Robert Tauxe of the CDC

This article has been updated since it was originally posted.


Last May, Robert Tauxe, a food safety bigwig at the U.S. Centers for Disease Control (I know he’s a bigwig because he has lots of initials after his name and a 16-word title) wrote a letter to state epidemiologists and public health regulators in which he slammed raw milk. He asked the regulators to “continue to support pasteurization and consider further restricting or prohibiting the sale and distribution of raw milk and other unpasteurized dairy products in their states.”


Nothing much new there—just another political thrust by the supposedly scientific CDC to get a raw milk ban. We wouldn’t even know about the letter, except food safety lawyer Bill Marler put it on his blog with the heading, “Dr. Rob Takes on Raw Milk”. Marler added, patronizingly, “It is good to see a leader in public health taking a stand for public health.” Truly heart-warming. 


Unbeknownst to Marler and others who read it, the letter contained a big boo-boo that sheds important new light on the level of federal armaments being brought to bear in the Illinois raw milk controversy. 


The problem in the letter is this sentence: “Pasteurization is recommended for all animal milk consumed by humans by the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the American Academy of Pediatrics, the American Academy of Family Practitioners, the American Veterinary….” Hold it, stop there. You see, the fourth organization Tauxe mentioned, the American Academy of Family Practitioners (AAFP), never made the recommendation about pasteurized milk that Tauxe claimed it had, or any recommendation of any sort on raw milk. (By the way, Tauxe even screwed up the name–it is the American Academy of Family Physicians, not Practitioners.)


BFD, you say. So, the guy mixed up his medical organizations. They all sound pretty similar and, what the heck, one medical or veterinary association is like the other. 


No, if you are Tauxe and the other folks who run the CDC, guaranteed you know the difference between the American Academy of Pediatrics (AAP), the American Veterinary Medical Association (AVMA), and the American Academy of Family Physicians (AAFP). Why? Because these places and their “recommendations” are among the most valuable currency the CDC raw milk battlers seek out. Each of those organizations’ recommendations is worth its weight in Fort Knox gold, in their little world. 


You see, Tauxe and the CDC have only two sources of data in their war against raw milk: numerical data and the credibility provided by the organizations that are willing to be part and parcel of the CDC/FDA/Dean Foods assault team. The numerical data has long been crumbling before our eyes, from the ridiculous “studies” on raw milk (like the Minnesota study supposedly showing 20,000-plus raw milk illnesses) to the realization that CDC is counting illnesses from pre-pasteurized milk produced by commercial dairies to help pad the raw milk illness numbers. 


Moreover, studies seem to be nearly pouring out of Europe showing benefits from raw milk. The latest is the study of nearly 1,000 mothers of infants—those infants who consumed raw milk had 30% fewer respiratory and other infections than the kids drinking pasteurized milk. 


On top of that, the Raw Milk Institute (RAWMI) is coming on strong with safety standards for raw dairies. (See Mark McAfee’s account of Friday’s events at Penn State in a comment following the previous post.)


Time is running out for the CDC/FDA/Dean Foods assault team as ever more people learn about the serious health promises of raw milk and that safe raw milk can be and is consistently produced. 


The CDC is in a very big hurry to eliminate raw milk before the agency’s perceived window of opportunity closes. So much in a hurry that now there’s this embarrassing situation about the the anti-raw-milk endorsement not provided by the American Academy of Family Physicians. It is made even more embarrassing by the episode’s close connection to the two-year controversy in Illinois over proposed restrictions on the sale of raw milk. I know this is getting a little involved, but stay with me here. 


First, understand that the American Academy of Pediatrics has 62,000 members, and the American Academy of Family Physicians is nearly twice the size, at 116,000 members. The AAFP is thus twice as tempting to the CDC as AAP, which was pretty tempting to begin with.


If you’ll remember, last December the CDC coordinated release of its Minnesota study with the AAP’s release of a new policy statement advocating a ban on raw milk. I wrote about the interesting coincidences in timing of those releases for PR Watch


The CDC seems to have attempted a similar sort of coordination effort in connection with the AAFP and the Illinois battle, only in this case, the CDC apparently got way ahead of itself, and assumed a done deal before anything was firmed up. And as a result, the whole tete a tete that the CDC likely envisioned may have gone up in smoke. 


