Balancing the books

BMJ 2007; 335 doi: (Published 06 September 2007) Cite this as: BMJ 2007;335:471
  1. Bob Roehr
  1. Washington, DC

    Technically the US Food and Drug Administration goes out of business at the end of September, when legislation authorising it expires. The US Congress is working on a new law to address some of the controversies that have dogged the agency in recent years. FDA commissioner Andrew von Eschenbach talks to Bob Roehr

    It's been a tough few years for the US Food and Drug Administration, as it grapples with the problem of partial funding from the drug industry, which may compromise its impartiality; potential conflicts of interest on advisory committees; and the increasing difficulties in assessing risks and benefits of drugs.

    Congress is expected to pass a law to cover the FDA soon after it returns from its summer break. Meanwhile the FDA commissioner, Andrew von Eschenbach, a surgeon and friend of the Bush family, says he sees the controversies as part of a more fundamental shift. He thinks medicine is rapidly changing from the observation of symptoms of late stage disease to a molecular understanding of the mechanisms of earlier stages of disease, with interventions becoming increasingly early and pre-emptive.

    “The challenge for us is to not be a barrier to that new future but to be a bridge to it,” the commissioner told a small group of reporters last month. He acknowledges that the changes the agency must make may not …

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