 All right, I think we can go ahead and start in my clock at least. It says it's 12.30 in Central European time. So good morning, good afternoon or good evening, depending where you are joining us today. And thank you for taking the time of this usually very busy month of the year to attend this webinar. This month we have Dr. Mohamed Mousif with us. He'll be speaking about strengthening global health security and his work in the International Health Regulations or IHR. Dr. Mousif is the Chief Medical Officer at Casablanca International Airport and the National Coordinator of Morocco's Point of Entry program. He's also a fellow and a graduate of the Central Global Health Security in the Chatham House in London. And he has done a very impressive amount of work regarding this topic, the IHR, and he has joined a few 11 joint external evaluation missions of WHO across different regions. Besides many other titles and awards that he has, currently is a World Bank Pandemic Fund Technical Advisor, final member, and he has been working very closely with the US and US Department of State's Global Health Challenges International Visit Leadership Program. So we are very pleased to have him with us today and that it took the time to attend this webinar despite so much work and traveling. So just before I pass the floor to him, a quick outkeeping rules, please, next slide, to give your microphone on mute, please. If needed, rename yourself with your organization and country, follow by your name. The views presented by Dr. Musif in this game are his own and not FAO's. Please refrain from advertising or services your company or any commercial product or brand and post your questions in the chat. So this webinar series is called Knowledge Dissemination Dialogue and we use the word dialogue precisely because of that we always ask the speakers to make the presentations relatively short, about half an hour, to allow about half an hour for the dialogue or the discussion in the end. Do keep in mind that the meeting is being recorded and at the end we will share this PowerPoint that will be presented, some additional resources, and all of this will be posted in the FAO YouTube channel and other traditional dissemination channels. So I'll stop here, Mohammed and the floor is all yours and please share your screen. Thank you very much. Thank you. Thank you so much, George. I'm really and truly honored by your kind introduction. And by the way, I'd like to commend this series for, because it's timely and very relevant on critical topics such as food safety, antimicrobial resistance and zoonotic diseases. So as you know, these technical areas intersect at the interface of one health within the framework of global health security and the IHR, the International Health Regulations. So without further ado, I will share my screen. Can you see my screen? Okay. Thank you. So food safety management at borders is essentially for ensuring global health security and meeting the WHO, IHR and FAO requirements. It involves risk assessment, inspection, certification, collaboration and capacity building to prevent the entry of unsafe food products and at the end of the day to protect public health. As everybody knows now, due to the skyrocketing growth of travel industry, the provisions of millions of meals daily by airline companies, by catering establishments and cruise ship fleets is best testament to the vast scale and complexity of the global health travel industry, not only in terms of logistical efficiency, but also in terms of tangents adherence to food safety regulations and standards. So the spread of foodborne diseases during airlines' flights and cruise ship trips has occurred in the past, but due to the proximity of passengers, due to the complex logistics of providing food and beverages, creating opportunities for the transmission of food world pathogens. But besides meals served in air transport and maritime transport, this presentation will touch also upon regulatory requirements regarding imported and exported food, food products through borders, when borders mean points of entry or ports, airports and ground crossings. So first, let's start by the IHR. So the title of the presentation refers to the IHR. IHR is a legally binding instrument for WHO and its member states to prevent detect and respond to public health threats. So it's international commitment, it's international legally binding instrument. The IHR entered into force in June 2007, and it contains a certain number of rights, obligations and procedures for WHO member states and for WHO secretariat itself. So if I may, the soul and the spirits of the IHR, the IHR and next two, sorry, the IHR article two, sorry. So the IHR article two stipulates very clearly that's the purpose of the IHR is to prevent detect against control and to provide public health response to international speed of diseases, but in the way that are commensurate with and restricts public health risks. It means without any interference with international traffic and trade. This is to avoid the unnecessary interference with international traffic and trade is in line with other requirements from IKO, which is the International Civil Aviation Organization, another UN agency specialized in civil aviation and AMO International Balancing Organization. As you know, borders are governed not only by national regulatory framework, but also by standards and recommendations from these two UN agencies, IKO at airport and AMO at ports. The IHR 2005 law was adopted in May 2005 during the World Health Assembly, but the ancestor of this IHR was the international sanitary regulations followed by the IHR in 1951. And there are lots of differences between the current IHR and the previous IHR, especially the latest one, the IHR 1969. The IHR 1969 was about reporting six diseases