Although considerable progress has been made, federal food safety oversight in the United States has not overcome challenges posed by a decentralized, rapidly expanding food supply network. To complement limitations of federal measures, we believe that state-based food safety regulatory and surveillance systems should be better leveraged and integrated. A strengthened national food safety program would include implementation of uniform standards of food inspection and testing, reciprocal acceptance of state and federal inspection and laboratory findings, and systematic, timely sharing of data on pathogens recovered from contaminated foods and from ill persons.