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20, AVENUE APPIA – CH-1211 GENEVA 27 – SWITZERLAND – TEL CENTRAL +41 22 791 2111 – FAX CENTRAL +41 22 791 3111 – WWW.WHO.INT Ref.: C.L.20.2023 The World Health Organization (WHO) presents its compliments to Member States and has the honour to inform them that WHO is updating the estimates on the burden of foodborne diseases to be published in 2025. As part of the resolution under the Strengthening efforts on food safety (WHA73.5), WHO will update the global burden of foodborne diseases estimates, and report incidence, mortality and burden in terms of disability-adjusted life years (DALYs) at national, regional and international levels. Following WHO’s policy for data publication and prior to the official release of the final estimates, WHO will consult with Member States to provide opportunity for review and input on (i) national primary data sources where available, and (ii) individual country estimates derived from the statistical model applied to the national primary data from all countries. WHO will create a country-specific space within the WHO Country Portal dedicated to this technical area of work where designated focal point(s) will have access to relevant technical materials and information about the process, including documents on methodology, decision-making processes, and country-specific data. Once the first stage is complete, the official country consultation of WHO comparable estimates will be also conducted via the same portal space. Member States are requested to designate a focal point(s) who has relevant qualifications ... (see Annex 1). They may designate multiple focal points to cover a range of technical subjects (i.e. diseases caused by microbiological hazards, parasites, or chemicals and toxins), and determine, among them, one coordinator who will streamline communications with WHO as the primary national focal point and liaise with other national focal points for sharing relevant information and consolidating feedback. When a primary accountability of food safety or foodborne diseases falls under a ministry other than Ministry of Health (i.e. Ministry of Agriculture, National Food Safety Authority), Member States are requested to share this request with other relevant ministries and identify a most appropriate focal point(s). Designation of the focal point(s), together with contact details (full name, title, affiliation and email address) should be sent as soon as possible before the opening of the consultation to [email protected] no later than 18 August 2023. Focal point(s) will then get instructions on how to access the country consultation platform. ... ENCLS: (2)  Page 2 C.L.20.2023 The terms and conditions that apply to any data provided by countries to WHO is ... presented in Annex 2. By providing data to WHO, Member States confirm their understanding and agreement of these terms and conditions. In case any clarification or additional information is needed, an email can be sent to Ms Yuki Minato ([email protected] or [email protected]). The World Health Organization takes this opportunity to renew to Member States the assurance of its highest consideration. GENEVA, 26 June 2023  ANNEX 1 A SUGGESTED PROFILE SUITABLE FOR A DESIGNATED NATIONAL FOCAL POINT(S) The first global estimates of the incidence, mortality and disease burden in 2010 caused by 31 foodborne hazards was released in 2015.1,2 Three broad categories of hazards were included: enteric hazards such as bacteria and viruses, parasitic hazards, and chemicals and toxins. Please see below a list of hazards and causally related health states included for 2015 estimates. For the next updates, WHO plans to include, at least as a minimum, the same 31 hazards and four heavy metals, namely Arsenic, Cadmium, Lead and Methyl mercury. Other additional important hazards and new health states will also be considered subject to further discussions and decisions. As requested in the circular letter, WHO seeks a national focal point(s) for each country to receive technical information materials and preliminary estimates of the burden of foodborne diseases. WHO suggests its Member States consider seeking personnel(s) with the following knowledge and qualifications to act as a focal point(s): • Understanding and background in epidemiology, data science, health or bio-statistics, food science, risk assessment of chemicals or pathogens. • Familiarity with burden of disease assessment and associated metrics. • Familiarity with health surveillance and epidemiological modelling. Given a scope of hazards and disease areas, an engagement of multiple focal point(s) from more than one ministry or technical agencies may be required depending in a situation in each Member State. HAZARD HEALTH STATE Diarrhoeal disease agents 1 Norovirus Diarrhoeal disease 2 Campylobacter spp. Diarrhoeal disease Guillain-Barré syndrome 3 Enteropathogenic E. coli Diarrhoeal disease 4 Enterotoxigenic E. coli Diarrhoeal disease 5 Shiga-toxin producing E. coli Diarrhoeal disease Haemolytic uraemic syndrome End-stage renal disease 6 Non-typhoidal Salmonella enterica Diarrhoeal disease Invasive salmonellosis 7 Shigella spp. Diarrhoeal disease 8 Vibrio cholerae Diarrhoeal disease 9 Cryptosporidium spp. Diarrhoeal disease 10 Entamoeba histolytica Diarrhoeal disease 11 Giardia spp. Diarrhoeal disease 1 https://apps.who.int/iris/handle/10665/199350. 2 https://collections.plos.org/collection/ferg2015/.  