Institute for Food Safety and Nutrition Security Director Turns Tragedy to Advocacy

September 30, 2024

Authored by:

Ruth Steinhardt

At two years old, Barbara Kowalcyk's youngest son Kevin was just coming into his own. He was "a gentle soul," Kowalcyk remembers: a healthy child, affectionate with people and animals, who adored the TV show "Barney and Friends" and once fell asleep on the sidewalk in the middle of a tantrum.

Then, after a family trip, Kevin got sick. As his symptoms worsened, his parents took him to the emergency room. Doctors sent the family home, but Kevin didn't get better. He was re-hospitalized and tested positive for shiga toxin-producing E. coli, a serious foodborne pathogen that can cause cascading organ failure. The following day his kidneys failed.

Less than two weeks after his first symptoms of food poisoning, Kevin died.

The tragedy would have changed the course of any mother's life. But Kowalcyk, a trained epidemiologist and biostatician, turned her grief into fuel. Over the decades since Kevin's death in 2001, her technical background, her research acumen and her courage in sharing her story have made her one of the country's most respected food safety experts and advocates. Her family spent years advocating for proposed legislation known as "Kevin's Law,"a journey featured in the 2008 documentary "Food, Inc." Later, a report she co-authored became the blueprint for the Food Safety Modernization Act, signed by President Barack Obama in 2011 as the first major reform of food oversight at the FDA since 1938. Kowalcyk is currently chair of the U.S. Food and Drug Administration's Science Boardand has served on numerous other advisory committees, including the Centers for Disease Control and Prevention (CDC)'s Food Safety Modernization Act Surveillance Working Group.

She now brings her expertise and her deeply informed perspective to the George Washington University's Milken Institute School of Public Health, where she is the inaugural director of the school's Institute for Food Safety and Nutrition Security.There she and her colleagues work to advance food systems that promote public health, using the One Health modelto take into account the interlinkages between human, animal and environmental health. The institute works to build a holistic conversation around food safety, integrating questions of nutrition, food safety, equitable access and more.

Barbara Kowalcyk. (Courtesy B. Kowalcyk)

"Our food systems have become global and much more complex in recent years, and that can result in a lot of changes and public health impacts, both in terms of nutrition and also in terms of food safety and foodborne disease," Kowalcyk said. "Our vision is a food system that consistently and equitably deliver safe, affordable, nutritious food to all."

And while she's seen significant progress over the course of her career, Kowalcyk said, a recent deadly case illustrated how much progress still remains for American food safety culture, especially in terms of corporate responsibility.

'Predictable, but regrettable'

This summer's multistate Listeriaoutbreak originating at a Boar's Head deli product processing factoryhas, to date, hospitalized at least 57 people and killed ten. For Kowalcyk and her colleagues-who have known for decades about the potential danger of Listeria monocytogenesin deli meat, just as regulators and manufacturers do-the outbreak was a sign of a "system failure at multiple levels," she said.

The Boar's Head facility in Jarratt, Va., which shut down indefinitely last week, had logged dozens of instances of noncompliance over the months before government agencies formally announced they were investigating an outbreak linked to food produced at the plant. Inspectors from the U.S. Agriculture Department noted mold, insects and "heavy discolored meat buildup" on equipment since before August 2023.

It is damning that the facility was permitted to continue operating until its products sickened people in 18 states, Kowalcyk said. But she is wary of focusing too narrowly on regulatory failures and forgetting where ultimate responsibility lies: with the company producing tainted product.

"Boar's Head was accountable for producing a safe product, and they are making money off of that product," Kowalcyk pointed out. "The public health agencies charged with overseeing the safety of food do need to be held accountable. But in a proactive food safety system when your product is going to directly impact someone's health, you take every reasonable step possible to ensure it's safe. You don't rely on inspectors to tell you something is wrong."

Foodborne pathogens cause about 48 million illnesses, 128,000 hospitalizations and 3,000 deaths annuallyin the United States, according to the CDC. In the early 2000s, as Kowalcyk sought to understand what had led to her son's death, she encountered opaque bureaucracies and a frustrating lack of accountability. While conditions have improved over the course of her career, all too often responsibility for food safety is still turned back on the individual consumer, she said.

