Public Health Security

Globalism and bioterrorism are two of many good reasons to seek excellent leadership for government safety agencies. Which makes it all the more worrisome that the Food and Drug Administration and the National Institutes of Health have both been without chief executives for a year or more. President Bush and Congress are only now focusing on filling these gaps. More delay would be a big mistake.

The FDA, which has had no commissioner for a year, is scheduled this spring to draw up plans to speed up drug approval during an emergency without compromising public safety, close safety loopholes that Agriculture Secretary Ann M. Veneman says could let terrorists infect the nation’s food supply, and address demands to tighten oversight of the new abortion pill, RU-486.

The NIH, with no director for two years, oversees all taxpayer-funded health research, from stem cell experiments to cloning. It is in the midst of a multibillion-dollar anti-terrorism project that includes developing a new vaccine for anthrax and treatments for emerging pathogens like prions, which cause mad cow disease.

Luckily for both agencies, strong candidates are waiting in the wings.

The best candidate for NIH head is Anthony Fauci, currently the director of a major NIH division, the National Institute of Allergy and Infectious Diseases. Fauci is a deft politician and the nation’s leading AIDS researcher. Bush reportedly offered him the job, but Fauci has held out for assurance that he would have “protected time” each week to escape politics and do his own research. The president should give him that comfort and urge him to serve the nation.

This week, Bush is expected to nominate another promising leader, Alastair J.J. Wood, a Vanderbilt University assistant vice chancellor and medicine professor, to head the FDA.

Wood generally won respect as a medical peer reviewer while he was editor of the drug-review department of the New England Journal of Medicine. His term suffered some tarnish in early 2000 when he admitted he had overseen studies published in the journal that failed to disclose their authors’ potential conflicts of interest--a violation of the journal’s policy. However, Wood gained broad respect while serving on an FDA advisory committee when he forthrightly denounced the way the FDA had mishandled the potentially fatal diabetes drug Rezulin, releasing it despite clear indications it was dangerous.

The Senate should fast-track confirmation hearings for Wood, who is superior to the two other potential nominees whose names the administration has floated, biotechnology executive Michael Astrue and Lester Crawford, a former FDA bureaucrat who ran a food-industry-backed think tank.

The FDA and NIH may seem like obscure, easily ignored federal agencies, but their social importance is growing and they need strong leadership to be strong watchdogs of the national health.