which were later on reduced to only three diseases. Points of entry according to the IHR article one means a passage for international entry or exit of travelers, baggage, cargo containers, conveyances, goods, and postal parcels. So this is the definition mentioned in the IHR regarding points of entry. So it comes to international ports, airports, and ground crossings on land borders between neighboring countries. The IHR is about three pillars, if I may say. The first pillar is about the risk management, which means the capacity and implemented the ability to early detect any suspicious regarding public health facts. The second pillar is the risk assessment. It means it evaluates these findings in consultation with national public health authorities and the WHO original office. And the third pillar is the event management. It means the response on responding to these public health threats. If the requirements are met, and generally speaking, these requirements are in line with decision instruments contained in the IHR and X2. These are the IHR provisions addressing or dealing with international travels and transport and dealing with points of entry. So more of the health of the IHR document is dealing with international travel and trade. The current IHR 2005 is very different from the previous versions of the IHR. As you know, currently, WHO and the WHO member states are working on the amendment of certain articles of the IHR. So the next assembly in May 2024 will decide about adopting these amendments or not. But for the time being, the new IHR 2005 introduced the notion of the IHR national focal point, the broader scope. It means that IHR is dealing with any public health threats, not only biological or due to infectious communicable diseases, but also chemical, radionuclear, natural disaster and food safety. So as I mentioned earlier, there is a paradigm shift between the previous IHR and the current one from control of borders to containment at source, from restricted list of diseases to all threats and from preset measures to adapted in real-time response. But the issue is to really find the right balance between the minimum interference with international transport and trade and the maximum public health security, which is, as I said, the soul and spirit of the IHR. This is the IHR contents. The IHR is made of 10 parts, 66 articles and nine annexes. So the scope has been expanded from cholera plague and yellow fever to all public health emergencies. They include those caused by infectious diseases, but also chemical agents as active material and contaminated food. So as you can notice, contaminated food is really at the center of the IHR requirements. It is not sufficient to adopt the IHR. It is needed also to implement the IHR requirements in terms of strengthening national capacities regarding early detection, reporting, response, not only at national level but at points of entry level also. It comes to strengthening international capacities in terms of collaboration, coordination, communication between member states and IHR. And also it provides the opportunity to establish systems and procedures regarding legal advices, creating of committees like the IHR emergency committee, the IHR review committee, the roster of experts, and different other related reports. So as you can see in this slide, according to the IHR annex one, the potential hazards are infectious diseases, zonosis or zonotic diseases, food safety, chemical, and radionuclear threats. These potential hazards are dealt with across eight core capacities related to the IHR. So each one of these potential hazards deals with across these capacities. For example, food safety, there is a need for surveillance, coordination, legislation, this communication laboratory, and so on. The IHR annex one, dedicated to the points of entry, superlates very clearly that there are two types of activities at points of entry, routine activities and activities during public health emergency of international concern. And you can see clearly that among the routine activities, so the assessment of eating, establishment, flight, catering, companies or facilities are at the center of the routine activities of the IHR. These are the activities during public health emergency of international concern. There are SOPs, standard operational procedures to be implemented at points of entry. And the first one is of course SOPs related to food safety control measures at points of entry. As I said during the introduction of this presentation, at points of entry, we have millions of meals provided at onboard cruise ships and aircraft, but also we have imported and exported food products. This is the flow of information from the points of entry to the WHO. And points of entry, according to the IHR Article 4 and Article 22, are parts and parcel of the national surveillance system. To the extent that information gathered at points of entry, whether at ports, airports, or rail crossings, should be transmitted to the points of entry competent health authority to the IHR national and to the counterpart of the IHR national focal point at the WHO original office, to be assessed in 24 hours. And to open the assessment, the decision will be to respond to this public health emergency or not. The IHR is monitored and that's why we call the IHR monitoring and evaluation framework. And within this framework of monitoring and evaluation of the framework, there are four components. The first one is the IHR joint external evaluation, which is peer-reviewed evaluation between the member states and external evaluators. There is also the state party annual reports after action review and simulation exercise. The IHR joint external evaluation regarding the technical area, the food safety technical area is about the surveillance of foodborne diseases