The American people deserve a single food safety agency

The following article by Frank Yiannas and Mindy Brashears first appeared in Food Safety News on September 11, 2023, and is repost here with permission.

About the authors: Mindy Brashears served as Undersecretary for Food Safety at USDA from 2019 to 2020 and Frank Yiannas served as Deputy Commissioner for Food Policy and Response at the FDA from 2018 to 2022.

OPINION

Both of us have dedicated our careers to advancing food safety and protecting the public. We’ve both done so at the height of federal service, in academic settings, as well as within the private sector. That’s why we believe we’re well qualified to provide a perspective on this issue. 

There aren’t too many topics more important for a nation than its ability to provide its citizens access to safe, nutritious, and available food.  And to do that efficiently and effectively, while being good stewards of taxpayers’ dollars, things must change. It’s time for our nation to have a unified, future-looking, single food safety strategy. 

We both have led teams and worked within large organizations with thousands and even millions of employees, so we understand strategy should precede organizational structure. Therefore, if you agree that a unified, single food safety strategy is in the best interest of everyone in nation, then by default, one must support the idea of a unified, single food safety agency. In other words, the right structure is needed to effectuate a unified strategy and vision. 

The sad truth is that this isn’t a novel or unique idea. And let’s be clear, it’s not a political or partisan issue either. 

In 2017, the Trump administration proposed re-organizing the oversight of food safety regulatory activities into one agency, the Federal Food Safety Agency, to be housed within USDA.  Similarly, the Obama administration also proposed a single food safety agency, but it suggested that it reside within FDA.  In fact, efforts have been made to consolidate food safety activities into one agency since 1949. Over the past decade, Congresswoman Rosa DeLauro and Senator Richard Durbin have repeatedly introduced similar legislation, the call for a single food safety agency, without success.  The U.S. Government Accountability as also made similar recommendations.  The GAO stated “that creating a single food safety agency to administer a uniform, the risk-based inspection system is the most effective way for the federal government to resolve long-standing problems, address emerging food safety issues, and better ensure the safety of the nation’s food supply.”

Recently, we (Mindy Brashears and Frank Yiannas) participated in a podcast hosted by the Federalist Society, along with Stephen Ostroff, former Acting Commissioner of FDA.  

The goal of the podcast was to discuss a re-organization within FDA, as a result of the findings of a report titled, “Operational Evaluation of the FDA Human Foods Program” conducted by the Reagan-Udall Foundation.  This report was written at the direction of current FDA commissioner, Dr. Robert Califf.  Commissioner Califf asked for the independent evaluation after a barrage of stakeholder complaints ranging from the infant formula crisis, the agency receiving 3 separate lawsuits for failing to issue food safety rules within required timeframes Congress stipulated when they passed the Food Safety Modernization Act in 2011 (over a decade ago), as well as the agency failing to address toxic heavy metals in baby foods, among other issues. 

The Reagan-Udall report discussed several problems with the current FDA Human Foods Program.  First and foremost, there was concern that this program had no defined leader in the organizational structure.  Office leaders each individually reported to the FDA commissioner without a designated leader responsible for oversight of the food programs.  This resulted in a lack of clear vision or mission for the human foods program apart from the overall FDA.  It was also noted in the report that the focus at FDA was on “consensus building” rather than decision-making thus pulling the organization down to the “lowest common denominator” to get buy in from everyone.  The consensus model is needed in some situations, but this process slows decision-making and leads to a lack of ability to implement the latest scientific advancements. A lack of allocation of funds from congress and limitations in the ability to compete with industry for employees because of low salaries were also concerns.

To summarize, on the Podcast, while there was agreement that changes needed to be made at FDA, there was also consensus that a single food safety agency – with a broader view beyond just FDA – is needed in order to further strengthen the safety of our food supply and to have the greatest impact on public health.  

While we didn’t have enough time to warrant a discussion on where a new, single food safety agency would be housed (USDA, FDA, or HHS as new, independent agency), it was apparent that we all believe, based on our experiences, that current system is fragmented and, in some cases, duplicative and ineffective.  

To illustrate this point, think about this. A frozen pizza that contains cheese and pepperoni is subjected to continuous inspection under USDA, but frozen pizza with cheese only (no meat) is inspected by FDA, as a non-high risk, once every 5 years. These differences are not based on science, nor risk. 

