John C. Bailar III

The food supply in the United States is generally secure and relatively safe from noxious agents. It is also ample, inexpensive, varied, nutritious, and often appetizing—attributes that must be protected and extended at the same time that food safety is enhanced. Although poor nutrition is common, it is usually the result of failures at the individual and family levels rather than general institutional failures.

Furthermore, the United States, like few other nations, is fortunate to have no history of widespread famine, whether natural or man-made, or pestilential disease, at least for many decades. Thus, it may be difficult to imagine major disruptions in food production, transportation, or distribution. Simultaneous failures of major crops across this vast and varied country seem highly unlikely.

Yet we do have some food safety problems. Recent examples include parasites on imported raspberries, large-scale tainting of hamburger and milk, pathological organisms in cheese, and the recognition of uncommon but highly dangerous strains of Escherichia coli. Fortunately, most of these outbreaks were detected before large numbers of people were severely harmed.

What does it mean to say that our food supply is safe? Because perfect safety in our food supply is simply unattainable, an operational definition

of safety is needed. Lowrance (1976) once proposed that “a thing is safe if its risks are deemed acceptable.” This view makes safety a subjective matter, and it also makes clear that safety is a matter of degree, involving possible tradeoffs with other, perhaps beneficial, effects. Using Lowrance's definition, I would conclude that the U.S. food supply is safe. Nonetheless, it could be made safer.

The U.S. food supply changed enormously between 1900 and 1950. During this period a shift occurred away from subsistence farming; the use of preservatives (including cold and freezing) increased; and consumption of meat, eggs, and cheese rose. However, the food supply changed more between 1950 and 1999 than it did in the first half of the century. More recent changes include the growth in agribusiness and the consolidation of food processors, the loss of biodiversity (variety in the biological strains of plants and animals used for food), an explosive increase in meals eaten away from home (or at least prepared elsewhere), rising imports of many different fruits and vegetables, the changing mix of nutritional components—including an increase in protein and a decrease in fat consumption—and decreased needs for food energy per capita as fewer people engage in heavy manual labor. Many of the items we expect to see on our grocery shelves today were not available in 1950.

Changes in the food supply and our demands on it will continue and may even accelerate in directions that cannot be predicted. The food supply in 2050 likely will be quite different from that of today, and such change will require the recognition of new food-related problems as well as the development of new solutions, all on a large scale. In particular, a pressing need will emerge for changes in food inspection and in the assurance of food safety.

Many factors could have important effects on the U.S. food supply over the next 50 years. One is the resurgence of plant and animal pathogens, including new strains and new diseases that affect farm animals or food plants. Monoculture (the exclusive cultivation of a single, common, uniform product across a substantial area) has already replaced the family farm, which once produced several different kinds of food. Because of this specialization, there is cause for increased concern about food acting as a vector that can carry toxins or pathogens into the human gastro-intestinal tract.

Population growth, which will create increasing demands for sheer quantity in the food supply, must also be considered, as should the depletion of resources such as fertilizers and energy that are needed to sustain agricultural productivity. The total area and the condition of agricultural

lands also are important concerns. Agricultural land is diminishing, partly as a result of urban growth and sprawl; partly as a result of erosion, contamination with toxic chemicals, and other human-related activities; and partly as a result of the depletion of important nutrients in soil that has been tilled improperly or for too long. Water supplies are already tight and will become tighter as the available water must be shared by those who need it for agriculture and industry and by a growing urban and suburban population. Although new sources of fresh water may be developed—including economic approaches to desalinization—at the moment the expense of producing fresh water is likely to add substantially to the cost of agricultural products. In addition, major changes in climate may occur that could affect food production. Global climate change or environmental degradation also could have severe and essentially permanent effects.

Political unrest is unpredictable and could affect food sources in the United States as well as in countries that supply our imports. A point of special interest is the malicious release of harmful agents —whether microbiological, chemical, or physical—into the food supply. While there is no sign that this is currently a threat, the danger is real.

Several favorable influences may counterbalance these difficulties, including higher productivity from new strains of plants already in use and the genetic engineering of new plant species to produce food. We should expect to see new food products and new processes in ever-accelerating profusion. In its original form the green revolution is almost complete, but other research-based improvements in productivity may have profound effects on the assurance of a diverse and ample food supply.

