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Food for thought

How safe are some of the genetically modified food that are now being marketed in the Third World countries?.

Health Ministry appointed a special committee headed by Prof. Rohan Jayasekera head of the department of Anatomy and Head of the Human Genetics Unit of the Colombo Medical Faculty in August last year (8.8.2001 to be exact) to review the existing food regulations in the country in relation to G.M. Foods.

The four member committee after nine months of deliberation and hard work handed over its report to the Health Ministry in May this year.

Health Watch has been able to get the recommendations of the committee, with some other details relating to the issue.

The report is yet to be implemented. Today we place before our readers the recommendations of the committee with a few other details on the subject.

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Food act No. 26 of 1980

In Sri Lanka, the Food Act No. 26 of 1980 contains the laws and provisions for regulations in food safety. The Ministry of Health is the implementing organization. The Food advisory Committee (FAC) is the statutory body to advise the Minister of Health on matters arising out of the adminstration of this act and to carry out other functions assigned to it under this act.

The Food Advisory Committee having studied the issues relating to Genetically Modified (GM) foods for over one year, forwarded the recommendations to the Minister of Health, and the Minister having approved the recommendations, issued a Gazette notification cited as Food (Genetically Modified Foods) Regulations - 2001 on the 6th April 2001 (Annex 2). The regulations were to come into operation from 1st May 2001.

The regulations prohibited the import, manufacture for commercial purposes, transport, storage, distribution or sale, offer for sale of any food, raw or processed or any ingredient of food, food additive that has been subjected to any genetic modification using DNA recombinant technology, or any food that contains one or more ingredients, preservatives or additives that have been subjected to gene modification.

In addition, a list of 21 items were identified and the importation of such were prohibited without a certificate from an accredited laboratory or a competent Government Authority, certifying that the food product does not contain any material or ingredient that has been subjected to genetic modification.

The permanent mission of Sri Lanka to the United Nations raised the compatibility issues with the World Trade Organization (WTO) agreements to which Sri Lanka is also a signatory.

The Food Advisory Committee established a sub committee under the Food Act No. 26 of 1980 for monitoring and regulating Genetically Modified and Engineered Foods and other related matters on the 6th June 2001. This committee had their first meeting on the 22nd June 2001.

A second Gazette notification (Annex. 3) was issued on the 26th June 2001 rescinding the previous Gazette notification and citing new regulations as "Genetically Modified Foods" (Provisional) Regulations which would have come into operation on the 1st September 2001. These regulations carried the same prohibitions and the list of food items, which were in the previous Gazette.

In the second Gazette notification, the regulations were stated as provisional because the regulations stipulated in the previous notification did not comply with Article 5 of the Sanitary and Phytosanitary (SPS) agreement.

The attention of the Government of Sri Lanka was drawn to some of the representations (Annexes. 4 and 5) made by various governments, international agencies, institutions, importers, manufacturers and distributors on the regulations imposed. Considering the fact that some of these representations deserved to be carefully considered, the Ministry of Health appointed this special committee (Committee to Review Regulations on Genetically Modified Food) on the 8th August 2001.

A third Gazette notification was issued on the 30th August 2001 deferring the previous Gazette notification, "The Genetically Modified Foods (Provisional) regulations No. 1 of 2001" until further notice, pending the report from the Special Committee to Review Regulations on Genetically Modified Foods.

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Recommendations of the G.M. Food review committee

Examine case by case basis

The Food Advisory Committee should examine on a case-by-case basis, all the available information and certificates for approval or prohibition, for the commercial release (imports and local production) of Genetically Modified Foods, Organisms, Seeds and Materials.

Testing facilities urgently needed

Sri Lanka should immediately develop appropriate testing facilities and methods of risk assessment for GM Foods, Organisms, Seeds and Materials.

Unsafe GM foods be banned

Should the food advisory committee following careful scrutiny and analysis of all data pertaining to a particular Genetically Modified Food, Organism, Seed or Material conclude that it is unsafe to health, then a ban should be imposed on the importation, manufacture for commercial purposes, transportation, storage, distribution, sale or offer for sale of that product.

Set up efficient effective data base

A continuing process of collection and analysis of scientific data should contribute to the establishment of an efficient and effective database. The building of an analytical laboratory and the recruitment and training of high calibre personnel should be recognized as a priority in the area of food safety.

Be appropriately labelled

If Genetically Modified Foods, Organisms, Seeds or Materials are tested and if approved, it should then be labelled appropriately according to international guidelines. Such labelling should be mandatory. There should be provisions in the regulations for the consumers to take legal action against producer/ importer if the guidelines are not adhered to.