But it’s more than just about who inspects what foods.  More importantly, it’s about how do we take a more modern, risk based, and data-driven approach to how we regulate the safety of our food supply. Why is a pepperoni pizza subjected to continuous inspection, yet something as critical as powdered infant formula, at best, inspected only once per year. 

For those who do not know, FDA operates their inspection system different from USDA.  USDA operates on a continuous system with each animal being inspected before and after harvest with DVM oversight.  In processing facilities, an inspector is on sight at least once/day.  FDA’s food inspection oversight model requires that high risk food facilities be inspected once every 3 years and non-high-risk facilities once every 5 years. Moreover, most of FDA’s food inspections are done by State officials on behalf of FDA under contract with the Agency.

Modern times require more modern approaches. It’s time we moved to a more risk based, data-drive compliance approach, putting more oversight on products that pose the greatest risk to the consumers. 

While we were leaders at FSIS and FDA overseeing food safety at a very trying time in our nation, we worked together very closely, usually on a weekly and sometimes daily basis, on high level and impactful decisions due to long-time professional relationships – not because we were required to work together for decision-making, but because we knew that’s what the American people expected of us.  However, there was no standard or defined “requirement” for these interactions. In many instances, we both found ourselves experiencing the biases, turf battles, and silos that existed between the two organizations, although we made strides to break them down.  In our minds, it was critical, whether it was addressing the effects of the pandemic on food supply chains or in times of investigating foodborne outbreaks, the nation would be better served if we worked together. This often also included collaborating with another critical partner, the CDC.  There was indeed a joint committee among the 3 agencies to explore outbreak investigations.  However, in certain instances and in particular times of crisis, distance, structures, and unclear roles and responsibilities, resulted in difficulties in coordination of activities and communications. 

As we all know, changes within the government take time and a move towards a single food safety agency would be difficult and require an “act of congress”, but it isn’t impossible.  Sometimes, we need political leaders to have strength and courage to do the hard things.  

By no means are we suggesting that the staff at FDA and USDA are not doing a good job.  In fact, we commend the staff in both agencies for their service to the nation.  It’s just that we both believe we can strengthen the system to help them be even more effective at what they do.  

Lastly, for those who might think this would lead to bigger government, we are not advocating for that at all.   We believe, if executed and implemented well, it leads to more effective government by establishing clear roles, responsibilities, and lines of authority; reducing inefficiencies and duplication of efforts by allowing for a more integrated approach to the nation’s work on food safety, and leading to a more data-driven, risk-based approach to inspectional oversight which would be good for consumers and food producers.  No other developed country operates in such a divided system.  It’s time for the U.S. to make the hard decision, put aside turf or political differences, and prioritize public health by setting a plan in motion to migrate towards a single food safety agency.  Consumers nationwide, taxpayers, and the regulated industry deserve this.


The concept of a single food agency has been around for many decades, and has been put into practice in many countries around the world, including Canada, the United Kingdom, member countries of the European Union, Australia and New Zealand, to name a few.

It works.

I have been advocating the consolidation of all food regulatory activities into a single, independent food agency in the United States on multiple occasions since at least 2007 and I made the case again, most recently, in April of this year.

I am heartened to see Frank Yiannis and Mindy Brashears, both of whom have experienced the current, fractured system from the inside, take up the torch for a unified, independent food safety agency.


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Chapter 6. Birth of a Pathogen

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Cronobacter in infant formula: getting to the “root” of the problem

On August 30, 2023, the US Food and Drug Administration (FDA) issued formal Warning Letters to three manufacturers of powdered infant formulas: ByHeart, Inc., Reckitt/Mead Johnson Nutrition, and Perrigo Wisconsin, LLC.

That same day, the FDA released the redacted content of those Warning Letters to the public.

The letters reflected the agency’s concern that the companies had not established “ …a system of process controls covering all stages of processing that was designed to ensure that infant formula does not become adulterated due to the presence of microorganisms in the formula or in the processing environment…”

According to the information contained in the Warning Letters, all three companies had a history of Cronobacter sakazakii contamination in the production environment, with occasional positive finished product samples. And all three companies failed, in the FDA’s estimation, to conduct a thorough “root cause analysis” to determine and correct the source of their contamination issues.

Although the general conclusions reached by FDA investigators were similar for all three companies, each situation presented its own challenges. 

