We Agree: FDA Should Jettison Foods
[Commentary by Jim Dickinson, Editor] It has been discussed for decades and doubtless comes hard to those who respect heritage, but we agree with the Washington Post’s editorial board: the time has come for FDA to relieve itself of its Center for Food Safety and Applied Nutrition (CFSAN) so it can stand alone as an independent agency. There’s no need to change the initials – many people who should know better already call it the Federal Drug Administration.
The history could be harder to shake. Adulterated drugs from overseas were an issue but adulterated food was a far bigger public concern when FDA’s precursor agency, the Bureau of Chemistry, was formed in 1880. Through more than a century thereafter, the performance of the two arms of FDA established a global model and “gold standard” for others to follow and emulate.
Now it’s a sadly different story. Despite its top billing in FDA’s name and original purpose, food regulation has for decades been consistently given short shrift in the agency’s allocation of resources. Consistently, outside examinations of the agency’s food program have found its performance lacking, sometimes even chaotic, due to internal communication malfunction and ineptness. Low morale compared with better-resourced and organized Centers dedicated to human health might explain a large part of that.
When compared with its healthcare oriented rivals, CFSAN is truly the runt of the FDA litter. In 2021 it had only 1,100 employees, compared with 5,200 in CDER, 1,700 in CDRH, and 1,200 in CBER. The Office of Regulatory Affairs, FDA’s field inspection force, is its second-largest unit at 4,800 employees; they serve all Centers, including CFSAN.
Last year, a damning Politico exposé observed: “Over the years, the food side of FDA has been so ignored and grown so dysfunctional that even former FDA commissioners readily acknowledged problems in interviews.” The online news service elaborated that CFSAN “has repeatedly failed to take timely action on a wide range of safety and health issues the agency has been aware of for several years, including dangerous pathogens found in water used to grow produce and heavy metal contamination in baby foods. The agency has been slow to acknowledge numerous other chemicals of concern, including PFAS, so-called forever chemicals, which can be found in the food supply and are used in food packaging. FDA has dragged its feet on major nutrition issues, even as diet-related disease rates in the U.S. have continued to worsen. For example, FDA has spent the better part of a decade working on voluntary sodium reduction goals for food companies while many other countries moved ahead with their own years ago.”
Most recently, there has been – not for the first time – a CFSAN crisis in assuring the safety of infant formula. During the Post editorial board’s edited transcript of a group interview with commissioner Robert Califf and principal deputy commissioner Janet Woodcock, both leaders seemed to present somewhat lame arguments for keeping CFSAN in FDA.
What made urgent good sense in 1880 – food and drug regulation in the same agency – has little to commend it now.