food fights
Inside the USDA, FDA turf battle
No federal agency has the authority to go on farms to test for human diseases. It's a glaring gap in the U.S. food regulatory system, now more exposed than ever with the onset of avian flu in dairy cows. At the center of the regulatory confusion is a decades-long relationship between the USDA and the FDA, punctuated by tense turf battles, report my colleagues Rachel Cohrs Zhang, Lizzy Lawrence, and Nick Florko.
Even though H5N1 is currently an animal disease, public health experts are concerned that the scope of the USDA's testing regime is too limited. Some argue the agency has the tools to test on farms, and isn't using them — instead going with a voluntary approach that has human health officials increasingly concerned that we aren't responding as we should to the outbreak.
My colleagues spoke with more than 20 former agency officials and independent experts about the sprawling food regulation world and the ways in which the two agencies have stepped on each other's toes. Dive into what they found and what it means in the current outbreak.
Offshore oversight
Squawk go the China hawks
Tomorrow, the House Oversight Committee is scheduled to mark up legislation aimed at banning the Chinese biotech WuXi from doing business in the United States. But the bill was already revised to take it a little easier on the many U.S. biotechs that rely on the company for manufacturing and other research and development services, John Wilkerson writes.
The new version of the BIOSECURE Act, which was approved by members of both parties in the House and by Democrats on the Senate homeland security committee, aims to make clear that companies doing business with WuXi would not be banned from selling their products to Medicare and Medicaid. However, the bill would give the administration significant leeway on the law's execution, so a lot would still depend on who is in the White House when it takes effect.
The new version also adds WuXi Biologics to the blacklist — the previous version only named WuXi AppTec, though the bill's authors consider them the same company. U.S. biotechs could continue working with WuXi for seven years under existing contracts to give them time to find alternative suppliers.
The Defense Department, which maintains a list of companies with ties to the Chinese military, is supposed to conclude its review of Chinese biotech companies in mid-June. Several lawmakers asked the department to add WuXi to that list. On May 3, WuXi AppTec wrote a letter to the DoD refuting the many allegations made against the company, including that it has ties to the Chinese military and that it gave, without consent, one of its U.S. client's intellectual property to Chinese authorities.
doctor pay
Infectious disease specialists amp up compensation calls
Public health experts are clamoring for better H5N1 surveillance, testing, and containment — some of which agriculture and health officials set in motion late last week. But infectious disease doctors say we — specifically, they — need more.
The ID field is in danger of its own workforce shortage. Already, 80% of U.S. counties don't have infectious disease practitioners, members of the specialty's largest organization told reporters last week. A major reason, they say, is low incentives to join the field and stick it out in hospitals with lower pay.
It is "the third-lowest paid specialty," and "the current [Medicare compensation] codes that are being used undervalue the work that ID physicians do," said Tina Tan, a Northwestern University ID physician and president-elect of the Infectious Diseases Society of America. The group is pressing CMS to implement "better codes" to compensate for their speciality, she said.
Tan's comments came one day before HHS and USDA officials announced a slew of incentives to farms to contain the avian flu virus' spread among cows. But this isn't just about H5N1, IDSA has told HHS; other trends such as a rise in injectable drug use have fueled HIV and hepatitis spread in areas without many providers.
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