Invasive infectious disease agents 12 Hepatitis A virus Hepatitis 13 Brucella spp. Acute brucellosis Chronic brucellosis Orchitis 14 Listeria monocytogenes, perinatal Sepsis Central nervous system infection Neurological sequelae Listeria monocytogenes, acquired Sepsis Central nervous system infection Neurological sequelae 15 Mycobacterium bovis Tuberculosis 16 Salmonella Paratyphi Paratyphoid fever Liver abscesses and cysts 17 Salmonella Typhi Typhoid fever Liver abscesses and cysts 18 Toxoplasma gondii, congenital Intracranial calcification Hydrocephalus Chorioretinitis, early in life Chorioretinitis, later in life Central nervous system abnormalities Toxoplasma gondii, acquired Chorioretinitis, mild Chorioretinitis, moderate Chorioretinitis, severe Acute illness Post-acute illness Cestodes 19 Echinococcus granulosus, cases seeking Pulmonary cystic echinococcosis treatment Hepatic echinococcosis CNS echinococcosis Echinococcus granulosus, cases not seeking Pulmonary cystic echinococcosis treatment Hepatic echinococcosis CNS echinococcosis 20 Echinococcus multilocularis Alveolar echinococcosis 21 Taenia solium Epilepsy: treated, seizure free Epilepsy: treated, with recent seizures Epilepsy: severe Epilepsy: untreated Nematodes 22 Ascaris spp. Ascariasis infestation Mild abdominopelvic problems due to ascariasis Severe wasting due to ascariasis 23 Trichinella spp. Acute clinical trichinellosis  Trematodes 24 Clonorchis sinensis Abdominopelvic problems due to heavy clonorchiosis 25 Fasciola spp. Abdominopelvic problems due to heavy fasciolosis 26 Intestinal flukes Abdominopelvic problems due to heavy intestinal fluke infections 27 Opisthorchis spp. Abdominopelvic problems due to heavy opisthorchiosis 28 Paragonimus spp. Central nervous system problems due to heavy paragonimosis Pulmonary problems due to heavy paragonimosis Organic pollutants 29 Dioxin Infertility Hypothyroidy due to prenatal exposure Hypothyroidy due to postnatal exposure Toxins and allergens 30 Aflatoxin Hepatocellular carcinoma: diagnosis and primary therapy Hepatocellular carcinoma: metastatic Hepatocellular carcinoma: terminal phase with medication Hepatocellular carcinoma: terminal phase without medication 31 Cassava cyanide Konzo 32 Cadmium Chronic kidney disease 33 Lead Intellectual disability (mild, moderate, severe) 34 Methylmercury Intellectual disability (mild, moderate, severe) 35 Arsenic Lung cancer Skin cancer Bladder cancer  ANNEX 2 POLICY ON USE AND SHARING OF DATA COLLECTED IN MEMBER STATES BY THE WORLD HEALTH ORGANIZATION OUTSIDE THE CONTEXT OF PUBLIC HEALTH EMERGENCIES Data are the basis for all sound public health actions and the benefits of data sharing are widely recognized, including scientific and public health benefits. Whenever possible, WHO wishes to promote the sharing of health data, including but not restricted to surveillance and epidemiological data. In this connection, and without prejudice to information sharing and publication pursuant to legally binding instruments, by providing data to WHO the Ministry of Health of your Country: Confirms that all data to be supplied to WHO hereunder have been collected in accordance with applicable national laws, including data protection laws aimed at protecting the confidentiality of identifiable persons; Agrees that WHO shall be entitled, subject always to measures to ensure the ethical and secure use of the data, and subject always to an appropriate acknowledgement of your Country: – to publish the data, stripped of any personal identifiers (such data without personal identifiers being hereinafter referred to as “the Data”) and make the Data available to any interested party on request (to the extent they have not, or not yet, been published by WHO) on terms that allow non-commercial, not-for-profit use of the Data for public health purposes (provided always that publication of the Data shall remain under the control of WHO); – to use, compile, aggregate, evaluate and analyse the Data and publish and disseminate the results thereof in conjunction with WHO’s work and in accordance with the Organization’s policies and practices. – except where data sharing and publication is required under legally binding instruments (IHR, WHO Nomenclature Regulations 1967, etc.), the Ministry of Health of your Country may in respect of certain data opt out of (any part of) the above, by notifying WHO thereof in writing at the following address, [email protected], provided that any such notification shall clearly identify the data in question and clearly indicate the scope of the opt-out (in reference to the above), and provided that specific reasons shall be given for the opt-out. Saatja: <[email protected]> Saadetud: 28.06.2023 09:43 Koopia: <[email protected]> Teema: WHO: C.L.20.2023 (Foodborne diseases estimates) Manused: C.L.20.2023 (Global burden of foodborne diseases) Arabic.pdf; C.L.20.2023 (Global burden of foodborne diseases) Chinese.pdf; C.L.20.2023 (Global burden of foodborne diseases) English.pdf; C.L.20.2023 (Global burden of foodborne diseases) Russian.pdf; C.L.20.2023 (Global burden of foodborne diseases) French.pdf; C.L.20.2023 (Global burden of foodborne diseases) Spanish.pdf Dear Member States of the World Health Organization, Please find attached, in the six official languages, C.L.20.2023 regarding the country estimates for the global burden of foodborne diseases. Should you have questions regarding C.L.20.2023 please send an email to fbd- [email protected]. Best regards, Department of Governing Bodies World Health Organization ***DO NOT RESPOND TO THIS E-MAIL. YOU WILL NOT RECEIVE A REPLY***