Battle over FDA’s future heads to Congress

A coalition calling for bigger reforms at FDA looks to Capitol Hill to intervene. Equity commission recommends improved access to nutrition programs. Plus, a look at obesity drugs in the media.

A photograph of the U.S. Capitol building.s

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Alright, let’s get to it –



Today, in Food Fix:

– A coalition calling for bigger reforms at FDA looks to Capitol Hill to intervene

– Equity commission recommends improved access to nutrition programs

– Obesity drugs attract more media attention


Battle over FDA’s future heads to Congress

Now that the FDA has finished unveiling its plans for reorganizing the agency’s foods division – at least for the time being – all eyes are on Capitol Hill to see whether lawmakers are really buying what FDA is selling.

As readers of this newsletter are well aware, FDA has been under tremendous pressure to fix how it oversees 80 percent of the U.S. food supply. There is broad consensus that the foods part of the agency is not working well due to serious structural, cultural, leadership and resource problems. (I’ve reported on this ad nauseam and an independent panel confirmed these findings at the end of last year.)

FDA has unveiled a plan to revamp the foods program (more on that here), but it doesn’t go as far as many reform advocates had hoped. In January agency officials outlined the basics of their reorganization plan and this week they shared some additional detail, but this latest announcement didn’t do anything to assuage FDA’s critics – if anything it seemed to embolden them. 

“The plans that have been unveiled by the agency today kind of leave us with no other option but to go to Congress,” said Roberta Wagner, vice president of regulatory and technical affairs at the Consumer Brands Association, which represents the consumer packaged goods industry (including the likes of General Mills and Coca-Cola). 

Wagner made these comments Tuesday during a briefing hosted by a broad coalition of industry, consumer and state regulatory groups – informally called the Friday Breakfast Club. Throughout the call, coalition members ripped the agency for digging in on its original reorg plan.

Leaving food inspections separate: The central complaint – from both consumer advocates and industry – continues to be that FDA’s reorg plan doesn’t fully consolidate the foods program. Most notably, it doesn’t move food inspections under the new foods leader – those functions will stay under another arm at FDA called the Office of Regulatory Affairs.

“If they continue to go down this road, and kind of ignore the Reagan-Udall Foundation recommendations, I think legislative language might be appropriate,” said Brian Ronholm, director of food policy for Consumer Reports. Ronholm suggested legislative language could ensure the type of structure that the coalition has been urging, one with “direct line authority over all of the key components of the foods program.”

“There is tremendous bipartisan support for effective change at FDA,” Donna Garren, executive vice president of science and policy at the American Frozen Food Institute, said during the briefing. “I think we will see support for making sure that there’s direct line authority.”

To matrix or not to matrix: In an interview with Food Fix this week, FDA Commissioner Robert Califf defended leaving the Office of Regulatory Affairs (ORA) separate in a so-called matrix management structure (a more decentralized management setup that’s common in the private sector).

“One of the fascinating things is people in government are not used to matrix organizations,” Califf told me. “And yet, that’s the way the whole rest of the world functions.”

“We’re in a much more complex society. We’re regulating 600,000 plus [food] entities,” he added. “We have to function like a modern organization.”

Critics of FDA’s plan argue that while matrix org charts may work in the private sector – where it’s more likely to have intense performance metrics and easier to lose your job – they don’t work in the government, where the situation and incentives are fundamentally different.

“They’ve been doing matrix management,” Wagner (of Consumer Brands) told me this week. “That is what they’ve been doing with the foods program and it’s been a failure.” These comments are particularly sharp coming from Wagner, who worked at FDA for more than two decades where she held various leadership positions.

What’s next: I’ll be watching to see how lawmakers wade into this debate during FDA budget hearings on the Hill, which are expected at the end of this month. Critics are hoping that Califf gets an earful about the agency’s proposal coming up short. Stay tuned.


Equity commission recommends improved access to nutrition programs

The Agriculture Department and Congress should take steps to improve access to federal nutrition programs, particularly for marginalized communities, the USDA Equity Commission said in an interim report to Agriculture Secretary Tom Vilsack this week.

