Early Warning Rapid Alert Systems for Food Safety

“Food safety and foodborne illness are of low priority for many governments and general populations in low to middle income countries. Limited budgets and donor-driven funding likely encourage governments to focus on other problems such as food security and Human Immunodeficiency Virus, tuberculosis and malaria. Some populations may not be educated about food safety and are habituated to chronic gastrointestinal diseases. Data that measures the burden of food safety events is not available to make evidence-based decisions. The need to develop EWRA systems for food safety is likely to be incompletely understood and accepted by stakeholders without significant collaborative groundwork.”

Rome195The CCH was contracted by the EMPRES Food Safety and Products Unit (AGDF) of the FAO to identify, evaluate, and summarize information on existing early warning and rapid alert (EWRA) systems applicable to food safety, and then use this information to discover key principles, good practices, and essential framework elements for establishing or enhancing EWRA systems at the country level. This was undertaken over a six-month time frame with the goal of providing immediate assistance to the EMPRES Food Safety and Products Unit to move forward with two of its important objectives: helping countries to build and enhance their EWRA capacities in food safety, and establishing sustainable global food safety networks.

Early Warning Rapid Alert Systems for Food SafetyTo gather preliminary knowledge relevant to the project goals, we performed scoping interviews and a rapid review of the peer-reviewed and grey literature. We compiled a database of global experts in EWRA and food safety, concentrating particularly on identifying those working in low and middle income countries, and developed an online survey to gather their opinions about the role of EWRA systems in improving food safety, critical elements for EWRA systems, limitations to developing reliable EWRA systems, how best to assess EWRA systems, and how all of these subjects might vary by organizational or resource levels. We then performed semi-structured interviews with 15 experts with extensive experience working in EWRA for food safety in low-resource settings to collect in-depth knowledge and commentary on important topics about which there was no clear consensus of evidence or opinion. We synthesized results from all activities into outputs which included a full final report, an executive summary and a technical report. A primary recommendation to bring together experts for high level discussions on EWRA systems resulted in a contract to facilitate an expert workshop in Rome, Italy, in October 2013.

Rome275A critical finding of this work is the recognition that food safety systems exist along a continuum that may require the use of different early warning systems, from predictive risk-based and forecasting approaches through to active and reactive systems that identify hazards at varying points in time in the food to fork chain.  These early warning  systems may make use of one or more surveillance techniques (active, event-based or  syndromic for example) that target human cases of disease occurring after exposure to contaminated food.  Alternatively, EW systems can be targeted to food chain points during harvest or production involving food inspection and sampling in order to identify a contamination event before human exposure. Ultimately, published literature on evaluating EWRA systems for food safety is limited, and there is a lack of validated data on how best to set up, sustain and evaluate these systems.  As a result, it is not currently feasible to take any one existing system and use it as a portable blueprint for low to middle income countries seeking to develop EWRA capacity.

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