Before I explain the particulars, you should understand that not only is the AAFP nearly twice as large as the AAP, it’s also much less pliable than the AAP. Family physicians are an offshoot of the old general practice doctors who used to come around with their little black bags and make home visits. When these GPs tried to organize themselves into a new practice area devoted to treating the family unit, back in the 1960s and 1970s, there was much resistance from the established medical profession, which was increasingly oriented toward ever more specialization.  Moreover, this new practice area represented business competition to internists. 


Eventually, through expert organization and management, the AAFP established itself within the profession, though some of its doctors still see themselves as rebels and outsiders. Now that AAFP is well established, with chapters in each state, the chapters have increasingly taken on identities of their own. 


Illinois, as we know, has become Ground Zero in the battle over raw milk. The federal government and Big Dairy have thrown everything they have into the two-year battle to obliterate raw milk in Illinois (per the previous post), and want to use the shock waves to intimidate other states in going along with similar tough-on-raw-milk strategies. 


The Illinois public health community appears to have marched in lockstep with the FDA, CDC, Dean Foods, and others, and has worked on a local basis to mobilize support. One of those public health people very active in the anti-raw-milk effort has been an Illinois family physician and member of the Illinois chapter of the AAFP,  Dr. Rashmi K. Chugh. Last March, two months before Tauxe made his blunder about AAFP being against raw milk, Chugh testified before the Illinois Department of Public Health (see page 15 of the testimony), along with four other state public health people. They all castigated the IDPH for its proposed rules to limit the sale of raw milk—in their judgment, IDPH was being too accommodating, and all sales of raw milk should be banned in Illinois. There was absolutely no possibility for compromise in their rigid ideology. 


Chugh identified herself as being a family physician as well as a medical officer for the DuPage County Health Department, and a spokesperson for something called the Northern Illinois Public Health Consortium. Her five minutes or so of testimony about  the dangers of raw milk sounded as if it was put together by the CDC.  So did Resolution #407 that she convinced the Illinois Academy of Family Physicians to introduce at the AAFP’s annual Congress in Washington last month. It isn’t online, so I have copied it below, following this post. My guess is both her testimony and the resolution were ghost-written by the CDC.


Now, Tauxe and company may have anticipated an easy win at the AAFP annual Congress, where about 50 resolutions on various aspects of health are introduced each year. But, surprise of surprises, Resolution #407, “Prohibiting Sale and Distribution of Raw or Unpasteurized Milk and Milk Products”, encountered opposition among some of the rebel AAFP docs. One is understood to have recounted raids on small dairies carried out by regulators in Wisconsin and Pennsylvania, and to have concluded: “We shouldn’t prohibit this, we should regulate it properly.” 


The entire discussion lasted less than ten minutes, but the raw milk resolution wasn’t voted on, where it could have been passed or rejected, and was instead sent to the AAFP’s board of directors for further study, which is generally understood to be at best a delaying mechanism, and often a means of disposing of resolutions considered tangential to AAFP’s overall focus. 


Rashmi Chugh and CDC weren’t about to give up, though. Earlier this month, a few weeks after the AAFP Congress, Chugh surfaced again, this time at the annual meeting of the Illinois Academy of Family Physicians (IAFP) proposing the same resolution. At this meeting, it passed the Illinois chapter. 


I tried to speak to Chugh, but she relayed word through a spokesperson for the Illinois chapter that she wasn’t able to speak with me. Maybe because I had alerted her that I wanted to inquire about what specifically prompted her to take on this ban-raw-milk agenda, given that Illinois isn’t known to have had illnesses from raw milk in the last 30 years. 


Here’s my guess of how the CDC screwup occurred: Chugh either was encouraged by colleagues at the CDC or decided personally to spearhead a campaign to push the IDPH to seek a ban on the sale of raw milk in Illinois. A big part of that campaign for her turned into pushing through a ban-raw-milk resolution at AAFP.  The CDC provided “help,” reviewing Chugh’s testimony, and the proposed AAFP resolution. Once Chugh committed to presenting the resolution to AAFP, a flunky she was dealing with at the CDC heard what he/she wanted to hear—that the AAFP was on board, and getting the resolution through would be a piece of cake. That enthusiasm led Tauxe to assume CDC had a deal when it had nothing. 


When I pointed out the inaccuracy of the Tauxe letter to a spokesperson at the AAFP headquarters, an AAFP spokesperson suggested the organization was understanding, but firm in its neutral stance: “The CDC may have reviewed American Family Physician articles that recommended not drinking unpasteurized products, but we currently have no policy on this topic.”  


