Foodborne illness in the United States is extensive and expensive. The incidence of foodborne illness is estimated to range from 6.5 million to 81 million cases each year and result in as few as 500 to as many as 9,100 related deaths annually. In terms of medical costs and productivity losses, foodborne illness costs the nation between $7 billion and $37 billion annually, according to USDA’s estimates. Public health officials believe that the risk of foodborne illness has been increasing over the last 20 years. Trends in the incidence of foodborne illness in the United States are linked, at least in part, to changes in Americans’ eating habits. For example, Americans today consume more raw fruits and vegetables than they did in the past and in some cases may mishandle them by not washing them. While this change in diet has many health benefits, the mishandling of these foods and other foods, such as undercooking and/or improperly refrigerating meat and poultry, may also contribute to the spread of foodborne illnesses. The scientific community has recognized that preventing contamination is the key to reducing the risk of foodborne illness. However, FSIS conducts organoleptic meat and poultry inspections of each and every meat and poultry carcass in order to fulfill current program requirements for carcass-by-carcass inspections in slaughtering plants. While these inspections fulfill the requirements, they primarily identify defects in quality but do not detect microbial contamination. However, as the threat of microbial contamination has increased, a Hazard Analysis and Critical Control Point (HACCP) system has come to be considered the best approach currently available for ensuring safe food because it focuses on preventing contamination rather than on detecting it once it has occurred. The HACCP system (1) identifies hazards and assesses the risks associated with each phase of food production, (2) determines the critical points where the identified hazards can be controlled, and (3) establishes procedures to monitor these critical control points. In January 1998, FSIS began to require meat and poultry plants to implement HACCP systems. Implementation is expected to take 3 years, starting with the nation’s 300 largest slaughtering plants, which account for 75 percent of all meat and poultry slaughter production. In 2000, this system will be fully implemented and will have reached very small plants—those with fewer than 10 employees. The HACCP system requires FSIS’ verification that a plant’s overall system—not just the individual control points—is working. This verification relies on, among other things, microbial and other types of testing of product samples taken at various times throughout production. These tests contribute to verifying whether the plants meet food safety standards and alert the plants to deficiencies in the slaughtering process. In addition to carcass-by-carcass slaughter inspections, FSIS inspects meat- and poultry-processing plants at least once per day during each operating shift. Its current inspection program practice for processing plants is labor-intensive and is not based on the health risk that a plant poses. Processing plants’ operations can include the simple cutting and packaging of meat and poultry, grinding, complex canning procedures, or the preparation of ready-to-eat products. Multiple agencies share the responsibility for ensuring the safety of the nation’s food supply. In fact, 12 different federal agencies located within six federal entities are involved: HHS’ Food and Drug Administration and Centers for Disease Control and Prevention (CDC); USDA’s FSIS, Agricultural Marketing Service (AMS), Animal and Plant Health Inspection Service (APHIS), Agricultural Research Service (ARS), and Grain Inspection, Packers, and Stockyards Administration; the Department of Commerce’s National Marine Fisheries Service (NMFS); the Department of the Treasury’s U.S. Customs Service and Bureau of Alcohol, Tobacco, and Firearms; the Environmental Protection Agency (EPA); and the Federal Trade Commission. Appendix I describes these 12 agencies’ roles and responsibilities in food safety, and table I.1 shows the food safety funding for and staffing levels of the agencies for selected years. This structure necessitates extensive coordination to minimize duplication of effort, prevent gaps in regulatory coverage, and avoid conflicting actions. Our past reviews have shown inconsistencies and differences between agencies’ approaches and enforcement authorities that undercut overall efforts to ensure a safe food supply. In the past, we have recommended a single food safety agency to correct the problems created by this fragmented system. In addition to the more than $1 billion provided for routine food safety activities, the administration’s food safety initiatives increased funding for federal food safety efforts by $43 million in fiscal year 1998 and requested $101 million for fiscal 1999. These funds went to various agencies—some of which previously did not have any food safety activities—to target efforts for collaborating on food safety priorities in six areas: (1) enhance surveillance of foodborne illnesses and build an early warning system; (2) improve the assessment of the risks associated