SOCIETY: THE BATTLE FOR HEALTHY FOOD

Published January 3, 2021
Clockwise from top: The Punjab Food Authority team carries out an inspection in a milk shop in Lahore; pesticide residues in foods have been found to be beyond permissible limits across the country; a child receives nutrition treatment at a centre in Tharparkar 
| World Food Programme/Amjad Jamal
Clockwise from top: The Punjab Food Authority team carries out an inspection in a milk shop in Lahore; pesticide residues in foods have been found to be beyond permissible limits across the country; a child receives nutrition treatment at a centre in Tharparkar | World Food Programme/Amjad Jamal

For decades into its existence, food safety was simply not a priority for Pakistan.

The country did not have anything resembling a proper system of food quality regulation, with food security and nutrition being the primary focus of attention for policymakers. Laws relating to food safety had been on the books since the 1960s (notably the Pure Food Ordinance of 1960) yet, for decades, the bulk of food production and distribution networks were informal and beyond the limited capacity of the state to monitor and regulate beyond supply and pricing interventions.

The relationship between food safety and public health is, of course, undeniable. Food and waterborne diseases are the leading causes of illness and death in developing countries, killing an estimated 2.2 million people annually, most of them children.

Globally, the processes of urbanisation, growth of processed food industries and globalisation of the food trade have fundamentally changed patterns of food production and distribution, presenting new challenges for food safety and public health.

Less known is the economic cost: each year, the impact of unsafe food causes production losses of around 95 billion US dollars in low and middle-income economies. Unsafe food accounted for the loss of 33 million disability-adjusted life years (DALYs) in 2010.

Foodborne illnesses also contribute significantly to premature mortality and low life expectancy in Pakistan, including being a significant cause of child mortality and morbidity. Studies have documented the widespread prevalence of aflatoxins, pesticide residues, heavy metal contaminants and adulterants in foods beyond permissible limits across the country. Ingestion of food contaminants is also the potential cause of several chronic diseases, including malignancies and cancers.

As food imports and the processed food industry grew in the 1990s, the need for a system of quality standards was finally felt, resulting in the establishment of the Pakistan Standards and Quality Control Authority (PSQCA), under the Ministry of Science and Technology, through the PSQCA Act of 1996. The authority was tasked with prescribing standards for food products and food grade materials (as well as other items) at the national level, as well as consumer protection.

Pakistan has only recently begun to develop an effective system for food safety and quality. However, federal-provincial conflict over jurisdictions, pressure from the food and beverage industry and the threat of regulatory capture present major obstacles to ensuring all Pakistanis can access safe and nutritious food as a right...

The PSQCA adopted the Joint Food and Agriculture Organisation/World Health Organisation Codex Alimentarius standards programme for food quality and food trade, and adapted nutrition labelling and import regulations from the US Food and Drug Authority (FDA), with some additional local requirements added.

However, as is the case with many policy and regulatory frameworks in Pakistan, the enforcement of food regulations remained a distant dream. The PSQCA was a federal body with no administrative presence at the provincial or district level. With the exception of occasional factory visits by district administration officials and provincial food departments (which continued to focus on food production and distribution), no concrete system of inspections or monitoring existed.

Then came the 18th constitutional amendment in 2010, and the devolution of food regulation to the provinces, following which the provinces began to establish their own food regulation authorities. The first of these was the Punjab Food Authority (PFA), established through the Punjab Food Authority Act of 2011 “to ensure the availability of safe and wholesome food for human consumption” in Punjab.

The PFA marked the first systematic attempt by state institutions to create an enforcement system for food safety and quality in Pakistan. Empowered by budgetary allocations from an increased provincial resource pool, the authority soon established a regulatory presence, starting from Lahore, followed by offices in Faisalabad, Gujranwala, Rawalpindi and Multan and, thereafter, to the whole of Punjab.

The PFA soon began a regime of impromptu facility inspections and on-site sample testing, typified by the heavily-mediatised raids in factories and food production facilities conducted by PFA Director General, the ‘Iron Lady’ Ayesha Mumtaz, from 2015 onward.

