Laurie Garrett and Yanzhong Huang provide a backgrounder for the CFR Symposium, Food and Drugs: Can Safety Be Ensured in a Time of Increased Globalization?
Every aspect of the world's food, drug, and medicine supply chain has globalized, often to such a degree of complexity that it is difficult to determine where a given agricultural component in a food product was grown, from what source a specific chemical used in pharmaceutical formulation originated, or through which channels particular medicines were packaged and distributed. The scale and pace of transformation of food and drug production and distribution has far outstripped the capacity of national regulatory agencies or law enforcement offices to verify authenticity and safety. In a single generation countries that have, for centuries, been self-reliant for food have become net importers. On a similarly rapid timetable, drug and vaccine manufacturers that were once entirely domestically based have morphed into global webs of subcontractors and chemical plants located all over the world.
Most of the twentieth-century institutions created to guarantee food and drug authenticity and safety are nation-state functions that focus on domestic inspection and surveillance activities. Violators of national regulations are typically identified through domestic regulatory and law enforcement mechanisms and reprimanded, fined, or imprisoned based on national law and justice protocols. Agricultural inspectors visit local slaughterhouses, granaries, and food processing centers. Drug inspectors investigate some facilities around the world, but their resources are limited and the bulk of their inspections are domestic. Though many countries lack the resources to execute such actions on a routine basis, the food and drug safety and regulatory systems in wealthy and middle-income nations have functioned reasonably well most of the time, limiting human health catastrophes and disease spread.
As we enter the second decade of the twenty-first century, however, the national regulatory and health systems of all nations, regardless of their comparative wealth, are hard-pressed to meet the challenge of globalized food and drug production, processing, and distribution. In the absence of viable forms of global governance in food and drug manufacture and trade, the risk to public safety is rising all over the world.