The USDA Equity Commission, launched in early 2022, is a panel that’s tasked with looking at how to change USDA programs, policies, systems and practices to “help lift barriers to inclusion or access and address systemic discrimination or racial, economic, health and social disparities.”

The report covers a variety of USDA farm and conservation programs – which have a long and well-documented track record of discriminating against farmers of color – but it also includes several specific recommendations for nutrition programs.

Farmworker nutrition access: Recommendations include things like ensuring farmworkers and their families have access to all USDA food and nutrition programs by ending any requirements to have a social security number.

The commission recommends removing any eligibility rules for the Supplemental Nutrition Assistance Program (AKA food stamps) that “disproportionately limit access” for Black, Indigenous and people of color, including: restrictions based on immigration status, the prohibition on receiving SNAP benefits and food from the Food Distribution Program on Indian Reservations (FDPIR) in the same month, “the time limit on benefit receipt for unemployed people who are not living with dependent children,” and the ban on SNAP assistance for people with previous drug felony convictions.

The commission also calls for transitioning Puerto Rico and other territories from their more limited block-grant versions of the program to SNAP.

To read up on what the commission recommended for agriculture programs, Ximena Bustillo at NPR has a great rundown

The Equity Commission plans to publish its final report by the end of 2023.

While we’re here, the USDA this week announced the appointment of L’Tonya Davis as its “first-ever permanent Chief Diversity and Inclusion Officer.” Davis joins USDA from FDA, where she most recently served as director of the Office of Communications and Project Management in the Office of Regulatory Affairs.


Obesity drugs attract more media attention

A new class of weight loss drugs, including Ozempic and Wegovy, have put obesity back in the mainstream news spotlight.

In recent days, these drugs were featured in provocative cover stories in The Economist and New York Magazine

Credit: The Economist and New York Magazine.

The New York Times’ Ezra Klein Show also dove into the topic this week, with host Ezra Klein interviewing neurobiologist Stephan Guyenet about how our brains essentially “weren’t designed” to cope with our current food environment and how this new class of drugs could help with this unfair and ultimately harmful mismatch.

I’ve shared some reporting on these drugs in past editions of the newsletter. If you are trying to make sense of it all, Julia Belluz’s piece in Vox is an excellent, in-depth place to start. If you have time for a good 20-minute primer, Belluz recently joined the Apple News podcast.

Belluz also had a piece in STAT this week that’s headline caught my eye: Obesity could cost the world over $4 trillion a year by 2035.


What I’m reading 

Study suggests possible link between sugar substitute and heart issues. Experts say, don’t panic. (New York Times). A new study in the journal Nature Medicine linked popular zero-calorie sugar substitute, erythritol, and an increased risk of cardiovascular events, including heart attack and stroke. It got a ton of press coverage this week, but the study also had some limitations. “The sweetener, which is often added to many low- or zero-calorie foods and drinks, is just one of many sugar substitutes researchers have called into question in terms of their long-term safety risks,” per Dani Blum.

Alaska’s unprecedented food stamp backlog is taking a harsh toll on rural communities (Anchorage Daily News). “It’s been nearly six months since the Alaska Division of Public Assistance first began to fall behind on processing federal food stamp applications, leaving thousands of Alaskans still waiting for benefits to arrive now,” reports Annie Berman. “In rural Alaska, where food costs can be astronomical and food banks or pantries are rare, residents are experiencing particularly dire consequences from the unprecedented backlog, advocates say.”

Processed foods are making us sick. It’s time for the FDA and USDA to step in. (Harvard Public Health). “In recent years, evidence has mounted that these chronic illnesses are caused by deleterious substances in ultra-processed foods,” writes Jerold Mande, co-founder of the nonprofit Nourish Science. “It is time for the U.S. Food and Drug Administration and the U.S. Department of Agriculture to use their authority under federal law to protect us from these highly processed foods. This would be a paradigm shift – but it’s also common sense: FDA and USDA must make at least as much effort preventing chronic food illness as they do acute food illness.”


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