Spoiled by Nicols Fox, Basic Books (US), $25, ISBN 0465019803

IT SOUNDS good: “From Farm to Fork” is the soholistic title of a research
programme on microorgainisms in food being conducted by the Ministry of
Agriculture, Fisheries and Food (MAFF). Those in the know call it “From Turd to
Table”. Cynicism about food safety—or realism about its deficiencies and
their causes—is not restricted to the cognoscenti. The BSE crisis has had
a catalytic effect in transforming public concern into fear, and anger into
outrage—powerfully fuelled, no doubt, by the incessant reporting of “food
scares”. These are, of course, not scares but real incidents with real people
falling sick—some to death.

Governments across the world—in Australia, New Zealand, Denmark,
Germany and Ireland—have recently tried to strengthen the national
machinery which protects the public from bad food. David Clark is Britain’s
Chancellor of the Duchy of Lancaster. (I quoted above his redefinition of “food
scares” as “real incidents”.) He is currently chairing a Cabinet committee that
is preparing legislation for a new Food Agency. Even Douglas Hogg, the hapless
agriculture minister in the previous administration, had conceded that something
was sadly wrong by proposing to create a Food Council—with the major aim
of “restoring public confidence”. Not before time.

Rightly, as far as food is concerned, Britain is seen as the sick man of
Europe. Not only did we create and magnify BSE, but in Scotland we have the
nation with the highest incidence of infection with the O157 strain of
Escherichia coli in the world. We are also doing pretty well in the
Campylobacter and Salmonella stakes: these organisms are less
lethal than O157, but make up for it by being much more common.

What has gone wrong? Who is to blame? How serious a problem is food
poisoning? Nicols Fox doesn’t have all the answers, neither does she often move
from an American focus—though she must for BSE. Nor does Spoiled
contain a single table or illustration. It is, nevertheless, a gripping,
authoritative and detailed account of our current food safety crises.

Being a journalist, Fox cannot resist casting the players as heroes, victims
or villains. Epidemiologists, who are usually starved of funds and fighting
against time and all the other odds one can imagine, play the first role. The
food industry—wealthy, secretive and cynical—the villain. Fox
documents her opinions well, so her arguments are compelling and difficult to
fault.

Her American focus means that she doesn’t discuss the dual role of Britain’s
MAFF. On the one hand, it’s supposed to promote food production and the industry
behind it, and on the other to safeguard public health. Public opinion seems to
be that the MAFF finds it very difficult to escape the clutches of commercial
interest, and that the public health has always been second on its priority
list—if placed at all.

To be fair to the MAFF its remit, which goes back to a time when German
U-boats threatened Britain’s food supplies in the Second World War, is mainly to
blame. Some say that the MAFF behaves as though nobody has told it that the
Kriegs-marine ceased its offensive operations in 1945.

The epidemiologists are presented in the classical triumphalist mode favoured
by those doctors who write medical history, and by those academics who write
histories of universities to mark the anniversaries of their foundation. These
accounts are often found wanting by professional historians and are rubbished by
them as being celebratory and Whiggish because they focus on the positive
achievements of individuals and institutions rather than their failures, and
have as their philosophical underpinning a belief in progress.

These criticisms are valid, in that in real life epidemiologists are human
and like any other group of professionals have their incompetents and idlers.
The notion of progress is belied by the remarkable resemblance of current
investigative techniques to those employed by pioneer John Snow, who
investigated the spread of cholera in the mid-19th century.

But, in epidemiologists’ defence, they are certainly no worse than policemen
at identifying suspects and producing the evidence of guilt—with far
smaller resources and much less public support. Certainly, they never have the
comfort of getting their evidence backed up by confessions from their microbial
suspects, and the “smoking gun” is hardly ever found—by the time people
fall ill in a food poisoning outbreak the contaminated food has been eaten or
thrown away.

Fox opens by describing in detail one of the fatal cases that went to make up
what is now known as the 1992 Jack-in-the-box E. coli O157 outbreak in
the US. Being a skilful journalist she vividly juxtaposes the banality of
everyday life with the tragedy. A little girl is taken as a treat to a fast-food
restaurant at the beginning of the weekend. She contracts E. coli and
after much suffering dies in intensive care 10 days later. This outbreak was
particularly important because of its size. There were more than 700 cases
across four states. The incident gave food poisoning, and E. coli O157
in particular, a political significance up to presidential level.

Fox looks at previous outbreaks of E. coli O157 as a paradigm for
bacterial food pathogens and as an emerging organism. She also discusses food,
and in particular how technology has changed the way food is prepared,
distributed and cooked—often in ways which open new avenues for
exploitation by bacteria.

Most of the 12 succeeding chapters present a nice mix of anecdote, analysis
and opinion, ranging from cholera, through Yersinia enterocolitica,
botulism, shigella and salmonella. There’s a whole chapter
on Edwina Currie’s ministerial nemesis, Salmonella enteritidis, and a
chapter apiece for campylobacter and E. coli O157. Fox finishes with a
long chapter on BSE and CJD, and a concluding piece entitled “A reluctant
vegetarian and the search for clean food”.

Interwoven among the pathogens are historical accounts. Here the author’s
sure touch deserts her—John Snow was long dead by 1880, when she has him
stopping a cholera outbreak by removing the handle of the Broad Street water
pump.

Nothing can rival a visit to a slaughterhouse to open one’s eyes to the
difficulties in processing animals for food of preventing—or even
minimizing—the microbial contamination of meat, but Fox does a pretty good
literary descriptive job.

