Are foodborne illnesses on the rise?

In 2022, CDC recorded around 5,600 foodborne illnesses, a decline from roughly 13,800 cases recorded in 2009. However, the agency noted that this number is likely just a small fraction of the true burden of foodborne illnesses every year. According to CDC estimates, some 48 million people likely become sick with foodborne illnesses each year, with around 3,000 people dying from these infections annually.

In 2020, the federal government set a goal to reduce the number of infections by some of the deadliest pathogens by 2030. However, a September report from CDC found that rates of illness from listeria, salmonella, and E. coli have not improved while the rate of illness from other pathogens have increased.

"We're just not making the progress we had hoped," said Jennifer Cope, a medical epidemiologist and chief of enteric diseases at CDC.

Between 2012 and 2024, the number of recalls from FDA has nearly doubled, though the agency combines both food and cosmetic recalls. Some of this increase may be due to advancements in testing, which has allowed investigators to issue recalls before any illnesses have been reported, but there are also greater risks of contamination of certain foods, such as fresh produce.

In 2011, President Barack Obama signed the Food Safety Modernization Act, which aimed to reduce contamination in produce-growing areas. However, its reach has been limited by another law that prohibits FDA inspectors from taking test samples from neighboring animal farms without the owners' permission.  "I won't say the food supply is getting less safe, but it's not getting safer either," said Donald Schaffner, a professor of food science at Rutgers University. "We've sort of stalled out."

Challenges to food safety

According to experts, an increasingly complex food supply system has made it harder to ensure food safety. As the supply chain grows and becomes less integrated, there are more opportunities for food to be contaminated.

For example, it is difficult for regulators to ensure the safety of fresh produce, seafood, and other products that are sourced from overseas. Currently, FDA doesn't have the resources to inspect many foreign food facilities, and the agency physically inspects less than 1% of food imports.

This lack of oversight has already led to health consequences in the United States. Last year, applesauce pouches that contained lead-tainted cinnamon from Ecuador caused hundreds of children to fall ill. FDA did not inspect the plant in Ecuador or sample the product when it entered the United States.

Separately, Sarah Sorscher, director of regulatory affairs at the Center for Science in the Public Interest, said that future inspections could be hindered by proposed cuts to federal funding for state food safety programs. State programs often carry out on-site inspections of restaurants, food processing facilities, and farms for FDA.

Federal inspectors have also been sharply criticized for not acting quickly enough once potential contamination issues were identified. For example, a whistle-blower complaint alerted FDA in February 2021 to unsafe conditions at a baby formula manufacturing plant in Michigan. However, the agency did not conduct an inspection until nearly a year later, and by then, an infant had already died from an infection from a bacteria linked to the formula.

The U.S. Department of Agriculture was also criticized for not taking action after its inspectors repeatedly found black mold, rust, and other issues at a Boar's Head deli meat processing plant in Virginia. Although the problems had been identified starting in September 2022, a recall was only issued after a listeria outbreak hospitalized dozens and killed several others this summer.

Robert F. Kennedy Jr., President-elect Donald Trump's pick for HHS Secretary, has vowed to cut entire departments at FDA, saying that large agricultural producers "control" the agency. Kennedy has also repeatedly said that the U.S. food system is "broken."

However, Susan Mayne, who served as FDA's director of food safety during the Obama, Trump, and Biden administrations, said Kennedy's "narrative that F.D.A. experts are somehow captured by industry is simply not true."

Mayne added that reducing staffing will only make it more difficult for federal inspectors to do their work, and that regulators can only do so much to ensure food safety. "F.D.A functions as a food safety cop on the beat," she said. "But the ultimate responsibility for making things safer really comes from the food industry."