The FDA conducted its inspection of ByHeart’s Pennsylvania manufacturing subsidiary from December 21, 2022, through February 17, 2023. The operation, located at 61 Vanguard Drive, Reading, PA, manufactured an infant formula base product that was subsequently blended and packaged at a third-party contract manufacturing facility.

In October 2022, the company learned that a powdered infant formula product manufactured during a continuous production campaign at the facility from July 13, 2022, through August 23, 2022 and blended and packaged from September 15, 2022 through October 7, 2022, had tested positive for Cronobacter sakazakii.

The company’s “root cause analysis” blamed the positive result on lab error on the part of a third-party laboratory. A detailed review of the laboratory’s protocols and records found no basis to support such a conclusion.

A separate infant formula base mix that was manufactured on August 24, 2022, also tested positive for the pathogen.

This contamination event was blamed on a failure to follow specified cleaning and sanitation procedures following maintenance work and valve repair. 

Cronobacter sakazakii also was found in multiple locations in the production environment from July 25, 2022 through August 27, 2022, all of which were attributed to “…isolated events such as facility repairs, using an ineffective sanitizer, or ineffective cleaning frequency.”

In it’s Warning Letter, the FDA emphasized that the company’s root cause analyses were inadequate and did not get to the root of the problems. For example, ByHeart could have—should have, in the agency’s opinion—carried out whole genome sequencing (WGS) on the various Cronobacter sakazakii cultures in order to determine whether or not the same strain was consistently present in the production plant.

The FDA’s inspection of Perrigo’s Eau Claire, Wisconsin, manufacturing facility took place from March 6 through April 26, 2023.

On four separate occasions prior to and during the FDA inspection, the company found Cronobacter sakazakii in samples of its spray-dried infant formula manufactured during the period from October 2022 through April 2023.

The company blamed the contamination variously on probable cross-contamination betwen the dryer environment and the product contact equipment, packaging line downtime due to multiple scoop jams during production, and potential contamination introduced into the packaging line during increased dry cleaning interventions.

The FDA took exception to Perrigo’s root cause analysis in each case, pointing out that the company had not thoroughly investigated the source of the contamination. In addition, the agency expressed its disapproval of the company’s sanitation protocols and practices, stating:

“The detection of C. sakazakii in your facility across multiple independent inspections is significant in that it demonstrates your sanitation procedures have been inadequate to significantly minimize or prevent the presence of C. sakazakii in your facility.”

The FDA Warning Letter detailed outstanding issues at two separate manufacturing plants: Zeeland, Michigan (inspected from February 7, 2023, through February 23, 2023) and Wanamingo, Minnesota (inspected from November 28, 2022 through January 9, 2023).

As was the case for Perrigo and ByHeart, FDA investigators found evidence of multiple reports of Cronobacter sakazakii in both finished products and environmental swab samples at both manufacturing plants

The FDA was once again unhappy with the manufacturer’s response to the Cronobacter-positive findings, stating, “Upon receiving notification of this result, you failed to conduct an independent root cause analysis or investigation and you did not evaluate whether other products may have been impacted by this contamination event.”

Cronobacter sakazakii is a common presence in the environment, and can be found in soil, surface water, mud, grains, rotting wood, bird droppings, and food. 

The microbe is relatively harmless to most people, but can cause severe illness, often leading to death in susceptible individuals, especially in preterm, low-birthweight, immunocompromised, and/or infants under than 28 days of age.

It is, therefore, incumbent upon manufacturers of powdered infant formulas to take every possible step to ensure that their products are not contaminated with this potentially dangerous microbe.

In principle, any finding of Cronobacter sakazakii in the production environment or finished infant formula should trigger what is known as a “root cause analysis”—a systematic and intensive effort to find the source of the contamination and to make the necessary corrections before proceeding with additional production.

In practice, what ByHeart, Mead Johnson, and Perrigo did was to treat the symptoms rather than diagnose and correct the problem.

For example, in some instances, the companies responded to the finding of Cronobacter by performing an intensive cleaning and sanitizing without first carrying out environmental sampling to determine where in the production or packaging environment the microbe was lurking.

The sanitation effort provided a temporary solution, but did not prevent a recurrence of the contamination. Effectively, this approach treated the symptoms, rather than eliminating the source(s) of the contamination.

In its trilogy of Warning Letters, the FDA emphasized that a proper root cause analysis must be comprehensive and complete in order to be of value in determining the source of a contaminant. 

