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Sunday, August 6, 2006

A chief for the FDA

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The Food and Drug Administration has lacked a permanent commissioner for nearly two years. The absence of such executive leadership at the helm of what is arguably one of the most important public-health agencies in the world is hampering its transformation from a regulatory entity that sees risk as an all-or-nothing proposition to one using better scientific tools to adjust the evaluation of risks and benefits to the diversity of medical conditions.

President Bush has nominated Dr. Andrew von Eschenbach, now acting FDA commissioner, to continue this transformation. As an oncologist, researcher and former director of the National Cancer institute, he has combined courage and a commitment to science to move resistant institutions into sync with cutting-edge medical trends. In his current capacity, he is working to help the FDA promote personalized medicine: The agency's Critical Path Initiative will improve the effectiveness and safety of medical products by tailoring treatments to each individual patient. The program applies knowledge about how medical products "interact with different patients, different drugs, and under different conditions."

But leadership in limbo undermines authority. It has made it hard for the agency to move forward or respond to congressional overseers who are more interested in promoting their careers than the public health. The holdup can be blamed on Sens. Hillary Clinton and Patty Murray, who, as today's Op-Ed "Distorting science" notes, are blocking his nomination until the FDA agrees to make the contraceptive Plan B, or "morning-after" pill, available without a prescription and without any restrictions on age or access. The FDA and Dr. von Eschenbach have decided that women 18 and over should have such access while younger women can still get it with a prescription. The senators don't want a permanent commissioner. They want a decision that makes their base happy.

Capitulation to this ransom demand would open the FDA up to political manipulation of the rankest sort. This is not about science and health. If it were, Dr. von Eschenbach would be confirmed in a heartbeat. This is about attacking the administration, just as its opponents did when they blocked John Bolton's nomination as U.N. ambassador.

Mr. Bush made Mr. Bolton permanent ambassador through a recess appointment, a decision vindicated by his performance in the job. The president should do the same with Dr. von Eschenbach as FDA chief.

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