San Francisco Chronicle
Marion Nestle
Q: President Obama has nominated Dr. Margaret Hamburg as the next Food and Drug administrator. What issues would you like her to tackle?
A: And what a good choice she is. I worked with Dr. Hamburg in the Office of Disease Prevention and Health Promotion in the late 1980s, and have followed her subsequent career – at the National Institutes of Health, as New York City health commissioner, as assistant secretary for health, and as an expert on bioterrorism – with much admiration.
But to answer your question: Food and Drug Administration commissioners are political appointees who require congressional approval. Once approved, Dr. Hamburg’s first order of business will be to fix the FDA.
The FDA desperately needs fixing. This agency oversees the safety of drugs, medical devices, and food for animals as well as people. This is a large order, but the FDA faces particular hurdles. The industries it regulates do not like being regulated. They prefer self-regulation, and they let Congress know it.
And it is Congress that tells the FDA what to do. In the 1990s, when FDA regulators attempted to tighten controls on cigarettes and dietary supplements, Congress balked. Congress could not close down the FDA, but it could make the agency impotent. It passed laws requiring the FDA to take on dozens of new oversight responsibilities but provided no additional funding or personnel. The result? Experienced staff fled the agency, survivors kept heads down and did little to protest, and the FDA lost respect and credibility.
Food is just a small part of the FDA’s oversight mission, but accounts for disproportionate levels of vexation. Dietary supplements, for example, have their passionate followers. And the science isn’t always available to fully evaluate whether such things as artificial sweeteners, bisphenol A, genetic modification, or nanotechnology pose risks to health.
The safety scandals of the past few years – spinach, pet food, peanut butter, and now pistachios – revealed profound weaknesses in the ability of the FDA to protect public health. Polls say nearly 75 percent of Americans are more afraid of food than they are of terrorists.
Fixing the FDA
The FDA’s own science board says it needs more money, better morale, stronger leadership, and greater scientific capacity. Dr. Hamburg will have to persuade Congress to empower her agency to do its job, starting with better inspection capacity. The FDA currently inspects just 1 percent or 2 percent of imported food shipments. It can never inspect all shipments, but must be able to examine enough of them to deter bad guys. Exporters of tainted foods need to know that they have an excellent chance of getting caught.
Unbelievable but true, the FDA has no right to order companies producing unsafe food to recall their products. Food recalls are voluntary. Although it is now months after the first recalls of contaminated peanut butter, the FDA still announces daily recalls of additional products. Dr. Hamburg must convince Congress to give the FDA recall authority.
She also must convince Congress to order the FDA to require – and to enforce – the production of all foods under science-based food safety procedures. Currently, the FDA only requires such procedures for seafood, eggs and fresh juices. Everybody else is supposed to follow less rigorous “good manufacturing practices.” As we learned from the peanut butter situation, this doesn’t always happen. We need better procedures and better enforcement.
And the FDA needs major structural changes. A new report from the Robert Wood Johnson Foundation addresses this point. The FDA, it says, should concentrate its resources on the highest risks, enforce existing rules (what a concept), and appoint someone with authority over all the agency’s food safety programs, animal as well as human.
The report goes on to suggest that the FDA work with Congress to establish a Food Safety Administration within the Department of Health and Human Services (HHS). This last idea sounds like an alternative approach to the food safety problem. Forget trying to fix the FDA. Instead, fix the entire food safety system.
Fixing the system
The system needs a fix because the FDA is not the only food safety agency. Meat and poultry (roughly one-quarter of the food supply) are regulated by the USDA .
This split happened as a result of history. The FDA started out as part of the USDA. Although it is now part of HHS, FDA funding still comes from congressional agricultural appropriations committees who give the USDA about 80 percent of the overall funding for food safety.
As I explain in my book, “Safe Food,” this weird division of responsibility began in 1906, and it is breathtaking in its irrationality. To cite two typical examples: the FDA oversees the safety of cheese pizza; the USDA oversees pepperoni pizza. The FDA oversees closed-face meat sandwiches, but the USDA regulates open-face sandwiches. Most relevant, toxic bacteria in wastes from food animals (USDA-regulated) contaminate fruits and vegetables (FDA-regulated).
Don’t we need one food safety system? I think we do.
I am not alone in this view. Since the early 1990s, the Government Accountability Office has advised Congress that public protection demands creation of a single food safety agency that oversees the entire food supply from farm to table.
Congress is currently considering nearly a dozen bills dealing with food safety, of which two get much attention. The one introduced by Rosa DeLauro (D-Conn.) aims to fix the FDA (HR 875). The bill by John Dingell (D-Mich.) aims to fix the system (HR 759). Much of what Dr. Hamburg can do depends on how Congress decides among these bills.
In the meantime, it is clear that strengthening the FDA – or the system – would help restore confidence in the food supply and in government’s ability to protect the public, and would be good for business as well as public health. Advocates should tell Congress it needs to act swiftly so that Dr. Hamburg and her colleagues can get right to work ensuring a safe food supply for all of us.
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Marion Nestle is the author of “Pet Food Politics,” “Food Politics,” “Safe Food” and “What to Eat,” and a professor in the department of nutrition, food studies and public health at New York University. E-mail her at [email protected] and read her previous columns at sfgate.com/food.