Is there any good news in this book? Not much. One glimmer of hope is an
internationally agreed way to produce safe food—the hazard analysis and
critical control point systems. I disagree with Fox’s high scepticism, but agree
that it isn’t a quick fix for our problems. Its full implementation will take a
long time and will require enormous efforts both by food producers and by
enforcers.

One of the things that we have been very poor at in the food safety field is
learning from experience. Outbreak after outbreak takes place. Many are
investigated in detail and written up—seemingly just for the record. Sad
to relate, it takes massive outbreaks such as Jack-in-the-box, or last year’s
Wishaw outbreak of E. coli O157, to simulate action.

Fox’s book will help here. With its mix of human interest stories and
authoritative analysis, it is a well-referenced and readable review of our
current food safety crises. It is approachable both for nontechnical readers and
experts in the field, though its high moral tone might irritate some European
readers. More importantly, the book reminds us about the lessons that we still
have to learn, and of the high penalties that foodborne pathogens have exacted
from us through involuntary coprophagy due to complacency, official casuistry,
conflicts of interest and general incompetence.

Those who promote this view, however, tend to present it as a self-evident truth rather than produce supporting evidence. They may have good reason. It is, for example, virtually impossible to find out how much universities actually spend on research. Nevertheless, we do have to try if we are to find out just how well the policy has been working and test the underlying notion that bigger centres do better science because they are bigger.

Of all the research councils, the Medical Research Council has undergone least change in recent years, making it particularly suitable for analysing patterns in funding. Over the past 10 years, grants in universities have been handed out in a very specific fashion. Most of the money goes to a small minority of institutions, with two-thirds going to the top four. In fact, in recent years the “inequality” for those institutions receiving more than a handful of grants follows a simple and regular pattern, as a log-log plot of MRC funds for 1992-93 shows.

This pattern is not the consequence of some hidden hand at the MRC’s London headquarters. Patterns of distributions are similar in other parts of the system. The Scottish Higher Education Funding Council, for example, disburses its research funds to the eight older Scottish universities with exactly the same kind of unevenness.

These patterns of distribution follow the kind of trends predicted by the American mathematical biologist Alfred Lotka in his law of scientific productivity. This states that the number of scientists producing n papers is proportional to 1/n². To borrow the words of Derek de Solla Price, the American science historian who pioneered statistical ways of evaluating science research: “If there are 100 authors and the most prolific has written 100 papers, half of all the papers will have been written by the 10 highest scorers, and the other half by those with fewer than 10 papers each.”

In his classic discussion of this law, de Solla Price says: “If the number of scientific papers were distributed in a manner similar to the number of men with various heights, or the number [of people] kicked to death by horses, we should find far fewer large scores. Scientific papers do not rain from heaven so that they are distributed by chance, on the contrary, up to a point, the more you have the easier it seems to be to get the next.”

This is the well-known “Matthew” effect: “Unto every one that hath shall be given, and he shall have abundance; but from him that hath not shall be taken away even that which he hath” (Matthew, XXV, 29). For research, the effect has a meritorious performance the past as its starting point, and so its consequences could continue to be very beneficial. Thus, the American sociologist Robert Merton identified the effect nearly 30 years ago as a powerful factor involved in those processes of social selection that currently lead to the concentration of scientific resources and talent”.

The US Congress Office of Science and Technology put the impact of the effect on peer review succinctly in its review of federally funded research: “Institutional reputation is part of a cycle of credibility that gives investigators an edge in competition for scarce resources – the very resources that strengthen the institution as a productive research performer, which builds more credibility, and so on.”

Two outcomes follow. First, because the distribution of resources for research is already highly unequal – even among universities that would claim to be significant players – it is certain that even if all the available funds were redistributed so that the money went only to the top ten, the recipients would gain very little. They already have the lion’s share.

Secondly, universities should realise that unequal patterns of distribution of research funding have been around for a long time and are likely to persist for the foreseeable future. Surely it would be better for them to argue collectively for more funds for the system as a whole rather than to fight among themselves over the crumbs that fall from the table? They should also remind the funding bodies about the two classic examples of university systems that led the world in research a century ago and lead now, despite, or may be because of, the successful operation of powerful forces working against the Matthew effect.

The distribution of public funds to both the 19th century German-speaking universities and to the present-day American ones was, and is, much less concentrated than in Britain today. Thus in 1875, for example, 70 per cent of Prussian and Austrian universities received 83 per cent of government funds spent on equipping and maintaining medical school laboratories, and in 1989, 85 per cent of US federal expenditure on research and development was distributed among half of the 200 or so universities receiving such funding. In sharp contrast, to return to the MRC example, 82 per cent of funds in 1992/93 went to only 17 per cent “old” universities.

Joseph Ben-David, an Israeli sociologist, has a persuasive argument to explain why the German and American distributions follow a different pattern from Britain. He suggests that the success of the former systems followed the impetus given to science by institutional competition, which, in its turn, stemmed from political decentralisation in Germany (where universities were funded by the component, often small, states), and from the administrative decentralisation of university funding in the US. Competition between princely states to attract the best staff for their local universities was an important driving force in 19th century Germany, and operates – without the princes – in the US today.

There can be no doubt that the current overcentralised British system has favoured the untrammelled operation of the Matthew effect. In fact, current policies all seem to be designed to accelerate and strengthen its influence. Take, for example, the extensive use that the forthcoming research assessment exercise will make of measures of past performance (This Week, 18 November). We can be sure that “from them that hath not shall be taken away even that which they hath”.

We would be wise to remember Merton’s claim that the effect creates “difficulties for any efforts to counteract institutional consequences … in order to produce new clusters of scientific excellence”. Funders of science, you have been warned. (see Graph)