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a guide to Healthy food Markets a guide to Healthy food Markets WHO Library Cat

a guide to Healthy food Markets a guide to Healthy food Markets WHO Library Cataloguing-in-Publication Data A guide to healthy food markets. 1. Food contamination - prevention and control. 2. Food handling. 3. Food supply. 4. Environmental health. 5. INFLUENZA, HUMAN - PREVENTION AND CONTROL. 6. Guidelines. I. World Health Organization. ISBN 92 4 159393 8 (NLM classification: WA 695) © World Health Organization 2006 All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel: +41 22 791 2476; fax: +41 22 791 4857; email: bookorders@who.int). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; email: permissions@who.int). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by WHO to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. Acknowledgements WHO would like to acknowledge the dedication and commitment of the many market stakeholders who have worked to make their pilot projects successful. WHO would also like to acknowledge the contributions of the food safety experts as well as institutions who have advised on pilot projects, especially the School of Architecture, Lund University, Lund, Sweden. The generous support provided by various development agencies that have made much of this work possible, including Swiss Disaster Relief, German Gesellschaft für Technische Zusammenarbeit (GTZ), United Kingdom Department for International Development (DFID) and the Aga Khan Foundation, is gratefully acknowledged. Contact for further information: Department of Food Safety, Zoonoses and Foodborne Diseases Email: foodsafety@who.int Web site: http://www.who.int/foodsafety Design: Steve Ewart, WHO Graphics Photographs: Nelli Sheffer ii CONTENTS SUMMARY 1 INTRODUCTION 3 WHY HEALTHY FOOD MARKETS? 5 Need for a food safety approach 5 Special character of food markets 7 What are major foodborne hazards? 7 Who benefits from a Healthy Food Market? 8 GUIDING PRINCIPLES FOR A HEALTHY FOOD MARKET 11 Ensure the market provides safe and nutritious food to the community 11 Seek to promote food safety from production to consumption 12 Foster partnerships among food suppliers, government and consumers 13 BASIC COMPONENTS OF A PILOT PROJECT 15 Preparatory activities 15 Planning and implementation 16 Monitoring and evaluation 17 IMPROVING MARKET ENVIRONMENTS 19 Infrastructure 19 Operational environment 19 Health services 20 Environmental health 21 PROMOTING SAFE FOOD HANDLING 23 Education and training 23 Key messages in Healthy Food Markets 23 Other relevant materials 25 ANNEX 1: BUGURUNI MARKET, DAR ES SALAAM, TANZANIA – A CASE STUDY 27 ANNEX 2: TERMS OF REFERENCE FOR A HEALTHY FOOD MARKET TASK FORCE 30 ANNEX 3: Measures TO reducE transmission of avian influenza in wet markets in developing countries 31 ANNEX 4: FURTHER READING AND USEFUL LINKS 37 iii iv 1 Summary With over half of the world’s population now living in urban areas, food markets have become important sources of affordable food for many millions of people. At the same time, however, such markets have been associated with major outbreaks of diseases, including cholera, SARS and avian influenza. Food markets vary greatly from country to country and even from province to province, depend- ing on the local culture, socioeconomic conditions, food varieties and dietary preferences. However, all food markets should have one major thing in common – they should provide the community with safe and nutritious food. This essen- tial function is at the centre of the World Health Organization’s Healthy Food Markets initiative. Given the differences among markets, the implementation of Healthy Food Markets pilot projects will also differ greatly in various regions of the world. Therefore, this guide is intended as a basic orientation and reference point for developing a Healthy Food Market pilot project. While the principles in this guide do indeed apply to all markets, some markets may require flex- ibility for achieving their goals. Successful Healthy Food Market pilot projects are ones where the community comes together to work for a common vision of a safe and healthy market. Regardless of whether specific improvements can be achieved in one month, one year or ten years, working towards their vision of a Healthy Food Market will ultimately mean better health and nutritional status for everyone in the community. This guide is meant as a tool to help foster the Healthy Food Market vision among those who have truly come to understand that we are what we eat. 2 1Moy, G.G. Healthy Food Markets: an approach for ensuring food safety and environmental health, Food Control, 12 (2001) 499–504. 3 Introduction A majority of the world’s population now live in urban areas. This is the result of rapid growth of cities and peri-urban areas over the past few decades, particularly in developing countries. Health problems in many cities are aggravated because urban growth is often unplanned, uncontrolled, and under-financed. This has overwhelmed the capacity of many municipal authorities to provide basic health and environmental services and infrastructure, which are minimum prerequisites for a healthy population. A growing number of people in cities, particularly the poor, are experiencing stresses and exposures that result in health problems ranging from communicable diseases to chronic malnutrition. In view of the projected trends of increasing urbanization and deteriorating physical and social environments, WHO developed the concept of Healthy Cities in 1986 as a vital tool for assuring that health is explicitly considered in urban management and development planning through community empowerment. The objective of the Healthy Cities initiative is to improve the health of urban dwellers, especially those with low incomes, through improved environmental conditions and better public health services. The initiative operates by raising awareness of unsatisfac- tory environmental and health conditions and by mobilizing community participa- tion through partnerships with local (usually municipal) agencies and institutions. In addition to schools and workplaces, one of the most important settings in cities is the food market. Access to safe and nutritious food is essential for life and is indeed the foundation for health. The food market often serves as the commercial and social centre of communities, reflecting local culture and traditions of the people. Unfortunately, markets in some cases have also become associated with the spread of a number of emerging diseases. With this in mind, WHO began the promotion of Healthy Food Markets as an approach for promoting food safety and related environmental health issues.1 Interest in Healthy Food Markets has been substantial in recent years, with pilot projects being planned or implemented in all WHO Regions (see Map). This guide has been prepared to advocate Healthy Food Markets as valuable settings that can effectively improve food safety, nutritional status and environmental health in even the least developed countries. For those considering a Healthy Food Market pilot project, this guide also provides basic principles and practical advice on how to proceed. It has drawn on experiences from a number of ongoing projects and studies set within com- munities that have undertaken steps to improve their food markets. A case study of one such pilot project is provided in Annex 1. a guide to Healthy food Markets CITIES WITH WHO HEALTHY FOOD MARKET PROJECTS La Paz, Santa Cruz Bolivia Brazzaville, Congo Georgetown, Guyana Santa Domingo, Dominican Republic Alexandria, Egypt Port au Prince, Haiti Beirut, Lebanon Ulan Bator, Mongolia Boading, China Maputo, Mozambique Ibadan, Nigeria Port Moresby, Madang, Papua New Guinea Asunción, Paraguay Paramaribo, Suriname Dar es Salaam, Tanzania Hanoi, Hue,Hai Phong, Viet Nam Port Vila, Vanuatu Vientiane, Lao PDR Phnom Penh, Cambodia Marikina, Philippines Kuching, Malaysia It is expected that this guide will be used by all persons involved in Healthy Food Mar- ket projects, including local community leaders, food safety experts, health authorities, market vendors, and other stakeholders. Previous exposure to the concept of Healthy Cities, while useful, is not required. However, it may be helpful to become familiar with some of the Healthy Cities concepts in order to gain a broader perspective of urban environmental health problems. This guide can also be used by national authorities aiming to introduce the concept of Healthy Food Markets uploads/Ingenierie_Lourd/ healthy-markets-a-guide-to-food.pdf