Given that Ebola is still a problem in some parts of West Africa, it is natural to expect health systems or infectious diseases to be the theme of this year’s World Health Day.
But the World Health Organization chose instead to focus on food safety — for serious reasons.
The U.N. health agency is scheduled to publish by the fourth quarter of this year a final report providing a full picture of the global burden of foodborne diseases. Initial data already suggests that unsafe food is causing more than 200 diseases globally, from diarrhea to cancer. It is killing an estimated 2 million people annually. And, if left unchecked, it could spread like wildfire, threaten global health security, and leave a negative social and economic impact — similar to what Ebola did in West Africa.
“Because of our highly interconnected world … one food safety problem in one country could become [a] global concern,” Dr. Li Ailan, director of health security and emergencies for WHO’s western Pacific region, told Devex during the regional office’s World Health Day event in Manila.
Bird flu is one such threat WHO is closely monitoring at present. While it has a low rate of human transmissions to date, there are instances when humans have been infected by the virus, either through direct contact with infected poultry or because of human consumption of uncooked contaminated poultry. In its latest bulletin dated March 20, the organization reported one new case from China, bringing the total cases of human infections of the virus to 234 since 2003.
Li said people are increasingly worried of its potential to be the next health pandemic.
The challenge of keeping food safe
WHO is promoting five key steps to guarantee safe food consumption: keep food clean, separate raw and cooked food, cook thoroughly, keep food at safe temperatures, and use safe water and raw materials.
The guidance is available in 87 languages and provides very basic principles.
But Li admits there are huge challenges in its effective implementation.
One is lack of knowledge. Not all people, especially those in remote villages, are aware of these concepts or have access to such information. Even some of those who know about the key steps may tend to disregard or downplay the consequences.
“People will not change their behavior significantly if they believe the risk is low to them,” she explained.
Limited infrastructure, meanwhile, may make it difficult for food handlers, such as street food vendors, to follow food safety standards. Street food, when not prepared properly, may lead to liver disease or hepatitis E.
As such, the official emphasized the importance of countries having strong systems in place to ensure information on food safety is being disseminated down to the grassroots level, having an empowered public that can make informed decisions, and conducting inspections and collecting information on the food safety problem — even if it’s just due to a number of people who “don’t believe it’s a problem.”
She also underscored the need to engage the private sector more in the discussions, and, in the event of a potential or actual outbreak, urged national authorities to keep communication lines open and don’t withhold information so WHO can bring in international support as early as possible.
Can an event cause a public health emergency? 4 basic questions to answer:
• Is the public health impact of the event serious?
• Is the event unusual or unexpected?
• Is there significant risk of international spread?
• Is there a significant risk of international trade or travel restrictions?
Under International Health Regulations, WHO member states are legally required to designate a national focal point — perceived to be an office — whose obligation is to communicate to WHO any event that has the potential to cause a public health emergency of international concern. These focal points need to answer four basic questions, and if they say yes to at least two, they need to notify WHO within 24 hours.
But there doesn’t seem to be a strong “punishment mechanism” in place for those who fail to comply though. Li said WHO relies on peer pressure instead, in which the health agency discloses to the public what they learn from other reliable sources.
The importance of preparedness
So far, there have been no alarming food-related outbreaks that match the breadth and scale of the Ebola pandemic. But Li said the western Pacific region — or the world at large — cannot be complacent.
“If we don’t prepare, things may happen, and we just don’t know when. But if it happens, we’ll be under pressure again,” she said. “Ebola gave [WHO] an excellent opportunity to reform ourselves, to strengthen our backbone system for emergency response. If the food safety issue becomes a food safety emergency of international concern, this system has to be activated. And we have to prepare for that.”
Ebola has exposed the problem of weak health systems in a number of West African countries, and the lack of significant investments countries place on emergency response, not only at the country level but also international. Institutions such as WHO suffered major cutbacks in its emergency response budget, which many argue had an impact on its capacity to respond to the Ebola pandemic.
The outbreak however seems to have served as a wake-up call for a number of donors, which are now looking to focus on health systems strengthening. Member states have also called on an additional set of reforms at the WHO, including setting up a global health reserve workforce and boosting WHO’s own emergency personnel, although whether that will be matched with sufficient financial support remains to be seen.
Li notes many countries, even among the international donor community, put in resources only during a crisis situation, but don’t invest a lot of money “during peaceful time.” Further, she disclosed that nine countries in the western Pacific region have admitted to not being prepared for an outbreak, lacking core capacities as prescribed under the IHR.
While the WHO official is hopeful that the U.N. health agency would build a core group of experts in outbreak and emergency response — which could include epidemiologists, emergency managers, risk communication officers and logisticians — she remains cautiously optimistic.
“When we have [an] emergency, [it’s] very simple — we need to bring the right people in the right places, and we need the resources,” Li said, adding however that “we have significant shortage of staff and also funding. We do not have the global contingency funding mechanism.”
Read more international development news online, and subscribe to The Development Newswire to receive the latest from the world’s leading donors and decision-makers — emailed to you FREE every business day.