In 2017-18 alone, the authority conducted 43,689 inspection visits across Punjab, shut down 747 centres due to various violations, served 25,000 improvement notices to various food businesses and penalised thousands with heavy fines for violations.

The threats of facility shutdowns and public censure through the media proved to be an effective deterrent and compliance with food standards soon began to improve.

Following the much-acclaimed success of the PFA, other provinces soon followed suit with their own food authorities. The Sindh Food Authority (SFA) was formed in 2016, the Khyber Pakhtunkhwa Food Safety and Halal Food Authority (KPFSHFA) in 2018, and the Balochistan Food Authority (BFA) began functioning in 2019 (though legislation for it was passed earlier in 2014).

The ‘activist’ DG of the Punjab Food Authority became the target of ‘corruption’ allegations — very clearly as a result of her making ‘enemies in the food business and among politicians connected with it’. In October 2016, she was sacked from her post, apparently under pressure from sections she had targeted.

The KPFSHFA was the first, after PFA, to establish an institutional presence and begin crackdowns on violations of standards and regulations. In the past year, the Sindh and Balochistan food authorities have also started to expand and play a more proactive role in their jurisdictions.

From 2018 onward, the food authorities began expanding their focus from safety to food composition nutrition and labeling as well, developing regulations for salt iodisation, wheat fortification and trans-fat elimination, training food workers in food safety and establishing nutrition clinics to improve the population’s dietary intake. For both Punjab and KP, the food safety / quality standards put in place were increasingly stricter and closer to FAO/WHO recommendations than those maintained by the PSQCA.

The new decentralised regulatory regime had its shortcomings too, however. Chief among them was the fact that varying standards were in place in different provinces and at the federal level, complicating enforcement and creating legal hurdles for implementation. Technical capacity and resource gaps continued to hinder some of the authorities, particularly in Balochistan and Sindh, and make them vulnerable to the same kinds of shortcomings that made the PSQCA ineffective at enforcement. There was, nonetheless, a marked improvement from the nearly-nonexistent quality regulation of the past.

Former PFA Director General Ayesha Mumtaz
Former PFA Director General Ayesha Mumtaz

Unsurprisingly, the new food regulation regime and its enforcers soon came under attack from the food and beverage industry. Unwelcome food inspectors, attempting to fine producers or confiscate adulterated products in the performance of their duties, started being harassed by irate industry personnel and even shot at with firearms. The ‘activist’ DG of the Punjab Food Authority became the target of ‘corruption’ allegations — very clearly as a result of her making ‘enemies in the food business and among politicians connected with it’. In October 2016, she was sacked from her post, apparently under pressure from sections she had targeted.

In April 2019, the Punjab Assembly Speaker, Pervaiz Elahi of the government-allied Pakistan Muslim League (Quaid) (PML-Q), called on the Punjab government to ‘rein in’ the PFA and limit their power to impose fines, claiming it was impeding economic activity in the province.

Meanwhile, multiple legal challenges from the food industry mounted against the regulatory actions of the provincial food authorities, principally using the argument that food standards, safety and licencing/registration were a federal domain, something the provinces vehemently contested.

Eventually, the matter of jurisdiction ended up in the Council of Common Interests (CCI). In a December 2019 meeting of the CCI, it was decided that food standards and licencing/registration would henceforth remain the exclusive domain of the federal government (under the Pakistan Standard framework) and the different provincial food standards would be harmonised by the PSQCA’s National Standards Committees (which would also include representation from the provincial food authorities) — a process that is now underway.

It was decided at the same meeting that enforcement would remain a provincial domain, which food authorities were naturally better placed to carry out, given their well-developed local presence as compared to the PSQCA. However, the decision to hand over licencing authority to the federal government took away both a revenue source and a key mechanism for provincial authorities to enforce regulations and penalise violators.

The government and the federal Science and Technology Minister celebrated the CCI decision as a landmark step that would improve ease of doing business in the country. It is indeed hard to argue with the fact that a uniform set of food standards would make for a simpler and common sense regulatory regime which would simplify both compliance and investment. There is also a compelling constitutional case for standards being a federal matter, as outlined in Part II of the federal legislative list.

