Leadership Void at Federal Health Agencies Raises Concern Among Lawmakers, Scientific Community
The Bush administration's struggle to fill leadership positions at the NIH, the FDA and other "critical health agencies" is raising concern among lawmakers, industry executives, academics and patient advocates that "key decisions" may be delayed or made without input from the scientific community, the Washington Post reports. At HHS, some of the "top positions" have been vacant for more than a year. For example, HHS is missing an assistant secretary of health and a director for the Health Resources and Services Administration. Also, five NIH institutes do not have directors, and the surgeon general's office will be vacant in a few weeks. The vacancies "appear" to be caused by a variety of factors, including objections by Senate Democrats to candidates "aligned with industry" and the administration's "struggle" over funding for embryonic stem cell research, the Post reports.
However, the delay also shows how "politicized" science and medicine have become, as many potential nominees are unwilling to "navigate the political land mines" associated with top federal jobs. Mohammed Akhter, executive director of the American Public Health Association, said, "Without good leaders, the agencies will continue to tread water without making any progress." A group of Massachusetts biotechnology industry executives recently wrote to White House Chief of Staff Andrew Card, saying that the lack of an FDA director is slowing the pace of new drug approvals. Sen. Ron Wyden (D-Ore.) said, "If we waste several years and we see continued hemorrhage of scientific talent out of these agencies, we're going to pay dearly in the development of new therapies, new pharmaceuticals [and] bioterrorism."
With HHS missing some key personnel, HHS Secretary Tommy Thompson has done the work himself "to a large extent," the Post reports. For example, Bush relied heavily on Thompson, who has no medical or scientific background, and a lawyer in the Office of Management and Budget to reach a decision on federal funding for stem cell research, the Post reports. Thompson also personally negotiated a deal with drug makers to purchase the antibiotic Cipro after last fall's anthrax scare and made the decision to treat those exposed to anthrax with an experimental vaccine. Now, Thompson is using outside consultants to help decide how to spend $2.5 billion in new bioterrorism funds. HHS spokesperson Bill Pierce said that Thompson has "great faith" in the agencies' acting directors. "The secretary believes these are very important positions. You don't want to rush it for the sake of rushing it," he said. However, without a director, it is difficult to recruit others and work becomes "demoralizing" for the existing staff, according to Elizabeth Marincola, executive director of the American Society for Cell Biology. Paul Berg, a Stanford University researcher, said, "What is so tragic about this is that the science is booming; there are an enormous number of opportunities" (Connolly, Washington Post, 1/10).
Speaking at a health care conference in San Francisco yesterday, former Vice President Al Gore called on Bush to nominate a commissioner for the FDA. Noting that the agency needs to keep up with "the dramatic research" in biotechnology, Gore endorsed Alastair Wood, a Vanderbilt University medical professor, who has been rumored to be a potential nominee. "We can't [regulate biotechnology breakthroughs] without effective leadership at the FDA. It's important to fill that post," he said. Gore also urged Bush to appoint a permanent director at the NIH (Elias, AP/San Francisco Chronicle, 1/9).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.