The recent swine flu scare provided the world with another example of the globalization of public health. The need for global institutions that can coordinate an international response to such emergencies has never been clearer. We also need to look more broadly at the weaknesses in the international public health system and how to solve them, as further epidemics are inevitable. While U.S. pork producers are hastening to get the word out — swine flu is not transmitted by eating pork! — food is also becoming increasingly globalized. And international food safety institutions aren’t currently up to the job of keeping the food supply safe.
The case of Sudan Red is illustrative. In the early 1700s, the British East India Company began importing pepper and other spices from India. One of the more famous “inventions” resulting from this trade is the condiment known as Worchestershire sauce, which was based on a recipe brought back from India. Worchestershire sauce is now consumed worldwide and is an ingredient of many other foods. In 1995, unscrupulous Indian producers of chili peppers illegally “enhanced” their crops with a red dye to make them look better. Unfortunately, the perpetrators used a dangerous textile dye called Sudan Red, a known carcinogen. These peppers were subsequently used in the production of certain brands of Worchestershire sauce. After this adulteration was discovered, a massive global recall occurred of not only Worchestershire sauce but also over 250 other products that used it as an ingredient, including ketchup packets provided at fast food outlets around the world. Unfortunately, much of the contaminated food was already consumed before it could be recalled. While the economic cost and health concerns of this incident were significant, this is but one in a series of international food safety incidents that have occurred with unsettling regularity.
International trade in food is nearing $600 billion a year, sustaining livelihoods around the world while making dining experiences more varied, healthy, and interesting. In spite of its obvious benefits, our complex global food web has also given rise to repeated incidents where outbreaks of food contaminated by harmful chemicals or microbes in one country are spread rapidly across the world. While a global monitoring and response network is needed, the long-term solution to this problem is to provide sustained, internationally coordinated support for strengthened national food safety programmes. Unfortunately, responsibilities for food safety at the international level remain fragmented. However, this is also the situation in many countries.
The United States is still burdened with an antiquated system that dates back to the Pure Food Act of 1906, which led in some cases to irrational regulation. For example, the current system has the Food and Drug Administration regulating pizza and the U.S. Department of Agriculture (USDA) regulating pepperoni on the pizza. Despite increasing consumer demands and many studies to support a single agency, including a Government Accountability Office report, the food industry position has been mainly to avoid government oversight. However, in light of increasing food safety problems, including most recently the discovery of salmonella in peanuts, even some segments of the food industry have acknowledged the need for a restructured U.S. food safety system. The possible creation of a single food safety agency in the U.S. government within the Department of Health and Human Services is currently under study by the new administration.
Similarly, at the international level, food safety is highly fragmented, with responsibility mainly divided between the Food and Agriculture Organization (FAO) and the World Health Organization (WHO). Just as with the USDA, the FAO has a primary mandate to promote the food industry and thus possesses technical knowledge and expertise about food production and distribution. In addition, it has also taken on a mandate to develop policies and recommendations related to food safety regulation. However, dual mandates to both promote and regulate the same sector have raised questions about potential conflict of interests. In some countries, this conflict has resulted in serious regulatory lapses, such as the case of BSE or “mad cow” disease in the United Kingdom.
By contrast, the WHO, which was established in 1948, has a broad mandate for public health. The WHO’s constitution gives it authority to establish safety standards for food. One of the better run UN agencies, the WHO operates through six regional offices and about 100 country offices located in developing countries.
Given the growing public concern about the safety of food, an International Food Safety Agency under the auspices of the WHO should be established that would:
- Be the only international agency coordinating food safety, from production to consumption, with counterpart agencies at the national level.
- Reduce the overlap, inefficiencies, and costs among the six major international agencies currently having food safety responsibilities, namely the WHO, FAO, Codex Alimentarius Commission, World Animal Health Organization, International Atomic Energy Agency, and World Trade Organization.
- Eliminate inherent conflicts of interest of agencies that are primarily mandated to promote the food industry.
- Provide a rapid mechanism for reporting and responding to food safety emergencies via the WHO’s legally binding International Health Regulations.
- Serve as the secretariat for the Codex Alimentarius Commission, currently administered by the FAO, to ensure that international standards for food safety protect public health.
Establishing this new agency would be a relatively simple matter. As with the establishment of the WHO’s International Agency for Research on Cancer, a simple resolution by WHO’s governing body, the World Health Assembly, can establish the new agency, which would have its own governing council and budget. At the same time, it could still use the existing WHO infrastructure and support network, which extends to more than 192 countries and areas around the world. The WHO’s department of food safety would form the core of the new agency, which could also incorporate other food safety functions, such as the Codex. Overall, the International Food Safety Agency would result in better value for countries by reducing redundancies and improving efficiency and effectiveness. Moreover, the new agency would reflect the increasingly recognized need to have a single specialized food safety body that is fully committed to public health and free from potential conflicts of interest.
Countries that have already consolidated their food safety authorities under one agency, including most European countries, would likely provide strong support for this proposition. Many other countries that have taken steps in that direction, such as China, would also likely say yes. The main opposition would come from the agricultural sector. But current trends suggest that consumers and their governments believe that food safety is essentially a public health function, separate and distinct from the production and marketing of food.