terrorism, and that enhanced vigilance is needed throughout. Nevertheless, facing the realities of human behavior, many nations may choose not to participate because of present circumstances and concerns. What a pity for public health.

by DOUGLAS L. ARCHER
Contributing Editor
Professor, Food Science and Human Nutrition Dept.
University of Florida