and contamination through indicator business surveillance and event business surveillance and through lab analysis results. It's also about the surveillance of foodborne diseases and contamination through the development and the implementation of national food safety emergency plan, the infosan emergency contact point, and the WHOHA or focal point on animal production food safety with the central coordination mechanism in place. Regarding food safety in air transport, so as you know, large flight catering facilities serve major international airports, so handle millions of meals per day. So these facilities are equipped and there are very stringent food safety standards to be followed as we can see here. So first we have to define the food safety management system. So the food safety management system provides a structured approach to ensuring the safety of food and enable the apparatus to identify the points in the food chain that are likely to have the most effective impact of the safety of the final product. So it is made of two parts, the accountability and the HACCP. HACCP is the Hazard Analysis Critical Control Point. Concept is very common contacts in the area of the food safety. So it's a systematic approach to identify and to assess food safety hazards and defining the means of their control. So as a management tool, the HACCP provides this approach to control and identify the hazards and to focus on prevention at every step of production rather than detecting unsafe products at the end of production. To support the HACCP system, there is a need for SOPs or support programs. So these support programs are also sometimes described are good practices or good manufacturing practices. It includes but only limited to supplier approval, personal hygiene, training, pest control, cleaning, sanitation, calibration and so on. So the support program are normally in place before the HACCP system is developed. This kind of list of SOPs or support programs, it might include product design to be assessed, health monitoring, supplier approval, as I said, hazardous means, ingredients, pest control, instrument calibration, physical contamination, stoke rotation and so on. There are many examples and many templates regarding the SOPs. So in this diagram, we can see the product at kitchen facilities at airports, for example, following the HACCP approach. There is a product design purchasing, but I'd like to put the emphasis on this one, the Chilean CCP, because it's not this step. It's not found at regular and usual kitchen at hotels or restaurants. It's very specific to the aviation. It's called the blast Chilean. This process rapidly reduces the temperature of hot food to a safe level, preventing bacterial growth and preserving the texture, the flavor and the nutritional quality of the food. And it's very crucial to ensure that in-flight meals maintain their quality during storage and reheating on the aircraft. So preparing meals for in-flight meals for passengers is very different from meals prepared in restaurants or hotels because of these steps. At cruise ships also, it's very different. So at cruise ships we have the assessment of food safety is part of the Ship Sanitation Certificate. So public health staff at ports deliver public health ship certificate based on assessing some predesignated number of areas. So it's really a frantic race against the clock for these public health officers or environmental inspectors to assess all the at-risk areas, if I may see, and in record time and to provide what is called the Ship Sanitation Control Exemption or Control Exemption Certificate. So and you can see here, it's the WHO IHR document. It's an X3 of the IHR. The first areas to be inspected are the galley, the pantry and the stores. So if there are findings, they had been mentioned here in the in these columns and comments regarding the conditions. If there is no finding, they issue this one. So the galley, pantry and service areas on board ships. So the requirements or the criteria to be controlled are temperature of perishable food, infected food handlers, cross-contamination, heat treatment of perishable food, contaminated raw ingredients, the use of non-possible water in the galley. So and it's subject to international standards and recommendations. As you can see, the products elementary is commissioned, which is a collection of internationally adopted food standards by FAO and WHO. So it's presented in uniform manner. It's also include advice in the form of codes and practices guidelines and other recommended measures. The ILO, maritime labor convention, regarding food and catering, each member state shall ensure that ships that fly its flag meet the minimum standards. There is also the ILO number 68, food and catering ships and the ECCP system. The main risks are biological hazards, chemical hazards and regarding equipment and instances. Decuments to be reviewed. So the cleaning schedule and logs, the purchase records, the food storage in-out record, the drainage construction drawings, previous inspection reports, the pest log book, the temperature records. Regarding imported and exported food, as you know, the national regulations supersede the international regulations in this regard. And there are the documentation requirements regarding food safety. So importers and exporters of food products are typically required to provide specific documentation related to the safety and quality of the goods. So the national requirements can include the food safety regulations. When we see food safety regulations, it's referred typically to national food safety regulation governing food products production, processing distribution, and compliance with these regulations is essential for both domestic production and imported goods. Level in requirements. Countries often have