The effects of some other changes in the food supply are more difficult to predict. Improvements in our understanding of nutrition may lead to demands for new kinds of food that will require novel approaches to agriculture and new types of food processing. Improvements in standards of living are generally positive, but they can and have led to harmful dietary patterns. Finally, it seems likely that our sense of what is safe (i.e., of what risks are acceptable) may change substantially. Such change is likely to be in the direction of diminished tolerance of problems and the resulting tightening of surveillance and control of the food stream. In short, the opportunity for “big ” problems in our food supply remains very much with us, and the risks may have even increased in recent years because of the following trends:

• Industrialization of food production, in which an error can become a very large problem.

• The growth of feed lots for cattle, the presence of mega-swine

operations, and the centralization of food processing (although the closing of big-city stockyards is a counter example).

• Globalization of the food supply, including imports that are virtually uninspected.

• Possible terrorism (which might be far more effective than in an economy based on subsistence farming).

• Rapid, frequent global commerce and travel, which can lead to serious and widespread problems involving food-related organisms.

Three additional social problems are likely to exacerbate the effects of these trends:

• Denial—there seems to be a widespread belief that “it can't happen here.”

• Inertia—including turf battles within or among regulatory agencies at all levels.

• Scientism—that is, the arrogance of those who think they have the knowledge and expertise to deal with any problems that may arise.

In this context, I think of Edmund Burke, who was reported to have said: “Good public policy is what men of good will, ten years hence, will wish we had done” (Stanlis, 1968). What will our children, grandchildren, and great-grandchildren wish we had done regarding future food supplies? There are many unknowns about the future of the food supply, and we must identify and prepare as best we can for those unknowns—whether good or bad and whether soon or well into the future.

How much benefit has the present system of food inspection brought us? Have numerous threats that would otherwise be broad and common been kept in check or even eliminated? This question cannot be answered at this time, but we do know that traditional organoleptic inspection (inspecting by appearance, feel, and smell) does little to detect the chemical and biological threats of current concern, although it does offer other advantages, and that major chemical and biological threats could escape detection indefinitely.

The traditional inspection of animal and poultry carcasses may once have served the important purposes of public health, but current threats are posed by microbiological agents and chemical hazards that cannot be detected by the traditional means of visual inspection, touch, and smell. To be sure, meat and poultry inspectors have numerous other responsibilities (such as assuring food cleanliness, proper labeling, and humane

slaughter), but they can add little to the prevention of modern foodborne health problems.

Our present testing program for chemicals in foods is grossly inadequate for understanding possible new threats or even for monitoring the food supply for existing threats. For example, in 1998 the Food Safety and Inspection Service Chemical Residue Program was designed to perform a total of 28,970 chemical tests on meat, but these samples were, by design, taken from a much smaller number of animals. The meat supply was divided into “slaughter classes” (such as broiler chickens) with an average of about 300 carcasses examined per class. The largest number of samples from any class was 460. These sample sizes not only are small but also are gathered from across the country over the course of an entire year. A total of 460 chickens, among the 7.5 billion slaughtered each year, represents about 1 in 16 million chickens sampled. This sample is not optimal for several other reasons: (1) there is no place-to-place or year-to-year linkage of findings, (2) sampling rates for establishments are proportional to their size (which has some important advantages in cost reduction but means that smaller places may escape monitoring), (3) the first stage of cluster sampling is random, and the second stage is a convenience sample picked by the inspector, (4) the tests themselves are not perfect, and (5) results of chemical testing generally are not available until well after the meat, poultry, or egg product and the remainder of the production lot have entered the distribution network and have been consumed.

Immediate and substantial increases in testing of the food supply are needed. Such testing must be on a sample basis but at a level of effort sufficient to identify threats that are less than nationwide in scope, and they must be rapid and consistent with what is known about the distribution and development of food hazards. In this context, automated laboratory operations provide an attractive approach. There is also a need to improve the use of sampling to protect food safety. Sample size alone is not enough to provide usable information; how the sample is designed and selected is even more important.

