Report calls for bolstering state, local food safety efforts

Robert Roos

Apr 17, 2009 (CIDRAP News) Part of the answer to the nation's food safety troubles lies in strengthening state and local food safety efforts and better integrating them with federal activities, according to a new report prepared by academic experts in collaboration with state and local public health groups.

State and local agencies handle the great majority of government food safety activities, including inspecting more than a million restaurants and grocery stores, as well as many food processing plants, says the report. While this decentralization is a good thing, state and local agencies "are hampered by chronic underfunding, wide disparities in capacity and practice in all areas of food safety, and substantial legal, resource, and institutional barriers to collaboration," it states.

The report, titled "Stronger Partnerships for Safer Food: An Agenda for Strengthening State and Local Roles in the Nation's Food Safety System," was written by Michael R. Taylor and Stephanie David of George Washington University. It offers a long list of recommendations for shoring up state and local food safety programs and harmonizing them with one another and federal efforts.

The recommendations include providing federal food safety block grants to states; setting up federally funded, regional outbreak response centers; establishing an interagency food safety leadership council; writing a model state and local food safety law; establishing protocols for managing multistate outbreaks; providing food traceability requirements; and establishing a food safety training institute, among other steps.

The report also echoes other recent proposals in calling for appointing one person to manage all the food safety functions of the Food and Drug Administration (FDA). But it does not call for splitting the FDA into separate food and drug agencies or for consolidating all federal food safety activities in a single agency.

Taylor and David wrote the report in collaboration with the Association of Food and Drug Officials (AFDO), the Association of State and Territorial Health Officials (ASTHO), and the National Association of County and City Health Officials (NACCHO). The project was funded by the Robert Wood Johnson Foundation.

The report comes in the wake of large, multistate outbreaks of Salmonella, including last summer's illnesses tied to hot peppers from Mexico and the past winter's episode blamed on peanut products from Peanut Corp. of America. The pepper-related outbreak pointed up weaknesses in governmental outbreak response, while the peanut-linked outbreak revealed breakdowns in prevention, Taylor and David note.

A shared vision
They write that federal, state, and local agencies have expanded their collaboration in some areas, especially illness surveillance and inspections, since the 1990s. Moreover, food safety officials today at all levels have "a widely shared vision of an integrated national food safety system that operates as a full partnership among federal, state, and local agencies." But the authors say many changes are needed to fulfill that vision.

A 1998 report by the National Academy of Sciences, "Ensuring Safe Food," sounded the call for a more integrated food safety system, the report notes. Subsequently, the FDA and its state and local partners launched the National Food Safety System Project, which made important strides toward a more integrated food safety system between 1999 and 2002. But the project stalled in 2002 because of lack of funding.

Recently, the push for improving food safety coordination has gathered new strength, the report says. In 2006, for example, the Centers for Disease Control and Prevention (CDC) and its state and local counterparts founded the interagency Council for Foodborne Outbreak Response (CIFOR). Last June CIFOR issued draft guidelines for responding to foodborne disease outbreaks.

Describing the current food safety regulatory landscape, Taylor and David write that states conduct more than 80% of all inspections of nonretail food establishments (other than meat and poultry facilities inspected by the US Department of Agriculture). The majority of FDA inspections of food processing facilities are actually handled by the states under contracts with the FDAabout 10,500 inspections in fiscal year 2008.

Key findings and recommendations
The report lays out 27 "key findings" on state and local food safety roles and activities, which provide the basis for the 19 recommendations.

First, the report says, Congress should give the secretary of the Department of Health and Human Services (HHS) "a legislative mandate to lead the development of an integrated, national food safety system."

In addition, Congress should direct HHS to put the management of all of the FDA's food safety functions under one person with clear authority and responsibility for them, the document states. This proposal echoes one made by the Trust for America's Health in a report released in March.

To shore up funding, Taylor and David say Congress should (1) authorize the FDA to set up a block grant program to support state and local capacity building and (2) establish a matching grant program to promote additional state and local improvement and innovation.

States and localities should do their part by providing adequate and stable funding and should improve coordination of their own food safety activities, the report asserts. That should include providing a "focal point" for linking the state's activities with the national system.

Further, state and local governments should join to develop and adopt a model state and local food safety law to parallel pending federal reforms, clarify state and local roles, and empower state and local agencies to cooperate with one another and with the federal government.

To improve outbreak response, the report suggests that HHS, working with the CDC, FDA, and state and local governments, set up a network of regional, federally funded outbreak response centers. With the aim of ensuring an integrated approach to outbreak response, the centers would be staffed by a multidisciplinary team of federal, state, and local specialists.

Further, HHS should foster the use of best practices for outbreak response on the basis of the CIFOR guidelines and should set protocols for managing multistate outbreaks, the report states. It also recommends that Congress establish food traceability requirements so that officials can quickly obtain reliable information on the sources of commodities and ingredients.

In other recommendations, the authors say:

· Congress should set up a "Food Safety Leadership Council" to foster federal, state, and local collaboration in designing an integrated food safety system. The council would include top federal food safety officials and representatives of state and local agencies. It would oversee many of the other recommendations and monitor progress, among other tasks.

· HHS should set up a "Food Safety Leadership and Training Institute" to promote a common vision for the national system and to build the skills and relationships needed to help the system succeed.

· Congress should direct the HHS secretary to cooperate with states in setting up a "National Foodborne Illness Data program." The aim would be to better integrate efforts at all levels to generate and analyze the data needed to understand and prevent foodborne illness.