specific level in regulations that dictate how food products should be labeled regarding ingredients, regarding nutritional information, allergens, and other details. Customs documentation, very important, the clearance, the release of the food products is subject to the clearance from customs, as you know. So and customs, generalists can require specific documentation for importing and exporting goods like invoices, certificates of origin, certificates of analysis, and other relevant paperwork. Import permits and licenses, also regarding certain types of food products. Importantly to obtain this document to ensure that products meet the important and country standards, quarantine and inspection. Some countries have quarantine and inspection procedure. So to assess the safety, the quality of imported food, it may involve just the physical inspections and in some cases laboratory testing and adherence to specific import protocol. Recibility and local systems, very important also to be enabled to track food products towards the supply chain. Countries may require manufacturers to have local systems in place for prompt action in case of safety issues. Regarding the international requirements, the Codex Alimentarius Commission, of course, we just touched upon it, the IHR, which is a global framework that aims to prevent the international spread of diseases. The WTO World Trade Organization, so regarding the agreements on the application of sanitary and phytosanitary measures to address standards of food safety, animal and plant health. The international trade agreements, also bilateral and multilateral trade agreements often include provisions related to importing and exporting food products. Harmonized system codes, also managed by the World Customs Organization. It's an international nomenclature for the classification of products. And finally, the Global Food Safety Initiative, which is private and sector initiative, so which sets global benchmarks for food safety management. The ISO, or International Organization for Standardization, which develops international standards, including those relating to food safety. For example, ISO 22,000. There are challenges and considerations regarding imported and imported food, primarily different standards, which means variations in national regulations and standards which can pose challenges for exporters requiring adaptation to meet the specific requirements of each important country. Documentation and certification, which means there is a need to strict adherence to proper documentation and certification, enabling smooth customs clearance and compliance with import regulations. Risk analysis, countries make conduct risk assessment to evaluate the safety and compliance of imported food products and exporters need to provide relevant data for such analysis. And finally, the supply chain transparency, which means there is more and more demand for transparency in the food supply chain, with some countries requiring information on sourcing, production methods and sustainability practices. And thank you for your attention. Over to you, George. Thank you very much, Mohamed. It's very, very interesting and impressive. I must say that the missions that we did together on the Joint External Evaluation Missions and the evaluation of the point of entry, we all travel so much, but once you see with those eyes, with those lenses, you look at airports in a different way. How much is happening in an airport? How much can happen in an airport? You will have to write the book of your memories of things that happened in airports and what you have found and controlled in airports. So thank you very much. And the international health regulations, it's really an interesting document or two that it's a reference thing to the world. We got a question on the chat. How can I get this presentation? The presentation will be shared in our YouTube channel, for example, and we seen it after the webinar, together with some additional resources that Mohamed came, we'll share with us also in it afterwards. If you have any other questions or got one, let me see. I read it out to you, Mohamed. So colleague is saying, have you worked in a border inspection post? Then being responsible to control catering at the border? I'll be very interested to know how the food and material return from international or national fights. I guess it's what happens to these out of the food and material return from international fights. What happens to these? Are they destroyed? What does it come back in the food circle preparation, not the food at home? But how do they control the watching and the disinfection of the jewelry that come back to the catering? So I don't know if it was clear. If you want, I can repeat Mohamed is that what happens to the food that comes in and out from international and national flights? Is it destroyed? And about the disinfection or washing off the trolleys where the food comes from the caterers? Yes. Yes. Thank you for this question. Actually, when there is evidence that the food is contaminated, the airports or the post authority, the post operator, as you know, at points of entry, we have ports and airports operator, which are agencies under the government or private agency. So it's up to the countries to decide of having a public operator or private operator. So this operator stands for the coordinator between the different stakeholders at points of entry. As you know, points of entry concentrates a huge number of different relevant stakeholders, customs, airlines, companies, maritime agents, immigration, law enforcement agencies. And these different stakeholders are brought together within a facilitation committee or security committee. And in the framework of this well regulated and environment, which has a point of entry, these commissions