Diabetes Self-Management Blog

On March 15, President Barack Obama named Margaret (”Peggy”) Hamburg, MD, as his pick for the top job at the U.S. Food and Drug Administration (FDA). The nomination requires Senate confirmation. Hamburg is a former New York City health commissioner and has also held posts in the U.S. Health and Human Services Department and the National Institute of Allergy and Infectious Diseases of the National Institutes of Health. She is currently a senior scientist at the nonprofit Nuclear Threat Initiative in Washington, DC.

As health commissioner for New York City from 1991 to 1997, she developed innovative programs for controlling the spread of tuberculosis (between 1992 and 1997, the TB rate for New York City fell by 46% overall and by 86% for the most resistant strains), instituted needle-exchange programs to combat HIV infection, and initiated the nation’s first public-health bioterrorism defense program.

Hamburg’s nomination has been met with approval by many in the public health field. For example Dr. Harvey V. Fineberg, president of the Institute of Medicine, the medical arm of the National Academy of Sciences, was quoted in The New York Times as saying, “Peggy has a deep commitment to the public’s health and, while she appreciates the vital role of industry, will surely focus on what is best for the public.”

Similarly, a statement released by Michael F. Jacobson, Executive Director of Center for Science in the Public Interest, said, “Dr. Margaret Hamburg has the experience and public-health focus that makes her a terrific choice for commissioner of the Food and Drug Administration.”

The FDA regulates more than $1 trillion worth of consumer goods, including foods, prescription and over-the-counter drugs, cosmetics, and vitamins, as well as devices as varied as microwave ovens, cell phones, and blood glucose meters.

In recent years, the admittedly underfunded FDA has been the focus of much criticism, particularly in the area of food safety. An outbreak of salmonella poisoning that began in late 2008 and was traced to contaminated peanut products, for example, is the latest in a number of widespread food contamination scares. (Others have involved spinach, tomatoes, peppers, and cantaloupe.) Because it lacked adequate staff, the FDA had contracted the Georgia Department of Agriculture to inspect the food manufacturing plant that produced the peanut products, Peanut Corporation of America, in Blakely, Georgia. But while the facility had previously discovered salmonella repeatedly during it own internal tests (and had then shipped its products anyway), no tests for salmonella were done when the factory was inspected by state inspectors. The outbreak has sickened thousands and caused at least nine consumer deaths.

Some people in the diabetes community have also criticized the FDA for its new rules regarding the approval of drugs to treat diabetes. In late 2008, the FDA announced that manufacturers developing new Type 2 diabetes drugs would need to provide evidence that the therapy would not increase the risk for cardiovascular events such as heart attacks. Read more about this controversy in Web Editor Tara Dairman’s January 12 Diabetes Flashpoints feature, “FDA: Stifler or Savior?”

What would you like to see the FDA focus on? How can it be most effective at protecting and promoting the nation’s health? Let us know your opinion in a comment.

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