Editor’s note: If you had a magic wand, how would you conjure up ways to make the food supply safe?  We asked several people to consider the possibilities. Here is another response, from food safety advocate Barbara Kowalcyk, co-founder of the Center for Foodborne Illness Research & Prevention.

I was recently asked what I would do if I had a food safety magic wand.

For me, that’s a loaded question, and it honestly took my breath away. I often dream of having such a magic wand so that I can do the one thing I’ve never done but desperately want to do–sit down for a family meal with my husband and all four of our children.

I would use that wand to go back to that fateful day in 2001 when the process broke down and the food that my 2 ½ year old son Kevin eventually ate became contaminated with E. coli O157:H7.  With the flick of my wand, I would change the course of my family’s life.

Every terrible memory of watching Kevin suffer, holding him after he died and the crushing grief that followed would be wiped away. My oldest, Megan, would have her best friend back– along with her childhood–and my younger two would finally meet the older brother they have grieved but never met. And then I would repeat this for every family I’ve met who has suffered a serious foodborne illness and all the ones I haven’t.

Sadly, I’d be a very busy person.

Now, there is a problem with my plan, and it is a big one. The problem is that it is reactive–it only deals with the problem after it has occurred. Kind of reminds me of our current food safety system–reacting to food safety crises instead of strategically planning to prevent them. So, as much as I’d like to go around wiping away the terrible memories of foodborne illness and the long term health outcomes that so often follow them, I would also want to use that wand to build a proactive food safety system that focuses on public health and prevents foodborne disease from happening in the first place.

So far, I don’t think I’ve said anything that anyone disagrees with. Getting people to agree on the need for a more proactive food safety system isn’t the hard part–it’s the how that stirs up all the controversy. The important thing is that we have an open, frank and reasonable discussion that involves all stakeholders. If we can do that–and I recognize that I might need to pull out my wand just to achieve that–then I think there’s hope for achieving our vision of a proactive food safety system.

A couple of years ago–hard to believe it was that long–I was invited to serve on a National Academies of Science Institute of Medicine committee to review the FDA’s role in ensuring safe food.  Last June, after 18 months of deliberations and writing, the committee of 13 published our report, “Enhancing Food Safety: the Role of the Food and Drug Administration,” that provides guidance on how to build a proactive, risk-based food safety system, not just within FDA. but overall.  In the report, the committee made the following recommendations for improving food safety:

• Adopt a risk-based approach to food safety that provides “a systematic means by which to facilitate decision making to reduce public health risks in light of limited resources and additional factors that may be considered.”

• Conduct comprehensive strategic planning for the development and implementation of a risk-based food safety system using a transparent process that involves stakeholder participation.

• Design and implement an integrated information infrastructure that provides the foundation necessary for bringing together the vast amounts of surveillance, behavioral, economic, and food production data needed to support a risk-based food safety system.

• Create a research infrastructure that balances basic and applied research to support and refine risk-based decision making.

 

• Integrate and harmonize federal, state and local government food safety programs in order to leverage efforts, eliminate duplication, improve responsiveness and increase inspection frequency.

• Increase the efficiency of inspections by adopting a risk-based approach to inspection frequency and intensity, with minimum standards, and improving training and inspection techniques.

• Develop a risk communication strategic plan that integrates communication into an overarching risk-based management strategy; improves our understanding of the knowledge, perceptions and behaviors of various stakeholder groups, and provides one voice for communicating timely, clear and accurate information to stakeholders.

• Modernize food safety legislation to provide FDA with the authorities it needs to fulfill its mission: mandatory registration of food facilities; authority to suspend registration for public health violations;  mandatory preventive controls; authority to issue enforceable performance standards; mandatory adoption of a risk-based approach to inspection frequency and intensity ; authority to mandate recalls; expansion of access to records, and authority to ban imports from countries that have inadequate food safety systems.

• Elevate and unify the efforts of all agencies and departments with major responsibility for the safety of the food supply through the establishment of a single food safety agency.

• Enhance the government’s ability to ensure a safe food supply by establishing an independent, centralized risk analysis and data management center that could also serve as a stepping stone to a single food agency.

I would use my wand to implement all these recommendations.

I would replace our fragmented, reactive system with a coordinated, proactive one; expand and improve our surveillance systems; remove institutional resistance to change and cultural barriers to data sharing; increase research funding; establish and enforce standards for federal, state and local food safety inspections; increase responsiveness to crises, and modernize food safety laws for all regulatory bodies, not just FDA.

 Of course, none of this is possible without adequate financial and human resources. Sadly, in this current anti-spending climate, the Food Safety Modernization Act–which incorporated some of the NAS recommendations–is at risk of becoming an unfunded mandate. So, I would use my magic wand to have Congress see the wisdom in investing in preventing foodborne disease instead of just responding to it.

Of course, I know that government can only do so much when it comes to food safety so I would also use my magic wand to have all food producers recognize the importance of adopting a food safety culture–from the top down–that puts the health and well-being of their customers first and recognizes their role in protecting public health.

I would use my magic wand to have company executives see their moral obligation to produce safe food and the wisdom in accepting responsibility when things do go wrong, rather than blaming the victim.

I would also use my wand to end practices that hinder food safety, such as putting a premium on the lowest price rather than on safety and quality; d
enying paid sick leave to food handlers; downplaying the inherent risks in their food products, and engaging in agricultural practices that ignore human and environmental impacts. With a flick of my wand, all food producers would embrace this new food safety culture and would adopt preventive controls aimed at stopping contamination at its source.

 I would not stop there because I know that, no matter how good the system is and how hard people try, there will occasionally be failures and people will get sick. So, I would use my wand on health care professionals to improve diagnosis, treatment and reporting of foodborne illness. And I would use my wand to improve the public health infrastructure to respond to crises that occur by providing adequate resources at the federal, state and local levels and by building the human capacity necessary to support it.

I would also use my magic wand on schools to implement targeted education strategies around food safety and on private funders to provide the resources needed to support organizations that are trying to drive all these changes.

Finally, I would use my magic wand–if it wasn’t worn out–to change how we think about the food we eat. Food is something we all consume and one of our most valuable resources.  Despite the abundance of food choices in this country, we often don’t think about the food that we are putting into our bodies and the impact it has on our health and our environment.

We don’t think strategically about food as a culture or as individuals. But we should and, in this country, we are blessed to have the power to change that. So, I would use my magic wand to get everyone to understand that food and food safety is a global health issue; to recognize the importance of adopting a comprehensive One Health approach that integrates human, animal and environmental health; and to vote for food safety both politically and with your buying power.

And maybe–just maybe–if I do all that, I’ll actually succeed in giving my friend Bill Marler what he wants–to go out of business because people are no longer suffering from foodborne disease. In the meantime, I’ll keep dreaming…