have under the national law to conduct destruction by incineration of any other relevant method of contaminated food. So it's very procedural and they have to sign so the report regarding the restriction of contaminated food and to provide the evidence that this food is really contaminated or infected based on lab results, based on physical inspection and the public authority. Of course, it's the first agency in charge of providing the evidence and participating in this committee as a full member and to conduct, to supervise the process of destruction of contaminated food. Thank you very much. Next, we have two other questions. One is from our colleague in the region of Latin America and Caribbean congratulating you from your presentation. And then the issue about that you mentioned in your challenge is the different standards and what it means to the equivalence of the different food control systems. If you could, the question being if you could please mention something to the effect of the DBT's technical barriers to trade and equivalence. I did understand the meaning of the standards. What's what's the different standards? Is there any different standards or the international standards that exist? Yes, actually there is international framework, international template provided by WHO FAO and other relevant international agencies and the national. As I mentioned earlier, the national regulations supersede and have the priority over the international standards in the framework of the sovereignty of the countries. The countries are sovereign and they can implement the regulatory framework or that they see fit for purpose. So, but basically and originally speaking, national standards are inspired and very influenced by international standards from UN agencies. So these international standards are adopted as as a ministerial decrease, for example, or other regulatory framework and are implemented by public authorities and and and agriculture or a ministry of agriculture authority and also by animal sector authorities. So it depends on the regulation of the country and at at at ports, airports and and ground crossings. There are differences due to the specificity and peculiarity of and idiosyncrasies of points of entry. As I said earlier, the points of entry are parts of national and international territory and they are governed by IKO IMO regulations also. And most of the time, these standards at points of entry should be in line with security and safety issues at points of entry. So for example, we can't we can't start, we can't have in fire to destroy contaminated food near near the aircraft or near the runway or and we have when we have smoke, we have to alert the companies about the smoke and so on. So there are other imperatives and other requirements and other obligations under the safety and security of points of entry themselves. But generally speaking, the standards regarding food safety are the same worldwide and and it's about about the right temperature, about the storage and other requirements regarding the food and hygiene, not only for food, but also potable water, given that potable water is part of the ingredients used to to prepare meals. All right, thank you very much for that. Then we have a question very close to our main areas of work and that's immatically support to ask. So could you envision at some point that AMR, chemical resistance, would be considered under the IHR regulations as a contaminant or health risk, for example? So the envision at the AMR will become part of the IHR regulations? Yes, of course. The AMR cross-cuts or intersects food safety and zoonotic diseases and in friction prevention and control. So whenever we have flows, we have dysfunctions, whenever we have gaps regarding food safety, regarding zoonotic diseases, so regarding also infection prevention and control, it might be leading or contributing to the AMR, so antimicrobial resistance, development and creation. So and at airports and ports, we have the issue of food safety. We have zoonotic diseases, as you know, all the pandemics and epidemics dealt with so far are from the origin from animal kingdom, whether it comes to Ebola, to the COVID, HIV, these are viruses jumping from the animal, from animals to humans due to the climate change, due to the deforestation, due to over urbanization. So we have to expect in the future more zoonotic diseases due to this issue, unfortunately, and infection prevention or control within medical facilities or public health hospitals and also infection prevention and control within the medical services at airports and ports. So all these issues are intricate and the conjection and having these issues together will lead, unfortunately, to AMR. All right, thank you. Mohamed, we have a comment from our colleague at HQP, let's see if I can read it. Would be interested in your experience in the relation, regulatory relation, between the competent authorities, relevant for food, Minister of Agriculture and Health and Customs. I wonder if you have come across some impact of the trade facilitation agreement on the existing relationship between these institutions. Between the competent authority. Related with food, Minister of Agriculture and Health and Customs. Yes, of course. Of course, at airports, as I said, customs issue the clearance for the release of goods, whatever the nature of goods, but this clearance is based on approval of relevant sector. For example, when it comes to animals to issue the clearance, they need the approval and the approval from the Ministry of Veterinary Authority, Minister of Agriculture, Fisheries and Animals. When it comes to vaccines or medical products, they need the approval of Minister of Health and so on. When it comes to, for example, mechanical or appliances, technology, technical appliances, they need