Only once the source has been identified correctly can a long-term, effective solution to the problem be put into effect.

In its August 30, 2023, news release announcing the Warning Letters, the FDA pledged its commitment to ensuring the safety of powdered infant formula, stating,

“The FDA will continue its regulatory oversight and engagement with industry to enhance infant formula safety, including continuing to conduct annual inspections of infant formula facilities, maintaining a dialogue with infant formula manufacturers on these issues, and furthering prevention-based research and activities.”

It behooves all manufacturers of powdered infant formula to do their part to maintain safe and sanitary production environments and to take all precautions necessary for the production of pathogen-free products, especially as these products are destined for the nourishment of a highly susceptible population.


TAINTED formats 3
“Reads like a true crime novel” – Food Safety News

Interested in learning more about food safety and the history of foodborne disease outbreaks and investigations?

Click on the link to listen to a short excerpt, then follow the buy links to add a digital, print or audio copy to your personal library.

Chapter 6. Birth of a Pathogen

TAINTED is available in digital format from all major on-line retailers. Press the button to go directly to your preferred digital bookstore.

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New audiobook exposes dark truths of the pet food industry

This book review by Jonan Pilet first appeared in Food Safety News and is reposted here with permission.

In an era where multitasking is a necessity, the audio edition of “TOXIC: From Factory to Food Bowl, Pet Food Is a Risky Business” by acclaimed food safety expert Phyllis Entis arrives as an invaluable resource for busy pet owners. This gripping audiobook, now available on Audible, Amazon, and Apple platforms, delves into the hidden corners of the pet food industry, exposing shocking practices that have led to numerous safety scandals.

Phyllis Entis

Drawing upon her extensive experience and research, Phyllis Entis takes listeners on a journey through the pet food industry’s dark history. Entis, also the author of the Amazon international bestseller “TAINTED: From Farm Gate to Dinner Plate, Fifty Years of Food Safety Failures,” focuses her expertise on the pet food sector this time. She unveils some of the most notorious pet food safety scandals of recent times, including pentobarbital in canned dog food, aflatoxin in kibble, and Salmonella in commercial raw pet foods.

“Pathogens and pentobarbital. Flies and filth. Obfuscation and outright lies,” writes Entis in the opening lines of the book. “For almost as long as commercial pet foods have existed, consumers have been forced to tease out the facts from the flummery when choosing what to feed their four-legged companions.” These words set the tone for the book, highlighting the long-standing challenge faced by pet owners in deciphering the truth behind their pets’ nutrition.

“TOXIC” is not just an exposé of the pet food industry; it’s a guide for pet owners seeking to make informed choices for their furry companions. With a passion for food safety that stems from her early career as a food safety microbiologist, Entis provides valuable insights and practical tips to help pet owners navigate the complex landscape of pet food choices.

Entis, who shares her home with an Australian Cobberdog named Rutlands Shalom, understands the importance of ensuring pet nutrition. This personal connection fuels her determination to inform pet owners about the hidden dangers lurking behind seemingly harmless packaging and advertisements.

Former global pathogen product manager George Nagle praised “TOXIC” as a worthy companion to Entis’s previous work. He commended the book for its meticulous insights, accountability, and its ability to empower readers with knowledge.

A section titled “Pentobarbital’s Pervasive Presence” exemplifies the book’s impactful narrative. The book recounts the tragic story of Mark Johnson, whose dogs fell ill and died after consuming tainted dog food, illustrating the urgent need for transparency and awareness in the pet food industry.

“TOXIC” is available in digital format from major ebook retailers and can also be purchased in paperback on Amazon, making it accessible to a wide range of readers and listeners.

Entis’s dedication to food safety and her compelling storytelling ability have once again converged in “TOXIC,” shedding light on the hidden truths of the pet food industry. As more pet owners seek the truth behind their pets’ nutrition, Entis’s audiobook promises to be an indispensable resource for those striving to keep their beloved animals safe and healthy.


TOXIC

From Factory To Food Bowl
PET FOOD IS A RISKY BUSINESS

Available from all major on-line retailers, including:

Enjoy the slideshow as you listen to a sample of TOXIC, narrated by the author.

“A complete and compelling account of the hidden and not-so-hidden ways the food we give our beloved pets can be contaminated.” – JoNel Aleccia, Health Reporter, Food & Nutrition, The Associated Press.