 A thousand years ago my ancestors moved from Iraq to northern India and 50 years ago my father moved from India to Pakistan and from there to the United States and then to Mexico. And regardless of time and place, humanity has always faced the challenge of producing adequate, safe, healthy and affordable food. For the last decade, my research has focused on one aspect of this challenge, the human health impact of bacteria and food. I have gradually realized, however, that microbiological food safety cannot be really understood without understanding the social, economic and political context. Mexico and India face common predicaments, rapidly growing economies, inequitable internal development and high rates of unemployment and population growth. What I want to talk about today is how standards of food safety are related to food security and current models of food production and economics, and how these in turn affect sustainability and affordability at the community level. For the last half of the century, the predominant model for guaranteeing food security has relied on large, highly technified systems with a narrow scientific approach. Although it has attained the goal of increasing food production to feed more mouths, it has failed to address the impact of dietary changes on population health, as well as the negative impact on local communities, animal health and the environment. Now, the industrial agricultural system relies on intensive animal farming, in which thousands of animals are reared together in cruel and unnatural conditions. Large quantities of antibiotics are used to achieve greater weight, gain, or to prevent massive infections in animal herds, and this practice has contributed to a significant increase in antibiotic-resistant bacteria and a growing number of food-borne infections that are harder to treat. One of the most dire consequences of this system has been the collapse of local food production chains and the loss of livelihood and food sufficiency in entire communities. This has been followed by mass migrations from rural to urban areas and the loss of cultural identity and family disintegration that now besiege both India and Mexico, as well as other developing countries. Both countries, moreover, now face an epidemiological paradox in which the poor suffer from malnutrition, while the more affluent suffer from chronic degenerative diseases such as diabetes, obesity, and heart disease due to the consumption of highly processed foods, rich in carbohydrates and saturated fats. But as food production chains became increasingly complex, sanitary standards became more stringent. The assumption was that if food was contaminated with bacteria and parasites and caused disease, then the solution was to eliminate these completely or almost completely from the food chain through the use of disinfectants, irradiation, and other technologies. While this reduced exposure to microorganism has resulted in a decline in diarrheal and parasitic diseases, ironically industrialized countries have witnessed a dramatic increase in allergic and autoimmune diseases in recent decades, and furthermore they have also been confronted with an increased number of foodborne outbreaks. One of the theories that have attempted to explain this phenomena is called the hygiene hypothesis, and it postulates that the drastic alteration of the microorganisms are an environment have occurred in such a short period that the human population has not enough time to adapt. In other words, humans have evolved over millennia to coexist with bacteria in their food and their environment, and exposure to the bacteria is vital to our immune development. In contrast, in developing countries we know that food is very frequently contaminated with bacteria that can produce disease at a frequency that would be unacceptable in industrialized countries. Now while these countries may have a higher incidence of diarrheal disease, large foodborne outbreaks are very uncommon. So the adverse consequences of the large-scale industrialized food production model on human, social, economic, and environment health forces us to question whether it is the best model for our countries, or whether we should be searching instead for a more appropriate context driven model. Now in an effort to address these questions, we conducted a study to determine the impact of food contamination on a well-nourished rural community in southeast Mexico, where bacteria frequently circulate through the food chain, and is typical of Indian Mexico. Many of the households lack toilets and keep food animals in their backyards. As part of the study, we sampled animals in slaughterhouses, retail meat, ready to eat food, and I analyzed them for a series of different bacteria. And we also followed 250 households with an either an infant or an elder, the two age groups that have the highest risk for diarrheal disease. And if the individuals developed diarrhea, we would take samples of their stools as well as those of family members, and we also measured antibodies in the blood. And all the participating households had to receive health education. Now salmonella, as you all know, is a bacteria that can cause diarrhea as well as fatal systemic disease and diarrhea. And in this community, we found very high levels of salmonella in raw retail meat, which can cause contamination when processing food. But we also found it in ready to eat foods. And what basically we mean here with four to five percent is that if you eat three to four meals a day, then you're ingesting salmonella at least once a week or at least 50 times a year. This would be completely unacceptable in industrialized countries. Despite the high prevalence of foodborne pathogens in animal and food, the impact on our population was very low. Most of the infants and half of the elders had diarrhea at least once a year, but all of the episodes were mild to moderate. And we did not register a single case of dehydration, hospitalization, or death. And there was not a single foodborne outbreak. And this is probably very likely to our health education program. But surprisingly, while salmonella was a very common cause of diarrhea in both infants and elders, only the infants got campylobacter. And the family members between eight and 60 years of age only got absymptomatic infections. What this means is that they were carrying the bacteria in their stool, but they weren't sick. Furthermore, about 90 percent of the adults had antibodies to salmonella. And so basically what this means, it confirms what other researchers have suggested that when you're continuously exposed to these bacteria, you get immunity. And of course, what it really ultimately means is that it illustrates the relevance of context when you define food safety. And when we examined the resistance of the bacteria antibiotics, we found that about 15 percent of the salmonella strains were resistant to three antibiotics, and 3 percent were resistant to five or more. And we also found a very large, a very high percentage of strains resistant to syprofloxacin. And basically what this means is that both the large poultry and swine producers were using a very large, large quantities of antibiotics in the animals. The highly resistant strains, which were no longer responding to conventional antibiotics, were basically from the large-scale producers and not the small-scale producers. So the sobering conclusion is that intensive large-scale farming uses massive amounts of antibiotic that select for resistant organisms and animals that may be subsequently transmitted to humans. And although we didn't register any life-threatening infections in this population, we don't want any antibiotic-resistant bacteria in our food chain because we want to be able to treat infections if necessary. Basically what I would say is regarding those households where the people were getting sick, they all had some kind of sanitary deficiencies or health risks that can be addressed in developing countries with very simple, cost-effective measures in health education. In conclusion, the microbiological standards required to safeguard the health of a population depends strongly on the setting. And our research suggests that food need not be pathogen-free in order to be safe. And of course the most important conclusion I would like to give here is that maybe a certain level of bacteria in food may be actually beneficial to individual population and community health. And more broadly of course it means that universally applicable standards for safe food perhaps do not exist. Now the precise balance between this beneficial exposure and detrimental development of disease still needs to be determined with further research. But the implication for India and Mexico is that our countries would be well advised to examine local conditions and develop a new model for food production. Central to this vision is the food sustainability and economic viability of local communities. It should address the growing trend of hunger, poverty and loss of traditional support systems. And within the new vision government should take a step beyond subsistency farming or scattered small-scale organic farming by convening experts from a broad array of disciplines to develop a food policy that considers food production in the broader context of human, animal and environmental health. With sufficient political will I believe that governments could establish networks of regional communities that could receive technical support for the implementation of cost-effective, agroecological methods appropriate for small-scale local agriculture. And support in economic incentives could also be offered to encourage the distribution of the products to local distributors for regional markets. And furthermore the model should incorporate local microbiological standards based on the possibility that certain levels of bacteria in food may well have long-term beneficial effects on local populations. So in conclusion there is an urgent need for developing a new paradigm for food production in the 21st century. And this vision should counterbalance the prevailing trend toward globalized food. This proposal for a new paradigm envisions long-range policies that safeguard the health of all sectors of society and that of our planet. We understand that policies that are just, sensible and wise may nonetheless encounter fierce opposition from powerful interests and elites. And we may reasonably anticipate such opposition to the implementation of this proposal. It is the unique responsibility of socially conscious individuals to undertake this daunting task. Please join me in moving this proposal forward.