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Special Edition IX — Salmonella Saintpaul Outbreak…Concerns About FDA/CDC

Pundit’s Mailbag — Plenty of FDA Incompetence to Go Around But TheProblem Is A Matter Of Politics, Says Marion Nestle,Esteemed Food Policy Professor

Jim Prevor’s Perishable Pundit, July 3, 2008

One of the great joys of doing the Pundit has been the opportunity to exchange ideas with brilliant people from across the globe. Today we are honored to receive a note from Marion Nestle, a woman who can only be described as an irreplaceable national resource on public policy as it relates to food and nutrition.

We say this not because we always agree with her policy prescriptions but because she is always willing to dialog; she recognizes intelligence and she brings to the policy debates a kind of common sense attitude that often gets lost when policy wonks stake out their positions.

Some see her as anti-business, but we find her to be open to discussion on the best way to advance our common interests. She certainly has been controversial but she is forthright and pays respect to her opponents.

She is a prolific author, weighing in with seminal books on food policy, such as, Food Politics: How the Food Industry Influences Nutrition, and Health and Safe Food: Bacteria, Biotechnology, and Bioterrorism and is co-editor of Taking Sides: Clashing Views on Controversial Issues in Food and Nutrition Her latest book is What to Eat.

She maintains websites, such as FoodPolitics.com, and blogs at WhatToEatBook.com. We’ve been honored to earn a few links from her when we’ve dealt with food safety and other public policy issues.

One of the biggest mistakes the industry can make is to circle its wagons and only talk to people who agree with the positions of the trade. To have credibility in the policy arena, we must have the courage to confront issues from a public policy perspective. We must also have the intellectual self-assurance to be willing to try to persuade those open to persuasion.

Inherently, the offerings of the produce industry always align the trade with those concerned about issues such as obesity. We need to do a better job of building on these commonalities of interest.

One always learns more by listening than by speaking, so let us listen to what Marion Nestle has to say:

I’m following your following of the tomato incident with great interest, to say the least. Your piece, What Would FDA Do With ‘Preventive Authority,’ raised important questions.

This one, I see differently. I don’t think the issue is totally FDA incompetence, although I agree there is plenty of that around. I think it is politics.

The Commissioner is a political appointee whose job it is to carry out the will of the administration. This administration doesn’t like regulation much and has made sure that the FDA can’t do too much of it.

Von Eschenbach got spanked when he asked Waxman for more money, and he sure hasn’t tried that again. Acheson would be fired if he spoke up, and he’s the best they’ve got, so it would be a shame to lose him.

My experience in government, limited as it was, taught me that the only way to maintain integrity is to have one foot out the door at all times and to be willing to be fired at a moment’s notice.

That’s a lot to ask of public servants. So what to do? Keep the pressure on, which is what you are doing. Thanks for doing it.

— Marion Nestle
Paulette Goddard Professor of Nutrition, Food Studies and Public Health
Steinhardt School of Culture, Education and Human Development
New York University

We certainly appreciate Professor Nestle’s kind words, and she can certainly count on us to “keep up the pressure” although to paraphrase Harry Truman — we just tell the truth and they think it is pressure.

There is a sense in which we can simply say we agree. Professor Nestle’s comments regarding her government service refers to a couple of years as Staff Director for Nutrition Policy and Senior Nutrition Policy Advisor at the Office of Disease Prevention and Health Promotion in the Department of Health and Human Services. The experience she gained from these government positions taught her that if you want to do what you think is right, you better be willing to be fired. This is true of pretty much all of life, with the exception of tenured professors.

When we wrote a piece for The Wall Street Journal entitled, The Roots of Editorial ‘Independence’, we wrote this: “Editorial independence is always a function of one thing and one thing only: an editor’s willingness to be fired.”

In this particular case, a willingness to be fired shouldn’t be that tough. The top people at FDA and CDC can almost certainly earn more money in the private sector. Some stay because of a genuine desire to advance public health, but a few too many are in love with the power.

What we think is interesting about Professor Nestle’s letter is that it speaks to a divide in the public policy community about how to respond to the obvious ineptness of the way this Salmonella Saintpaul outbreak has been handled.

On the one side is Professor Nestle and other policy advocates, such as Caroline Smith DeWaal of the Center for Science in the Public Interest. They see the FDA and CDC as inherently handicapped by the predilections of the Bush administration.

When FDA and CDC mess up, they may not quite excuse it but they sort of say “What do you expect? The Bush administration has starved the agencies of money, made clear it wants minimal regulation, and under these circumstances you are going to have the kind of performance you are seeing in this outbreak.”

These advocates want change — almost all advocate a single food safety agency — but, in the end, they see the problem as being primarily external to the agencies. Cure the rot at the top — they would say — and you will see big improvements.

There is merit to these arguments, although we think they significantly understate the necessity for personal responsibility.

All the players in this game are professionals, they are MDs, MPHs and PhDs, and they have an obligation to those professions to not cover up problems. So when in conference call after conference call, Dr. Acheson, FDA’s Associate Commissioner for Foods, explains that he will put out as many inspectors as necessary to handle this traceback, we assume he is telling the truth. If, in actuality, there are resource constraints that are slowing this process down, we would assume he would say that. If the penalty for saying that is he gets fired, we assume he would get fired gladly and demonstrate how serious the problem is that the administration won’t even allow such discussion.

Ironically, we would argue that the biggest impediment to regulation in the fresh produce industry is the zero-tolerance policy toward pathogens.

FDA can’t really regulate fresh produce because if it really tried to ensure zero pathogens on field-grown products, it would shut the industry down. So, inevitably, any regulatory scheme FDA proposed will, at best, only reduce the incidence of pathogens on produce.

Now normally, reducing a problem is a good thing. If a new director of the National Highway Traffic Safety Administration reduced auto accidents by 10%, we would give the director a medal.

Under the FDA’s zero-tolerance policy, it is of no importance. Under any plausible mandatory scheme, there will still be pathogens — and so the FDA, if it regulated, would be in a position during the next outbreak in which those reporters would be saying: “Well, Dr. Acheson, you have mandatory regulation of the produce industry. Is the problem that your regulations are inadequate or is your enforcement inadequate?”

Both PMA and United have endorsed mandatory federal regulation, as we discussed here, here and here. We don’t have mandatory federal regulation because the FDA would rather be blaming rogue tomato farmers than the adequacy of its regulation or enforcement.

We are not opposed to things such as a single food safety agency, and we want to budget to have a world-class scientific infrastructure. We think, though, that effective regulation of fresh produce starts with honesty.

If the FDA will abandon its zero-tolerance policy, we can actually make food safer. We should do studies to establish baselines for the incidence of pathogens on different products and then work to reduce that incidence in a series of multi-year efforts.

If they get hysterical every time they find some pathogen, we can’t regulate, we can’t make progress, we can scarcely discuss the issue. That is not a recipe for success.p>

Many thanks to Marion Nestle for helping us think hard about such important issues.

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