Group criticizes public health leadership as piecemeal, haphazard

When Trust for America's Health complained in August 2003 that federal efforts to prevent and control animal-borne illness were lacking, mad-cow disease hadn't yet been discovered in the United States. Now that bovine spongiform encephalopathy has been found, anxiety about whether to let our kids eat a McDonald's hamburger has added a new urgency to the trust's mission.

The organization, a nonprofit, nonpartisan group founded to raise the profile of public health matters, charges that the federal government and Congress have allowed the growing problem of animal-borne illness to be addressed in a diffuse and, therefore, needlessly haphazard way. "No one's truly in charge, and it leaves you at risk," said Shelley A. Hearne, the group's executive director. The trust's August report calculates that more than 200 government offices and programs have a hand in responding to the animal-borne diseases that have been making the news in the past few months.

In addition to mad-cow, apprehension has grown recently about monkeypox (from prairie dogs and Gambian giant rats), while fears persist over West Nile virus (from mosquitoes), Lyme disease (from deer ticks), and chronic wasting disease (from elk and deer). Add to that an underlying worry that terrorists could somehow use animals to infect Americans.

Hearne's group supports calls in recent years to create a new government agency to take the lead on food-safety matters, but Hearne says that the focus should be even bigger than that. "We need to look at overall leadership in public health in general....It can't be a piecemeal fix anymore," she said.

Still, most efforts at the federal level seem to address just part of the problem. Sen. Richard Durbin, D-Ill., for example, is planning to introduce a bill early this year to strengthen the federal government's role on mad-cow and other animal-borne disease; he sent a letter to colleagues this week urging their support for quick action.

Durbin, a member of the Senate Governmental Affairs Committee, says his legislation calls for tests that can diagnose mad-cow disease rapidly, in as little as four hours; for prohibitions on the slaughtering for consumption of cattle that exhibit neurological symptoms; and for a new national identification program so that infected cattle could be traced to their birthplace within 48 hours.

Even before the 2001 terrorist attacks that used airplanes and anthrax, Durbin and others were pushing for improved federal food-safety efforts. Indeed, Durbin was set to introduce a food-safety bill on September 11, 2001. He was then chairman of the Governmental Affairs oversight subcommittee. Durbin held a hearing, but his bill never advanced.

Durbin introduced his first food-safety bill in 1999, when he noted that more than 12 federal agencies were involved with food safety and that the overlapping jurisdictions often led to accountability gaps and to critical problems falling through the cracks. In addition to the mad-cow bill, Durbin said he will soon introduce an updated version of his earlier bill. The revised bill would consolidate all food-safety, inspection, and labeling functions into one independent agency, funded by the combined budgets of the current programs. The Agriculture Department now oversees meat, poultry, and egg products; the Food and Drug Administration oversees most other food products; and the Commerce Department's National Marine Fisheries Service inspects fish.

In recent years, both the General Accounting Office (in 2001 congressional testimony) and the Institute of Medicine (in a 1998 report) have backed the creation of a unified food-safety agency.

Trust for America's Health, meanwhile, says that the broader issue is strengthening the entire public health infrastructure so that it can address all food-safety and animal-borne illnesses, regardless of the source. The trust points to the confusing regulatory and enforcement maze that became evident during last summer's monkeypox outbreak.

The Centers for Disease Control and Prevention, which is part of Health and Human Services, initially had federal responsibility to investigate and manage the outbreak. When investigators finally linked monkey-pox to prairie dog pets that had been in contact with Gambian giant rats--the apparent source of the infection--jurisdiction became clouded. "While CDC has jurisdiction over national disease control and prevention," the trust report said, "it generally does not have the authority to regulate animals, agriculture, or food."

Instead, the report noted, the Agriculture, Interior, and Homeland Security departments, along with state and local governments, each must respond to different animal, wildlife, food-import, and food-security issues to supplement the efforts of HHS. For the monkeypox case, Agriculture's Animal and Plant Health Inspection Service was called in to investigate the movement of the suspect prairie dogs and giant rats.

In June, HHS banned imports of certain rodent species from Africa. States with potential monkeypox cases then had to devise their own animal-containment responses. "In total, four federal Cabinet departments, five federal agencies, and the corresponding departments in each of the impacted states and communities patched together monkeypox contamination solutions," the report said. The process, Hearne suggests, could have been a lot more efficient.

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