How can Americans lead healthier lives?
Solutions include reforming the Food and Drug Administration (FDA) and the Centers for Disease Control (CDC), along with replacing cigarette smoking with safer nicotine delivery systems.
InsideSources recently hosted the “Common Sense Public Health Roundtable” at the National Press Club in Washington, D.C., where three public health professionals laid out simple solutions that could pack a real public health punch.
“I would replace the FDA’s human food program, and I would replace it with something that would give both producers and consumers a better choice,” said Dr. Richard Williams. “And that would address food safety and nutrition problems that are plaguing us.” Williams, author of “Fixing Food: An FDA Insider Unravels the Myths and the Solutions,” worked at the FDA for nearly 30 years. “We treat FDA like it’s a revered institution when in fact, it’s like an old company that’s selling outdated products.”
The FDA is 117 years old, Williams noted, and “things are going on that they can’t keep up with.” He said while the most recent problem was the infant formula shortage, there have been a variety of other issues, especially with food safety and nutrition.
Thanks to a lack of innovation and little pressure from the public to improve, the results are underwhelming.
Every year, the FDA goes to Congress and asks for more money, making the same claims: 48 million people are getting sick from food-borne diseases, 128,000 are hospitalized, and 3,000 die Williams noted.
“Nobody ever says, ‘You’ve been saying the same thing every year, and we keep giving you more money, and nothing’s happening,’” said Williams. “They write regulations… They’re out of ideas, and unfortunately, we all pay for this” with taxes, higher food prices, illness, and death.
“Should almond milk be called milk? They spent a couple of years trying to figure that out,” said Williams
“Nutrition is a bigger problem,” he said. “Four out of 10 people are obese in this country.” Half the population will be obese by 2023. And food labels don’t help. Since they started labeling in 1973, “half of us now are diabetic or pre-diabetic. Heart disease and cancer are going up.”
“In 2020, COVID killed 350,000 people in this country. Poor nutrition killed 500,000,” said Williams. And the FDA still uses “old science.”
He suggested the FDA use a model like DARPA (Defense Advance Research Projects Agency) where the bureaucracy is minimal, and the agency can “develop new ideas.”
Among the steps, Williams suggested: Foods made in 3D printers; using robots in food production and intelligent packaging to signal that food is spoiled; and wearable nutrition devices that tell you what to eat and how much.
Clive Bates, editor of “The Counterfactual,” offered a basic yet bold public health policy. “Get rid of all smoking.”
About 480,000 people die from smoking each year, Bates noted, which is a huge number compared to other public health issues. And, he added, “another 16 million live in misery” from smoking-related diseases. Because smoking rates are far higher among lower socio-economic groups, targeting it also adds to social justice efforts. “If you can do something about smoking, you can do something about health disparities, which is a good thing.”
Bates argued the U.S. could do something about it. But it is just choosing not to, as a matter of public health policy.
Since 2010, there have been alternatives to what public health pros call “combustible cigarettes,” new products that provide nicotine without combustion.
“If you get rid of the smoke, you get rid of almost all the toxicant exposure,” said Bates. “People will continue to use nicotine but at much, much lower risk.” Government authorities in Great Britain have pegged the health risk from e-cigarettes, vaping, and other similar products at about 95 percent lower than smoking.
But instead of encouraging smokers to switch to lower-risk alternatives, as the U.K. has done, the FDA has been funding major marketing efforts targeting vaping and e-cigarettes, convincing smokers there is no health benefit from making the change.
As a result, most Americans incorrectly believe vaping is as dangerous as smoking.
One problem, Bates said, is that the FDA doesn’t know how to regulate something that comes with some risk but is far safer than the alternative. He said that vaping isn’t food or medicine; it is more like beer or coffee. It’s something people consume because they enjoy it.
“They don’t really know what they’re doing with these (smoking replacement) products,” he said. It would be better to consider them like coffee or moderate alcohol consumption. It’s pleasurable. It’s fun… It’s a harm reduction strategy. For people to use the products, they have to be appealing. Regulators have problems with that.”
And no, Bates added, the “F” in “FDA” does not stand for “fun.”
Dr. Brian Miller is a fellow at the American Enterprise Institute and a doctor at Johns Hopkins University. He used his real-world experience to discuss the CDC’s failures in the fight against COVID-19.
“I worked on COVID wards, and normally during a pandemic, you go to the CDC for advice,” Miller said. “Well, you’re in the middle of a global pandemic, and people are confined to their homes. You look up the CDC guidance, and the webpage hasn’t been updated. Or they don’t know.”
A pandemic caused by a communicable disease is the CDC’s reason for existence, and yet it wasn’t ready when the real thing happened. Why?
“The CDC’s mission has drifted,” he said. The agency started focusing on “current events” and health issues like the environment or addressing issues like racism and gun violence. Those healthcare issues keep the agency in the headlines but have little to do with the CDC’s job.
“Having an organization that is trying to be all things to all people all the time means that it cannot perform its basic functions, as we discovered during the pandemic.”
For Miller, the first step is obvious. “We should be directing our dollars to policy levers that work,” Miller said. “We should think about directing the CDC’s resources to its core mission and then some of those other funds and staff (could go to other agencies),” he said.
Also, the public should have the right to comment on CDC’s regulations.
“Public opinion still matters,” he said. “And public input matters.”