Health education on GM foods

Health Education programmes should be implemented to instil and improve knowledge and awareness of Genetically Modified Foods.

Rigorous monitoring of GM foods

There should be regular and rigorous monitoring of market foods for genetically modified origins.

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Conclusions

Report of the committee appointed by the Ministry of Health to study and review Genetically Modified Food Regulations in Sri Lanka.

Strong food safety regulations needed

In Sri Lanka, food safety is an area which needs a considerable amount of strengthening and regulation. Genetically Modified Foods is a new concept to most of the public. Considering the ongoing debate among the international scientific community and inconclusive and controversial reports on safety of such foods, Sri Lanka is also facing a dilemma similar to other developing countries.

Currently no bans but regulated

According to the available data, currently no country has imposed a total ban. Almost all countries have adopted regulatory mechanisms by way of registration, risk analysis, risk communication and mandatory labelling.

Our regulations lack scientific substation

The regulations imposed in Sri Lanka, which are currently, suspended, are too general and lack firm scientific substantiation. The issue of Genetically Modified Foods has to be addressed in a holistic manner and from a viewpoint of food safety and not merely as genetic modification.

Acceptable regulatory mechanisms needed

There should be an acceptable process of regulatory mechanisms in place. A formal procedure of risk assessment based on sound scientific backing is of paramount importance. The procedures and the process involved should be transparent and should involve all stakeholder.

The committee concludes

The Government of the Democratic Socialist Republic of Sri Lanka and her citizens should have an absolute right to determine the levels of environmental, health and safety precautions. Food safety and Public safety have to be considered as top priorities.

The regulations imposed which are currently suspended are too general, and lack firm scientific substantiation. The issue of GM Foods has to be looked into in a holistic manner and from a viewpoint of food safety and not merely as genetic modification.

Sri Lanka needs to take into account its international trade commitments in the form of WTO agreements. There is considerable disagreement on the advantages and disadvantages of Genetically Modified Foods within the scientific community.

The need to establish a mechanism with an associated formal process of risk assessment based on sound scientific backing is of paramount importance. The guidelines and the processes involved should be transparent and should involve all stakeholders.

Risk communication and the role of the Media need to be addressed in a sensitive and professional manner. Development of Health Education programmes to instil and improve knowledge and awareness of GM Foods is an essential prerequisite.

An ongoing collection and analysis of scientific data is a necessity. Risk management options have to be explored and analytical laboratory and personnel capacity building has to be considered as a priority in the food safety area.

The consumer's right to know, has to be respected at all times. Taking into consideration procedures and processes adopted by other countries, Sri Lanka should also implement strict mandatory labelling regulations.

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Committee

Appointed members

Professor Rohan Jayasekara, Professor of Anatomy/Head Department of Anatomy and Head - Human Genetics Unit, Faculty of Medicine, University of Colombo, Chairperson.

Mr. M. G. Hewage, Director General of Commerce, Department of Commerce, Member. Dr. Nandanie Ediriweera, Head/Manager (Food Products Development Group), Agro and Food Technology Division, Industrial Technology Institute (Successor to the Ceylon Institute of Scientific and Industrial Research CISIR) Member.

Dr. H. A. P. Kahandaliyanage, Senior Assistant Secretary (Medical Services) Ministry of Health, Secretary.

Co-opted members

- Professor Herbert A. Aponso, Emeritus Professor of Paediatrics, Faculty of Medicine, University of Peradeniya.

- Mr. BWMD Bandara, Senior Agronomist, Second Perennial Crop Development Project, Department of Agriculture, Peradeniya.

- Professor Upali Samarajeewa, Senior Professor, Department of Food Science and Technology, Faculty of Agriculture, University of Peradeniya.

- Professor Athula L. T. Perera, Professor of Agricultural Biology, Faculty of Agriculture, University of Peradeniya.

Co-ordinator

Dr. B. K. R. Batuwanthudawe, Medical Officer, Ministry of Health.

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Question Box

Dr. D. P. Atukorale, consultant Cardiologist and Member, Health Watch Medical Advisory Panel answers

Cholesterol levels are very high

Q. Mr. B. D. E. Silva who is 57 years of age from Wattala has done a lipid profile test and says "I see my cholesterol levels are very high. Kindly enlighten me on this matter".