Other reports in this volume describe the advantages of new high-throughput approaches to testing. Despite these advantages, there are some reasons for concern about relying too greatly on centralized, rapid, high-volume analytical facilities. First, consolidating testing and reducing the number of test facilities will ensure that the impact of any mistakes that occur will increase. Although serious laboratory problems will become less frequent, when a mistake is made, it will be immense. Second, several statistical issues require careful consideration. The effects of biases and

correlated errors may or may not be reduced, but they are less likely to be detected when there are fewer players on the scene and are much less likely to be considered in interpretations of test findings. In addition, agency heads and administrators responsible for regulation do not like to think about problems in the data that they receive, and if there is little or no opportunity to detect and assess any problems, far more weight may be given to scientific data than is warranted.

Although new chemical analytical procedures may be useful, they should be implemented in ways that meet the same criteria applied to any other innovation. First, as noted, larger and more representative samples are needed to increase the likelihood of detecting noxious agents, whether chemical, biological, or physical. There will be a need to consider what size of effect (perhaps after translation into what size of exposure) we want to be reasonably sure to detect through monitoring. The present chemical testing program of the U.S. Department of Agriculture can, in rough terms, detect with 95 percent assurance a 1 percent or greater level of risk, if it is uniform over the course of a year and acts on the entire nation, provided that the outcome does not occur at all in the absence of a new hazard. The likelihood of detection diminishes rapidly as the “natural” incidence of the hazard increases from 0 and as the region of concern shrinks to smaller agricultural areas or shorter time periods.

In the event of a major food-related problem, whether natural or deliberate, a further and massive short-term increase in the need for data will occur. These data needs will require facilities and skills that cannot be produced overnight. Furthermore, even interpretations of the data must be “on the shelf” in order to save the time needed to centralize, process, and study the data. While there is still time for reflection, it is important to determine ways in which to react to specific possible threats.

More and better methods for testing food are needed to assure that our nutrition is optimal. Such tests will generally focus on gross elements of diet (carbohydrate, protein, and fat) plus vitamins and minerals, rather than on trace elements and residues. However, it may be that the needs and methods for testing to improve nutrition will differ from those that are needed for safety testing.

How can rapid, high-volume, inexpensive testing help to protect the U.S. food supply? Such testing may improve:

• Research in basic food science, where obtaining reliable data is often the most difficult and time-consuming step in the process.

• The safety of new technologies (e.g., residues of antibiotics and hormones, irradiation of foods, genetic engineering).

• Testing of the stream of foods to detect and remove contaminated foodstuffs.

• Sample testing to characterize, monitor, and ultimately eliminate hazards by identifying feasible means to deal with problems at an early point in food production, processing, and distribution.

The distinction between testing the stream of foods to divert contaminated products and testing to prevent future mishaps is critical. Much of our inspection and testing is still founded on after-the-fact detection and diversion.

Although recent developments can vastly increase the range, depth, and speed of data generation, they can do little for other steps in food testing, such as selecting and collecting proper samples or transporting them to a central laboratory. When the cost or time needed to process a sample is the limiting factor, large-scale, high-throughput laboratories may help. Otherwise, they are likely to contribute little, except perhaps by modestly reducing the unit costs of data generation.

Bioterrorism makes many of us uneasy. However, the reality is that the highly distributed production, transportation, and distribution systems for food in the United States may make interruption of the food supply an unattractive target for terrorists, although numerous smaller acts could sow fear, confusion, doubts about the civil authorities, and general unrest.

What might a terrorist view as opportunities related to our food supply? Major damage to a great range of potential targets—humans, animals, plants, and even whole ecosystems—could advance terrorist goals, even if the damage is localized to the level of a town or neighborhood.

One grave possibility is the modification of biological or other agents that could damage substantial parts of the food economy. Such agents may be produced in ways that are relatively fast, inexpensive, and easily concealed and that do not require vast knowledge or technical skill. Further, such agents may be easy to transport and distribute. Microbiological agents might be especially attractive for terrorism because they reproduce themselves and can be made in ton lots. However, they may spread beyond the boundaries of the target area, and a terrorist organization might not want to use an agent that could affect its own community. On the other hand, it seems unlikely that a terrorist could have access to a biological, chemical, or physical food hazard the outcomes of which lie far outside already known risks. Rather, the terrorist is likely to be the vector of a known agent (possibly modified).