The WHO-recommended regulation is either two percent of fat content or a PHO ban. In fact, a study by the Ministry of Health and WHO in 2019 had found local vanaspati samples to contain trans-fatty acids in the range of 14 percent to 34 percent of total fats.

However, for those working in the public health and nutrition sectors, it was clear this was also a lobbying victory for the food industry, which would now have to comply with less stringent federal standards and weakened provincial regulators.

An example of this dynamic was the case of vanaspati ghee standards. The PFA’s scientific panel had imposed a phased ban on partially-hydrogenated (PHO) vanaspati in the province (on account of its high levels of trans-fats, a toxin strongly associated with heart disease, which the WHO and medical scientists have deemed unhealthy for human consumption).

The Pakistan Vanaspati Manufacturers Association challenged the PFA’s impending ban in the Lahore High Court, arguing that the provincial authority was not authorised to determine food standards and claimed that the industry was already complying with the PSQCA’s TFA limit of five percent of fat content (the WHO-recommended regulation is either two percent of fat content or a PHO ban). In fact, a study by the Ministry of Health and WHO in 2019 had found local vanaspati samples to contain trans-fatty acids (TFA) in the range of 14 percent to 34 percent of total fats.

In July 2020, the court suspended the PFA’s ban and restrained them from taking any action against vanaspati manufacturers. If the PSQCA’s existing TFA regulations are maintained for the coming years, Pakistan will miss the 2023 WHO global deadline for TFA elimination, at the cost of tens of thousands of lives.

According to officials in the health ministry, the food industry is more comfortable with PSQCA being the locus of regulatory authority, as the industry is heavily represented in the federal authority’s various food standards committees (as opposed to provincial food authorities’ scientific panels which mostly consist of nutritionists and technical personnel). While provincial regulators with limited travel budgets often cannot make it to federal standards committee meetings, industry representatives, with few such constraints, are readily able to attend and have their will reflected in regulatory decisions.

When asked, provincial food regulators from Punjab, KP and Sindh express similar reservations about the centralising direction the food regulation system is taking, and fear their enforcement powers will be further clipped by a government eager to meet investors’ needs.

Provincial food regulators and health officials are generally supportive of the move towards harmonised national standards. However, they are rightly concerned about regulatory capture compromising legitimate issues of public health and food safety that affect the health of millions, and insist they should be able to enforce safety and quality standards without restriction.

In an anaemic economy with low growth and high food inflation, it might be tempting for Pakistani policymakers to relax standards and limit regulatory enforcement to protect the industry. But to do so at this stage would be a profound mistake that would jeopardise both public health and food security. Unsafe food, and the consequential disease burden it generates, cost Pakistan tens of thousands of lives and billions in health costs and lost productivity. As the pandemic has shown, particularly in the developed world, unhealthy diets can leave populations deeply vulnerable to devastating mortality from disease outbreaks.

Pakistan, with its growing rates of obesity, diabetes and heart disease, in addition to communicable foodborne diseases, is also on a dangerous trajectory which will undermine public health and continue to sap productivity.

Addressing this in the coming years will necessitate building on the progress at the provincial level in recent years, and require concrete evidence-based interventions in food safety and quality — from regulating additives and pesticide residues, to cracking down on contaminants, to affecting change in dietary habits, including measures to curb our excessive, growing and unregulated salt and sugar consumption.

Enforcing food safety and quality will not just improve population health — it will also strengthen the food industry in the long run and bring its products to par with international standards and best practices, improving their export competitiveness.

To achieve all this, Pakistan needs an empowered food regulation system that prioritises science over short-term economism and public health over profits.

As the government streamlines uniform national food standards, it must ensure they are based on scientific consensus and established without pressure from industrial interests, while strengthening provincial authorities responsible for enforcing them, and equipping them with the administrative authority and technical capacity to do so.

The writer is a researcher in development, public policy and public health who currently works as a senior researcher at Heartfile. He tweets @ammarrashidt.

Published in Dawn, EOS, January 3rd, 2021

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