The Food and Drug Administration prides itself on being, first and foremost, a science-based organization. So, how did the agency that regulates about 30 percent of the U.S. economy get so caught up in the ugly world of backroom politics?
As a veteran of the regulatory wars, it’s my belief that the rocky seas began to roil when the position of FDA commissioner was converted from a career, to a political appointment in the late 1960s. Before that time, the FDA chieftain was generally someone who had advanced through the ranks of the agency, gaining experience and seasoning along the way. When the commissioner’s position became Senate-confirmable in the late 1980s, some believe an adverse change took place.
When one considers the mission of FDA — to protect and advance the public health without regard to politics or self-interest — it is not at all clear whether the job of FDA commissioner should be a Senate-confirmed political appointee who “serves at the pleasure of the president.”
Instead, I think that the American people would benefit more if the FDA commissioner was nominated by the president for a fixed six-year term – similar to the director of the Federal Bureau of Investigation FBI or the chairman of the Federal Reserve. Think about it: Why should the safety of food additives, the integrity of the blood and vaccine supply, and decisions on drug labeling (to name only a few FDA responsibilities) be considered a Democratic or Republican issues?
The boss of the FDA commissioner should remain the secretary of health and human services – a politically appointed, Senate-confirmed Cabinet officer. But the politics should stop there. Any more would lead to regulatory paralysis and discord – neither of which is beneficial to America’s health. It’s only reasonable that the person chosen to be FDA commissioner should be as free of political influence as possible.
On top of that, selecting a career official should not be dismissed out of hand. Such selections have proven successful at agencies like the Centers for Disease Control and Prevention and the Food Safety and Inspection Service, both of which carry out critical public health missions – and both of which are overseen by Cabinet secretaries.
Senate confirmation certainly adds legitimacy to the position of FDA commissioner as well as brings the nominee into intimate contact with many members of Congress. But the current confirmation system whereby senators haggle and bargain with the commissioner-designate over various matters is often unseemly if not entirely improper. The real question is: What value does a Senate confirmation add to the selection process? If it contributes to the hyperpoliticization of the office, which I believe it does, then the current process is at best problematical.
Having had the honor to serve our country and our president as an FDA associate commissioner, I can state unequivocally that the infusion of politics into a science-based organization makes the already difficult job of overseeing our nation’s health and safety virtually impossible.
What’s worse, to leave the job of commissioner unfilled for extended lengths of time grinds progress to a halt. It results in abysmally low morale, lengthy delays at all levels of the administration, and even postponements of necessary operations. This is simply not acceptable.
Who becomes the next FDA commissioner is undoubtedly important. I have my preference, others have theirs. But an important indication of how seriously the next president views the job of FDA commissioner will be how quickly he names a nominee for the position. Let’s hope it’s done swiftly and smartly.
Peter J. Pitts is president of the Center for Medicine in the Public Interest and a former FDA associate commissioner.