Mr. Silva's lipid profile report is as follows: Total cholesterol (T.C.) 278.4mg/dl; Triglycerides (T.G.) 339.2mg/dl; HDL 40.5mg/dl; V.L.D.L. 54.3 mg/dl; LDL 183.6 mg/dl and cholesterol (T.C.)/HDL ratio 6.9. Reply I fully agree with you that your T.C., T.G., LDL, VLDL and T.C./H.D.L ratio are all high. In addition to above your H.D.L. is on the low side which I think is associated with your high triglyceride level.

No physician will ever treat a lab report without examining the patient. Therefore kindly see a physician and get a check-up. Your physician will take a clinical history with a view to exclude excessive alcohol consumption, and diseases such as hypothyroidism and diabetes mellitus. I am sure he will take a family history of coronary artery disease as certain types of hyperlipidaemia. (conditions with high cholesterol and triglycerides) are familial and gives rise to heart attacks in close relatives.

Your physician will do a thorough physical examination and order certain tests such as thyroid profile, fasting blood sugar (F.B.S.), E.C.G, urine full report and any other tests depending on the physical findings. If all above tests are normal, your physician will diagnose your hyperlipidaemia as primary hyperlipidaemia and he may do one of 2 things: (a) He may prescribe a low saturated fat, low cholesterol diet and a low calorie diet if you are obese.(overweight).

or (b) Your physician may refer you to a dietician who are experts in this field of hyperlipidaemia with regard to diet.

If you have been taking alcohol (ethanol) you will be advised to either reduce the ethanol consumption or give it up if your liver function testes are abnormal.

Your physician will advise you to do regular exercises such as brisk walking or bycycling or swimming at least 4 times a week. He will advise you to give up smoking if you are a smoker. Your physician will also advise you to get lipid profile tests for your children, brothers and sisters etc.

After about 2 to 3 months of above diet and regular exercises, your physician will arrange for another lipid profile test from the same lab and if the lipids are still high he might start you on cholesterol-lowering drugs and get you down to see him in about one month with another lipid profile report and liver function tests (as cholesterol-lowering drugs can cause liver function abnormalities).

If the repeat lipid profile is still abnormal he may change the cholesterol-lowering drug or drugs. If you are a case of primary hyper-lipidaemia, you will have to take above drugs, lipid lowering diet and regular exercise for the rest of your life.

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The best hospitals in India

In a recent survey conducted in India by the Centre for forecasting and Research (Cfore) to categorise the best hospitals in India both in the state and in the private sector the following six have topped the list.

Cardiology - Escorts Heart Institute & Research Centre, New Delhi

Gastroenterology - All India Institute of Medical Sciences, New Delhi

Infertility - Institute of Reproductive Medicine, Calcutta

Mental Health - National Inst. of Mental Health and Neuro Sciences, Banglaore

Eye treatment* - Sankara Nethralaya, Chennai

Cancer Treatment** - Tata Memorial Hospital, Mumbai.

* Ophthalmology, ** Oncology.

Sent to health watch by Dr. Viraj Peramuna MO Batticaloa Base Hospital.

Methodology

Cfore conducted the study-in Delhi, Calcutta, Chennai, Bangalore, Hyderabad and Mumbai between January 2 and May 10, 2002. Hospitals offering specializations in the areas of cardiology, gastroenterology, infertility, oncology, ophthalmology, and mental health were chosen to be ranked.

A preliminary survey was conducted among doctors to identify top hospitals, parameters and corresponding weightage for evaluation.

Five parameters were identified:
Competence of doctors (weightage 0.3)
Infrastructure and facilities (0.3)
Value for money (0.2)
Attention to patients (0.1) and cleanliness (0.1).

The weightages were based on the importance given to each parameter by doctors surveyed. A questionnaire was designed and after pretesting, administered to doctors of different specializations.

In all, 679 doctors were contacted. The respondents were asked to rate the hospitals they were familiar with on a 10 point scale. Each hospital was evaluated by at least 10 doctors for a particular area of specialization. The hospitals were ranked passed on the aggregate score.

A similar exercise was followed to rank the top five hospitals in different disciplines in the country. The project team consisted of Premachand Palety, Dr. A.K. Sengupta, Dr. Balmiki Bhattacharya. Dr. Meenakshi Sharma, Naveen Bhatt, Tanmay Kumar Pradham, Ajay Kumar, C.K. Devassay, Lakshmi Shobha and Priya. The data was vetted by Dr. K.T. Bhowmilk, and Dr. Sandeep Bansal.

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Copyright 2001 The Associated Newspapers of Ceylon Ltd.
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