It’s one thing if Mark McAfee complains because the CDC misrepresents the raw milk  illness and death data put out by the CDC. Or if I complain about the pathetic CDC raw milk studies. They can easily ignore us. But it’s a little tougher to ignore one of the nation’s largest physician organizations, especially when you have completely misrepresented its views on an important public health issue (and added insult to injury by misstating its name).  


I guarantee you the CDC people will never blush, never offer apologies, however. They may look for ways to ease the pain by making a deal. They could offer the AAFP millions of dollars in research money for some AAFP person’s favored research project, or a job or two to one of its members who would like to move into government. ANYTHING to get that coveted, and desperately needed, AAFP endorsement of a raw milk ban. And suddenly, the AAFP’s independence could quickly fade away, turning into “cooperation.” 


Never underestimate the CDC’s willingness to do whatever it takes to beat down raw milk, to beat down small raw dairy farmers, to beat down consumers who want access to this nutritious food…..and to support the medical and Big Ag corporations that profit from processed sterile foods. 


Thanks again to Bill Marler for introducing us to the dirty business of the non-endorsement endorsement against raw milk. And keep those comments coming to the IDPH about why raw milk should remain widely available. This is one agency under a ton of pressure to do the wrong thing. 




From the Congress of the American Academy of Family Practitioners (AAFP)

Resolution No. 407 (Illinois B)


Prohibiting Sale and Distribution of Raw or Unpasteurized Milk and Milk Products

Introduced by the Illinois Chapter


WHEREAS, the American Academy of Family Physicians currently has no policy regarding the sale or distribution of raw milk or milk products, and 


WHEREAS, the Centers for Disease Control and Prevention (CDC), the U.S. Food and Drug Administration, the American Medical Association, and the American Veterinary Medical Association all strongly advise against human consumption of raw milk since it may contain a wide variety of harmful bacteria – including Salmonella, E. coli O157:H7, Listeria, Campylobacter and Brucella–which may cause illness and possibly death,1,2,3,4 and 

WHEREAS, because of the potential for serious illness, federal law prohibits dairies from distributing raw milk across state lines in final package form (i.e., packaged so that it can be consumed), meaning that raw milk can only be distributed across state lines if it is going to be pasteurized or used to make aged (over 60 days) cheese before being sold to consumers,5 and 

WHEREAS, each state makes its own laws about selling raw milk within the borders of the state; in about half of states, sale of raw milk directly to consumers is illegal, and in the remaining states, raw milk may be sold directly to consumers,5 and 

WHEREAS, reports received by CDC from 2007 to 2012 indicate 81% of outbreaks were reported from states where the sale of raw milk was legal in some form; only 19% occurred in states where the sale of raw milk was illegal,6 and 

WHEREAS, the rate of outbreaks caused by raw or unpasteurized milk and products made from it was 150 times greater than outbreaks linked to pasteurized milk, according to a study reviewing dairy product outbreaks from 1993 to 2006 in all 50 states, published by CDC in February 2012,7 and 

WHEREAS, among dairy product-associated outbreaks reported to CDC between 1998 and 2011 in which the investigators reported whether the product was pasteurized or raw, 79% were due to raw milk or cheese; from 1998 through 2011, 148 outbreaks due to consumption of raw milk or raw milk products were reported to CDC, which resulted in 2,384 illnesses, 284 hospitalizations, and 2 deaths,5 and 

WHEREAS, it is important to note that a substantial proportion of the raw milk-associated disease burden falls on children; among the 104 outbreaks from 1998-2011 with information on the patients’ ages available, 82% involved at least one person younger than 20 years old,5 and 

WHEREAS, the American Academy of Pediatrics approves a ban on the sale of raw or unpasteurized milk and milk products throughout the United States,8 and 

WHEREAS, the number of reported cases determined to be outbreak-related likely represents a small proportion of the actual number of illnesses associated with raw or unpasteurized milk consumption,9 and 

WHEREAS, human consumption of raw, unpasteurized dairy products cannot be considered safe under any circumstances,7 therefore be it 

RESOLVED, that the Illinois Academy of Family Physicians support prohibiting the sale and/or distribution of all raw or unpasteurized milk and milk products for end-user human consumption in the United States, by educating physicians, and by promoting implementation and enforcement of regulations by appropriate government agencies.