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DeLauro mulls infant formula fixes — and what to do about FDA

Food Fix (August 16, 2022)

DeLauro mulls infant formula fixes — and what to do about FDA

Originally published here.

House Appropriations Chair Rosa DeLauro is fired up, not just about FDA’s failings on the food front, but also about what might be done to make the infant formula market less concentrated in the wake of the ongoing shortage.

In a recent interview with Food Fix, DeLauro laid out her thinking as she works on another formula bill – and reflected on what ails FDA, a key food safety agency.

The following conversation has been edited for clarity and length. 

Food at FDA is under a microscope now in a way that it hasn’t been in a long time. I’m sure you’ve seen that the agency has now commissioned an outside review of its foods program by the Reagan-Udall Foundation. Some folks see this as punting difficult decisions on the issue. Where do you see FDA right now in terms of changing or listening to all of this outside criticism? 

I was opposed to the Reagan-Udall Foundation from its inception. Why were we engaging in this effort? What was their mission? What were they about? What are they going to do? I still have that view. They are so cozy with industry. And they get budget from ag approps. [The group receives federal funding from FDA through the annual food and agriculture spending bill.] This is incestuous. The idea that they could provide an independent, outside review – it defies imagination.

In an ideal world, what do you want FDA to do? There is a really strong consensus here that something has to change, but what do you want to see happen?

Historically, the FDA has not paid attention to food safety the way that they should. I believe food safety ought to be an independent agency. I’m not foolish or Pollyanna in viewing that as a slam dunk. This is an institution that is consumed with turf. No one wants to give up an iota of turf. I went around to everyone (on the Hill) and I couldn’t get people to agree to do this.

In the short term, we need a deputy commissioner of food safety, somebody who is confirmed by the Senate, somebody who has credentials in food safety. Food safety is low on the food chain, it really is. Who is the person responsible? 

Turning to the infant formula shortage: The agency has moved toward enforcement discretion to allow more imports for now. Where do you see that heading next? 

How are we monitoring the product as it comes in? How many people do we have inspecting that product as it comes in, testing it, seeing if it’s safe? I asked the inspector general – and they agreed to take on – the question of what the FDA and officials from the company did in the lead up to the recall. I recently asked the inspector general for (an inquiry) on this enforcement discretion. I’m concerned. 

There are some experts who think that WIC has helped keep the infant formula market highly concentrated. How are you thinking about this right now? There seems to be less appetite on the Hill to look at sole-source contracting. 

We’ve got to force them to do it. That’s a tougher road. Imagine a sole-source contract. Abbott has 43 percent of the WIC market. That is unconscionable. In that instance, we’re putting our most vulnerable population at risk. Some 50 to 66 percent of all infant formula in the U.S. is purchased through WIC. What are we doing to cultivate other domestic manufacturers? 

They are feeling a little left out right now.

The consolidation piece – I’m going to introduce a bill that will be out in September that focuses on the infant formula market, but I’m going to look more generally at consolidation, and that’s a tough road.

Well, some of the opposition comes from anti-hunger groups who are nervous that opening up contracting could make WIC more vulnerable politically and/or more costly generally.

Yes. They don’t want to open it up, especially if it costs more. But the apple cart was upended when this one company with 43 percent of the market failed and put all of these people at risk. We had to get USDA involved. I want to compliment Agriculture Secretary Tom Vilsack on what he was able to do, of looking at the waivers, etc. Abbott not having a contingency plan? My god. How could we be put in this position?

I want to pivot to the White House conference on hunger, nutrition and health – still a lot of outstanding questions, but folks are excited about this event. What are your hopes for that? 

What we can do to end hunger. How can we increase healthy eating? What are the diet-related diseases we can look at? I’m looking for the same kind of results out of this one as the groundbreaking efforts of the 1969 [White House food conference]. I also want to see discussion of the safety of food that we’re eating. I’m going to fight to make sure food safety is a part of this.

Circling back to FDA, it’s going to be really interesting to see what this review finds – and how FDA handles it. There’s a lot of pressure to shake things up over there.

Maybe I’m too cynical and skeptical. I think it’s going to be a cover-up. All they are going to say is, “We’re going to need more money.” I don’t know how they would want to address their structural issues, it’s going to be about revenue.

Content note: The above is just a portion of my lengthy conversation with the chairwoman recently on food policy issues. Are you interested in reading more in-depth Q&As with lawmakers? The newsletter format is more suited to content that keeps moving, but I will explore sharing longer-format content if folks are interested. Let me know.