"If a food company, with all of its microbiological testing and procedures and experts, can't control these pathogens, why would anyone think that a consumer armed with kitchen cleaner and a meat thermometer would?" Kowalcyk asked rhetorically. "Everyone needs to do their part, but let's be realistic about what consumers really can do. They have the least amount of control in the system. That's why we need a multi-hurdle approach from farm to fork."

Creating safer food systems means bringing all voices to the table, Kowalcyk believes, including legislators, academics, activists and industry professionals.

"When you're working to improve the food system, you need the producers to be part of the solution, because the system is not something we can turn off and then turn back on when it's better," she said. "You have to be collaborative, because this is a team effort."

There are, of course, things individuals can do to mitigate risk. As Food Safety Education Monthends, Kowalcyk pointed consumers to the World Health Organization's five keys to safer food: Use safe water and ingredients, clean yourself and your workspace thoroughly, separate raw foods from cooked ones, cook all foods thoroughly with the help of a thermometer (Kowalcyk recommends a digital tip-sensitive model) and store foods at a safe temperature. That means not leaving leftovers out for more than two hours.

But major responsibility for food safety has to lie with the systems that supply it, Kowalcyk said. In the case of Boar's Head, the potential for Listeria in deli meats has been a known problem for decades. In fact, illness and death from the pathogen were significantly reduced after high-profile outbreaks in the 1990s(although they've plateaued since). So when Kowalcyk initially heard about the Boar's Head outbreak, her reaction was "Haven't we already learned this lesson?"

"It is predictable that a plant that is not employing good sanitation hygiene practices would have a problem with listeria, but it was unpredictable in the sense that we thought we already knew this," Kowalcyk said. "We shouldn't have to relearn it."

Building safer systems

It is possible to create guardrails that ensure deadly lessons don't have to be learned over and over again, Kowalcyk said, as she saw firsthand when the Food Safety Modernization Act was signed into law more than a decade ago. That's part of the reason she's excited to be at GW, where proximity to federal lawmaking agencies mean policy and practice are integral to the academic mission. Kowalcyk has already been able to invite students into closed-door meetings with industry and regulatory partners, guiding them through the practical realities of research and legislation. The institute will host its inaugural event Nov. 15, an interactive symposium called "Fresh Perspectives on Advancing Food Safety and Nutrition Security."

Kowalcyk hopes to impress upon students the importance of being scientists who are also storytellers, able both to comprehend the technical aspects of an issue and to bring it to life for the public. That's what she does for Kevin, a single face illuminating the 600 million people made ill by contaminated food every year.

"600 million sounds like a lot, but having a story to go with those numbers really makes a difference," Kowalcyk said.

Lynn R. Goldman, the Michael and Lori Milken Dean of Public Health at the Milken Institute SPH, said the school is "excited to have Barbara Kowalcyk join the Milken Institute School of Public Health, bringing her passion for science-based solutions to protecting our food supply."

"Her decades of leadership on these issues, combined with the resources and proximity to the federal government that our school provides, will position the Institute for Food Safety and Nutrition Securityas a leading voice on this issue," Goldman said.

"I couldn't be happier with Barbara Kowalcyk coming to GW," said Lance B. Price, professor of environmental and occupational health and the founder and co-director of the GW Antibiotic Resistance Action Center, whose expertise includes studying the risks posed by foodborne pathogens. "Her unique combination of expertise in epidemiology, risk analysis and One Health will make her a major asset to our school. I'm eager to work with her to drive evidence-based solutions for decreasing foodborne infections in the U.S. and around the world."

Kowalcyk and her husband have three living children who hope to impact the world for good. Kevin, who would now be in his 20s, never got to make that impact himself. So they carry his legacy forward.

"Ultimately, my goal is to prevent other families from going through what we went through," Kowalcyk said. "If I can do that even for one person or one family, one community, I will consider that to be a success."

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