with exposure to foodborne pathogens; (3) improve coordination among local, state, and federal health authorities; (4) improve the efficiency and effectiveness of seafood, fruits and vegetables, and other FDA inspections; (5) develop educational messages for a variety of audiences, such as consumers and schoolchildren, on the hazards associated with handling food; and (6) research methodologies for, among other things, more rapid and accurate identification and characterization of foodborne hazards. These areas represent important and specific food safety activities that, in many cases, existed prior to the initiatives but had difficulty obtaining funding through their agencies’ processes for setting budget priorities. Appendix II shows, by agency, the fiscal year 1998 funding and fiscal 1999 request for these initiatives. A significant area in which food safety funds could be spent more effectively is inspection resources. Most of the $271 million—over one-fourth of the food safety budget—spent annually on FSIS’ organoleptic, carcass-by-carcass slaughter inspections could be spent more effectively on other food safety activities that better address food safety risks. Once HACCP is fully implemented, the funds could become available through the Congress’s (1) authorizing FSIS to impose user fees on meat and poultry plants for carcass-by-carcass slaughter inspections, (2) eliminating the legislatively mandated requirement for these federal inspections and allowing slaughter plants to hire their own inspectors, or (3) combining the above options—permitting the slaughter plants to either pay the user fees for federal inspections or hire their own inspectors. In addition, if daily inspections of the processing plants—at an annual cost of about $109 million—were replaced by inspections based on health risk, an undetermined amount of funds could be made available. All or part of the funds made available through the implementation of revisions to food safety inspections could be redirected to other food safety priorities. Currently, FSIS spends about $271 million annually on inspectors who are present at each slaughter plant nationwide every day that it is in operation. These inspectors, under current FSIS rules and regulations, inspect each carcass—over 8 billion birds and livestock annually—for visible defects, such as lesions and diseases. Under the traditional organoleptic inspection system, an inspector has about 2 seconds per bird, at the fastest line speeds, to determine whether the carcass meets federal standards for wholesomeness. We previously reported that with the introduction of the HACCP system, the traditional system of organoleptic meat and poultry inspections of each meat and poultry carcass will become obsolete for improving the safety of meat and poultry because it does not prevent microbial contamination.Moreover, experts have recognized that post-mortem organoleptic inspections on every carcass must be changed because (1) they waste resources and cannot detect microbial pathogens, (2) the animal diseases for which they were originally designed have been eradicated in many countries, and (3) they result in unnecessary cross-contamination because the hands-on inspection techniques used virtually ensure that contamination spreads from one carcass to another. However, this type of inspection may be useful to slaughter plants, since it primarily provides an assurance of quality, such as ensuring that feathers are removed and that tumors and blood clots are not present. While these conditions do not generally threaten human health, they affect the quality of the product. Because the organoleptic inspections of slaughtered animals primarily help to ensure quality rather than food safety, these inspections are foremost in the slaughter plants’ interest. Therefore, as we previously reported, it may be appropriate to charge user fees to cover the cost of these activities. Historically, FSIS has sought but never received the authority to charge user fees for all of its inspection activities. FSIS is requesting user fees again in its fiscal year 1999 budget for all inspection activities. Although the Congress has decided in the past that it is not appropriate to impose user fees for all food safety inspections, the Congress, as a first option, may consider it appropriate to authorize user fees for the federal organoleptic, carcass-by-carcass inspection of slaughtered animals after FSIS has fully implemented the new science- and risk-based HACCP inspection system. If this authority were granted and used, most of the $271 million that FSIS currently spends on these inspections could be recovered. As a second option, the Congress could amend the mandated requirement for federal carcass-by-carcass inspections by stipulating that after a slaughter plant has operated under a HACCP system for a period of time, the plant could conduct its own carcass-by-carcass slaughter inspections, with appropriate FSIS oversight. Alternatively, as we previously recommended, the Congress could revise the meat and poultry acts to provide FSIS with the flexibility and discretion to target its inspection resources to meet the most serious food safety risks. Finally, the Congress could provide for a combination of the first two options.