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The local level is seen as a weak link in food safetyCOMMENTARY | May 151, 2009A George Washington University study reports that fewer people would suffer during outbreaks of sickness from unsafe foods if state and local agencies did a better job in collecting and disseminating information. We interview one of the authors of the study. By Alexa Millinger Last month a study by the Department of Health Policy at my school, George Washington University, reported that national efforts to improve food safety and prevent widespread outbreaks of sickness from foods should focus on state and local food safety agencies in the United States, which are currently hindered by a lack of funding and resources. The ereport, issued April 17th, is titled "Stronger Partnershnips for Safer Food." Food safety is obviously an important issue, and one reporters can follow up on for their news organizations, regardless of size, because good local stories may emerge from what state and local agriculture departments are doing—or are unable to do. I interviewed Michael R. Taylor of GW, shown at right, a co-author of the report and former Food and Drug Administration official. To say that there are serious problems at the state and local levels, what does that look like? What have they not been doing? One is the role of the state and local people and agencies in investigating outbreaks of illness. Which means when people get sick, it’s the state and local departments that first get the call and do the collection of information to try to discover what made people sick. And then the Centers for Disease Control at the federal level supports the investigation of what made people sick, and then FDA at the national level when it appears that you have a multi-state outbreak. When you get people, like in the peanut case, that are getting sick all over the country from a common source, then FDA gets involved. For that system to work well there has to be a seamless flow of information. There have to be consistent ways in which state and local people are collecting information so that it can be aggregated and compared and scientifically sound. We don’t have a seamless flow of information. We don't have the consistent approaches to collecting the data in the first place. And so we’re really far short of where we could be in getting the information in an outbreak situation, where there’s an immediate opportunity to contain the outbreak, to reduce the number of people who get sick. We don't have the flow of information. We don't have the quality of information that would permit us to do that as quickly and effectively as possible. So more people get sick than they should because the system isn’t integrated. What was the motivation for this study? This is one of a series of projects that we’ve been doing related to food safety reform and one of the themes is looking at the institutions, the government institutions that are responsible for food safety. A lot of the attention gets paid – properly – to legislative reform. Modernizing the laws under which FDA and Department of Agriculture operate, particularly FDA. But our view is that you do need a modern law but if that law is implemented by government institutions and those institutions aren’t equipped and aren’t functioning in a way that’s productive then the law won’t be effective. And in particular the food safety area, while the federal government, particularly the FDA, has a critical central leadership role in food safety, the majority of the food safety work from a government regulatory public health standpoint is done by state and local agencies. The basic motivation for this study is that unless you address the need to strengthen state and local roles in the system, you won’t achieve the goals of food safety reform. And of course there’s a very active debate here in Washington about food safety reform so we want to do what we can to put a very concrete set of ideas in front of Washington policymakers so that when they reform the federal agencies they can also do some things to strengthen state and local roles. The report says that local agencies are underfunded, but is now a good time to be looking for more funding? Well, that’s a huge issue for any government program. The positive thing is that the realization that the food safety system is underfunded has really sunk in on politicians. The last couple years, Congress has given FDA nice increases in budget for food safety and the president’s budget for 2010 would make another significant investment in FDA programs. And interestingly, when President Obama was a senator, he introduced legislation in the summer of 2008, just last year, that focused on strengthening state and local roles and would have included a federal grant program to support state and local capacities. So, while in general we’re kind of entering an age where I think there will be very scarce resources for anything but core functions, food safety I think is being recognized as a core function that needs reform. So the resource side of things is actually fairly promising. Now that can change because that reflects politics and changing public and media focus among other things but right now I think its credible to talk about greater investment in food safety. You had said previously that these ideas didn’t get very far because it wasn’t the right time, do you think this will have better luck now with a new administration? Not that food safety is or should be a partisan issue but the work that was done 10 years ago was part of the Clinton administration initiative to strengthen the food safety system and a lot of the work that some of the organizations representing state officials did to advocate for more integration of federal, state and local – that was done in the last couple of years of the Clinton administration and frankly the Bush administration didn’t take interest in this, they didn’t follow up on it and didn’t take interest generally in food safety regulation. It was a philosophical, ideological objection to regulation in the area of food safety. So the change of administration is very significant. But it’s really more than that, it’s also that the series of outbreaks of illness that we’ve seen the last couple of years involving produce; spinach, lettuce, tomatoes, peanut products and so forth. These outbreaks have really changed the picture politically on food safety. The food industry has come to the table advocating reform. Congress is ready to act. And now with the positive administration, supportive also of reform – the president has spoken personally about it – the forces are lined up for reform at the federal level. What are the consequences that we could see if this is not enacted? The whole thrust of this is to reduce food-borne illness to prevent illness. You don't have to think in apocalyptic terms. By some historical standards our food supply is safe, but it’s also the case that thousands of people die every year unnecessarily. So if you do that in a quantitative risk assessment sort of way, it’s a tiny, tiny percentage if you look at the billions of meals that are consumed every year. But believe me, one preventable illness that hits someone in your family is an apocalyptic event. And in my time in government I’ve sat with a lot of families who have experiences losses of children and parents and they have every right to expect that the government do everything that’s reasonably possible to prevent illness and that’s what this is really all about. I think there is a wide recognition that the system can do better, it needs to do better.
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