The details of some of the most important questions about our future food supply, including vulnerability to terrorism and appropriate methods

for dealing with these changes, are not yet clear. The combination of unclear problems and unclear methods is worrisome. At present, understanding of the uncertainties and risks of terrorist attacks on the food supply lies mostly in the realms of laboratory research, conflict resolution, and pure guesswork, although the prevention or control of specific problems is more likely to fall within the realm of epidemiology, engineering, technology, and agricultural science. All of these matters are essentially highly multidisciplinary.

What can be done to reduce the likelihood and scope of terrorist attacks on our food supply? We will need the following:

• Complete, accurate, and timely knowledge about what threats exist or may be created.

• Very early pinpoint identification of terrorist acts.

• Adequate means of defense against those threats and swift deployment of countermeasures.

• Capabilities for major transport of foodstuffs into an affected region.

Overall, bioterrorism focused on multiple small areas using microbiological agents is a credible threat now and in the future. It would not be surprising to learn that some efforts have already been launched.

Our federal structure for ensuring the safety and integrity of the food supply is byzantine. At least a dozen federal agencies have major responsibilities for food safety, and many others have important but smaller roles. These agencies administer more than 35 separate statutes, and they have developed more than 70 Memoranda of Understanding to deal with problems that cross agency boundaries. In Congress, 28 separate House and Senate committees are responsible for oversight of these food safety activities (National Research Council, 1998). The Food Safety and Inspection Service inspects meat and poultry. The Center for Food Safety and Applied Nutrition of the Food and Drug Administration (FDA) inspects fish but takes no regulatory action. Other agencies are responsible for the inspection of fruits and vegetables, but they rarely resort to using their regulatory powers. Testing is carried out and standards are set by the FDA and the Environmental Protection Agency. Imports are handled in a range of different ways. In addition to a more effective organizational structure, lacking at the federal level are:

• Up-to-date knowledge about possible agents and their effects, including exposure, biological mechanisms, and treatment or prevention.

• The capacity for extremely rapid response to indications of a new problem.

• The data needed for routine operations.

• Preparations for an effective response, including public education, stockpiling of the materials most likely to be needed, and improved linkages to make use of the substantial capacity of state and local governments in supporting an effective response.

Several approaches for response have been proposed, including forming a food safety council (of agency heads) and appointing a food safety “czar” (a coordinator without the staff or authority to direct needed action).

A council of agency chiefs would not be able to deal rapidly and effectively with the full range of possible microbiological, chemical, and physical hazards, as well as with the integrity of the food supply itself. The present structure is simply too fragmented to deal with the hazards outlined above in an effective and coordinated manner. What are the alternatives? The notion that a council of elders (e.g., agency heads) could deal with a significant problem promptly and decisively is unlikely. The notion that a czar could accomplish the task through persuasion is even more improbable. Either structure seems to ensure inadequate response to any major broad threat to the U.S. food supply. This makes a compelling case for the unification of responsibilities for food safety, whether microbiological, chemical, or physical. Our country needs a single independent food safety agency.

A Committee of the National Academy of Sciences recently made the following recommendation:

To implement a science-based system, Congress should establish by statute a unified and central framework for managing federal food safety programs, one that is headed by a single official and which has the responsibility and control of resources for all federal food safety activities, including outbreak management, standard-setting, inspection, monitoring, surveillance, risk assessment, enforcement, and education. (National Research Council, 1998)

This committee developed its recommendation based on the hazards that are already with us, paying almost no attention to bioterrorism or the other significant problems mentioned elsewhere in this paper. When bioterrorism is added to the mix, the case for prompt and sweeping change becomes compelling. While additional tinkering with the details of our food safety system might be helpful, the consolidation of responsibilities, authorities, and resources for food safety into a single high-level agency is critical.

Lowrance, W. W. 1976. Of Acceptable Risk: Science and the Determination of Safety. Los Altos, Calif: W. Kaufmann.

National Research Council. 1998. Ensuring Safe Food: From Production to Consumption. Washington, D.C.: National Academy Press.

Stanlis, P. J., ed. 1968. Selected Writings and Speeches by Edmund Burke. Gloucester, Mass.: P. Smith.