the approval from the Ministry of Industry and so on. They can't be specialized in all areas, in all technical areas. So accordingly, there is always coordination and at points of entry, we called it a single window. The single window brings together all relevant stakeholders with their ministries, with their private companies, the forwarding companies, Minister of Health, Food Authority and when it comes to imported and exported food, all the documents regarding these importations and importations are reviewed by different stakeholders and each one will issue the relevant approval regarding the exportation or the importation and the customs is part of the single window and based of the clearances from different relevant and concerned partners, customs will proceed and issue the customs clearance allowing the release of the consent shipments. Right, thank you Mohammed. I have a question myself on the challenges that you mentioned and I fully agree. One of them is the risk analysis capacity of countries because it is usually very demanding and you have such a broad experience in so many different countries and now a lot involved with the US. Is there any progress on this like or maybe some colleagues that are from countries that lack this capacity to do risk analysis? From your experience, how have you seen, is there a possibility if a country wants to do it but doesn't have much resources and usually it's human resource or financial resources. From your experience, how can these gaps be filled in? Yes, risk analysis as you said is crucial and very important. So it's the only way to evaluate the safety and the compliance of imported food. For example, the compliance with the national requirements. But to conduct a proper risk analysis we need relevant data and data has to be provided by the exporters and we need also as you rightly alluded to good international collaboration and coordination on the criteria of the risk assessment or the risk analysis. So each country can have its own risk analysis based on its particularities or its idiosyncrasies but it should be agreed upon risk analysis criteria and it's maybe the opportunity for member states to communicate, to collaborate and coordinate to develop a global framework for risk analysis and to conduct capacity building for relevant stakeholders working at points of entry. How to conduct this risk analysis and to implement it and to have commonly used framework or templates of risk analysis, to have risk analysis being as comprehensive as possible. All right, thank you. I mean and a question on the IHR itself, my answer is that it's one of the few legal binding documents, global binding documents. So I'm always intrigued like what happens when a country does not comply to the IHR? Is there a formal process or how frequently have you come across these things? We say this is a legally binding document as far as I understand and so what if a country does not comply to them? What is the process in those cases? Very, very good question, George, as usual. So actually this issue of the enforcement, the enforceability of the IHR provisions has raised lots of discussion. The IHR is an agreement. It's not a treaty. A treaty is more mandatory because there are instruments of treaty and the treaty should be enforced through the parliament and through the legal institutions within the states. Unfortunately, IHR is not a treaty, it's just an agreement and there is no sanctions behind the no-compliance. So it was adopted during the World Health Assembly in May 2005 and just the delegates agreed on this international agreement. The international agreement is based on the WHO constitution, so 18 and 19, while the treaty is based on the 20 and 21 WHO constitution. The only treaty developed by the WHO so far is the tobacco control, tobacco framework treaty and you can see now the warnings on the packages of tobacco products. It's due to this result of this WHO treaty. It's a great achievement and guess what? I mentioned that there is a non-going process at WHO regarding the IHR amendments but in parallel of this process there is another process which is the pandemic treaty or the pandemic accord and both the IHR Arctic amendments and the pandemic treaty is going to be adopted or not during the upcoming WHO assembly in May 2024. So some articles will be part of pandemic accord. When the accord is adopted, it's not like the IHR, it will be more enforceable and the adherence will be stronger from the member states' parts. So that's the difference. It's due to the origin of the development of the IHR due to certain articles in the WHO constitution because it was chosen in 2005 to make it international agreement instead of a treaty. All right. Thank you very much and it's really a pleasure to listen to you and it's from all your experience because you know it by heart from the past, how it was before and the present and the future. So for us it was a big pleasure and a privilege to have you on that side. Thank you for that, Mohammed. I think we have no further questions at this point. I would just like to, before we conclude, to ask colleagues to please fill in the feedback survey that my colleague Madina just put in the chat. It's always useful for us to collect new ideas of topics that colleagues are interested to address. And the next webinar is January 11. So it's at the same time, the topic will be very interesting and different. It's specifically about MRSA or MRSA, Metacicline Resistance Staff Horace. So in the interaction between the different animals and production species, etc. So I think it will be quite interesting. So that's after the New Year's in January 11. So thank you very much. I hope everybody has a good break, if that's already the case. And we'll be in touch afterwards this webinar. Thank you very much. Thank you.