- The Washington Times - Thursday, February 28, 2002

Last week's resignation of Centers for Disease Control and Prevention Director Dr. Jeffrey Koplan created the fifth major vacancy at a prominent federal health agency, causing consternation among some public health officials.

"It's been 14 months since the election and this is the longest I have seen and I've been in public health for 30 years with positions not being filled at the leadership level," Dr. Mohammad N. Akhter, executive director of the American Public Health Association, said Monday.

The other vacancies are the Office of the Surgeon General, open since Dr. David Satcher's term ended Feb. 13; Food and Drug Administration (FDA) commissioner; National Institutes of Health (NIH) director; and Health Resources and Services Administration (HRSA) administrator.

The Bush administration has been reviewing candidates for the various positions and may be close to naming someone for the NIH job, a spokesman in the Department of Health and Human Services (HHS) said this week.

However, since the September 11 terrorist attacks, head hunters have been told to find candidates who not only have medical credentials but also have expertise in bioterrorism, officials familiar with the search said.

This has led to the daunting task of finding "someone who knows the ins and outs of anthrax and abstinence education and is a Nobel Prize winner," said one Capitol Hill source.

The Bush administration, he added, could solve some problems by reorganizing agencies so that bioterrorism issues are handled apart from sexual health issues.

All five positions, which are part of HHS, are lightning rods for sexuality and family life issues. The surgeon general, CDC and HRSA play critical roles in birth control and abstinence education. The FDA has oversight over birth-control products such as RU-486; the NIH is central to debates over stem cell research and cloning.

Several agencies are now led by acting officials Dr. Ruth Kirschstein at NIH and Elizabeth M. Duke, acting administrator of HRSA, for example.

HHS Secretary Tommy G. Thompson Monday named Lester M. Crawford Jr., deputy commissioner at the FDA. Mr. Crawford takes over for FDA career executive Bernard V. Schwetz, who has been acting principal deputy commissioner for more than a year.

But the top FDA post remains officially open, which contributes to the leadership vacuum, observers said.

"Collectively, these agencies represent the leadership in public health," said Dr. Akhter, whose trade group represents 50,000 members from 50 public health fields.

"But the absence of leadership does not inspire confidence in the agencies or the nation," he said, adding that the delay was political. There are so many educated and talented people here, he said, "if they give me one week, I will find four or five candidates for each one of these positions."

Robert Rector, welfare analyst with the Heritage Foundation, said it was best to find the right people for the jobs.

"I think it's very clear that abstinence [education] and marriage are high personal priorities to President Bush … and I think it's therefore absolutely critical, particularly at the CDC, that there be someone there who is strongly committed to the president's agenda," he said. Otherwise, the appointee "is likely to be an impediment rather than an asset."

The talent search has led to the military, which has several surgeon generals and medical professionals with bioterrorism backgrounds, sources said.

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