Food Safety in Cambodia: Current Programs and Opportunities

This burden of disease is predominantly comprised of diarrheal diseases, with the incidence of acute diarrhea ranging from 11% among the wealthiest to 18% among the least wealthy quintiles of the population. The etiological agents responsible for most cases of diarrhea in Cambodia are unknown, with comprehensive data on etiological agents for foodborne diseases scarce. Officially recognized foodborne disease outbreaks have occurred throughout the country, resulting in large-scale outbreaks with associated fatalities. For example, from 2014-2019, Cambodia officially reported 135 foodborne disease outbreaks, resulting in 5,825 individual cases and 81 deaths. Recent high-profile outbreaks have involved methanol poisoning, parasitic infections, and contaminated food products. However, these data represent only confirmed cases, and the true incidence of foodborne disease is likely several orders of magnitude higher due to limits in surveillance, diagnostics, and epidemiology. The Cambodian government has established a framework for food safety governance, with the Food Safety Law of 1997, the Law on Cambodia Standards of 2011, and the Law on Management of Quality and Safety of Products and Service of 2018, among others. The country has also developed a newly drafted Food Safety Law, which is expected to be approved in the coming months. At the federal level, food safety is managed by six Cambodian ministries, each with different food safety responsibilities or jurisdictions. The six ministries coordinate their efforts through the Food Disease Outbreak and Investigation Response Team (FORT), which spans across different agencies. The ministries have also formed a Food Safety Technical Working Group, with representation from each ministry, and a national task force on risk assessment. Additionally, the Cambodian government has developed Rapid Response Teams (RRTs) to better identify and address outbreaks at the provincial level. The level to which these RRTs focus on foodborne disease outbreaks is unclear, but the country has developed several innovative reporting systems, including toll-free reporting systems, to identify smaller outbreaks. The MOH Communicable Disease Control Department (CDC) releases weekly incidence reports through their CamEWARN program, providing valuable data on foodborne disease outbreaks. However, there is a clear lack of data on etiological agents for acute diarrheal diseases, as well as chronic exposure to foodborne pathogens and foodborne illness that may not result in hospitalization. Malnutrition and associated effects, such as stunting, are significant challenges in Cambodia, and it is currently unclear how foodborne disease contributes to these challenges.