As listeriosis is not a notifiable disease elsewhere in the Southern African Development Community region, the death toll is likely to be far higher - some estimating as many as 500 deaths.
Lawyers have announced their intention to launch a class-action lawsuit, while the food manufacturers in the eye of the storm scramble to shift blame and hatch a PR response that’s vaguely compassionate.
The outbreak’s been a long time coming because of an alarming lack of government oversight of the sector. Now, food safety regulations are likely to be expedited to prevent other such outbreaks.
Health Minister Dr Aaron Motsoaledi has acknowledged there are flaws in the system, citing a lack of environmental health practitioners (EHPs), but has denied his department should have moved faster in identifying the listeria outbreak.
Yet countrywide, there’s a shortage of at least 3300 EHPs and local municipalities are unable to do the job effectively.
During a debate in the National Assembly on March 8, Motsoaledi said: “It was a mistake for the constitution to give that job to local government, because municipalities can’t afford it because they’ve got basic services to provide.”
Food safety expert Linda Jackson of Food Focus says, with this outbreak, the government is under pressure to improve its activities and is likely to publish the revised food hygiene regulations soon.
“We only have one regulation in place - the Regulations Governing General Hygiene Requirements for Food Premises and the Transport of Food (R962) - which is very basic in terms of controls.
“It is really not onerous and requires any restaurant to have a certain number of toilets, hand-wash basins and pest and waste control. It also addresses the finishes in kitchens in broad terms to ensure cleanability.
“It requires the person in charge to provide training for their staff on hygiene matters, but this is hugely problematic,” Jackson said.
The new requirements, known as R364, are far more stringent because they shift more responsibility on to who’s in charge: they need to be able to prove certain actions and be trained themselves.
“The guy who makes the decisions was never required to be trained on the principles of food safety - it’s the blind leading the blind,” she said.
“The new regulations bring us in line with the US and Europe. Often the owner of a restaurant doesn’t fully understand why certain activities are a risk to consumers’ health - and that not leading by example puts their business at risk.”
Jackson said implementation would be tough because hygiene controls need to be improved: “The restaurant chains set rules, they audit, but the privately-owned restaurants don’t necessarily have systems in place. They are doing things wrong and don’t realise this.
“The only way this is going to work is if we have more EHPs and more surveillance.”
The weaknesses in the system have been identified in the listeriosis outbreak and the government needs to be seen to act. “If we don’t increase our legislative framework, the rest of the world will take an even dimmer view of our food safety.
“It’s the right thing to introduce it, but to be effective we need to have increased capacity for monitoring. It’s the most basic thing we can do as a country, but we can’t have a toothless bulldog.”
R364 is an improvement, but it’s still lagging behind EU regulations, she said, because it tells the industry what to do but it doesn’t take into account risks such as the menu and raw materials.
“Although this regulation is an improvement, we are still not requiring a full-blown HACCP approach, as they do elsewhere.”
HACCP or Hazard Analysis and Critical Control Points is a systemic approach to food safety used by the World Health Organisation to prevent biological, chemical and physical hazards in production processes. It’s proactive in that it aims to avoid hazards rather than attempting to deal with the fallout of the effects of those hazards.
“The system is used at all stages of the food chain, from ‘farm to fork’, in production and preparation processes to packaging and distribution.
“It can also be applied to industries other than food, such as pharmaceuticals and cosmetics,” Jackson said.
The HACCP concept of managing food safety was originally a collaboration between the US Army, Nasa and Pillsbury to produce food safe for space exploration. It uses a worst-case scenario to prevent a problem rather than treat it. The only sector that has to comply to HACCP in South Africa is peanut butter, because of the school feeding schemes and the high risk of aflatoxin contamination in the peanuts that can have serious health implications.
“The scope of our HACCP regulation R908 must be extended beyond peanut butter,” she says. “The entire food sector should have to comply. It’s likely they’ll change the scope now, but it’s a reactive approach to a problem.”
“Using HACCP is like having a fire extinguisher - you hope you never need to use it, but you still have one - just in case. We think about what could go wrong and put all the controls in place to ensure that it doesn’t.
“The rest of the world is already applying these principles. We need to move to this. It’s all very well to have it, but if we aren’t enforcing it, again, it won’t help us to ensure safe food.”
Jackson’s also questioning why it’s taken so long for the food-safety regulations to be passed. R364 was first published in 2015 and has still not been signed into law, while the sugar tax, which has been criticised as being too low to be effective in curtailing sugar consumption, but which is estimated to generate in excess of R4billion annually for the fiscus, was promulgated barely 18 months after it was tabled.
With no indication of when R364 will become law and practical issues that still need to be resolved, Foster Mohale, communications director in the Health Department, could only confirm that the regulations were still under consideration, but could give no time line nor comment on the 3300 vacancies.
“The (R364 regulations) are currently undergoing the second phase of legal processes which include translation into the second language as part of the constitutional requirements. Once this is concluded, the minister will publish the regulations in the Government Gazette.”