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Senate Approves Crawford to Head FDA


The Senate has approved the nomination of veterinarian Lester Crawford to be the next head of the Food and Drug Administration. Crawford has been acting commissioner since the spring of 2004. He becomes the official head of an agency that has been in the spotlight lately for both its actions and inactions, as NPR's Joanne Silberner reports.


At Lester Crawford's Senate confirmation hearing in March, he said the agency, traditionally secretive and aloof, was starting to focus on transparency, collaboration and cutting-edge thinking.

Dr. LESTER CRAWFORD (Acting Commissioner, FDA): We're going to tap into new technologies and new ways of thinking and build upon collaborations with a broad network of partners, public and private, US and international.

SILBERNER: As acting commissioner since early 2004, Crawford has a track record and plenty of critics. Just before the full Senate vote yesterday, Republican Charles Grassley of Iowa castigated Crawford, saying he permitted a cozy relationship with the pharmaceutical industry and that the agency didn't listen to some of its own scientists.

Senator CHARLES GRASSLEY (Republican, Iowa): During the lat 18 months, this country's confidence in the FDA has been shaken. It has been shaken not because of one isolated incident or one isolated whistle-blower; it has been shaken because multiple drug safety concerns have been exposed by more than one courageous whistle-blower.

SILBERNER: Another hot spot for Crawford has been the morning-after pill. The agency was supposed to decide last January whether to allow over-the-counter sales. The missed deadline upset several senators, including Democrat Ted Kennedy, who questioned Crawford during his nomination hearing.

Senator TED KENNEDY (Democrat): And you're unable to indicate to us when we're going to have a time?

Dr. CRAWFORD: I can't give a date, but it won't be very much longer.

Sen. KENNEDY: Well, are we talking days? Are we talking weeks?

Dr. CRAWFORD: I wouldn't want to say days, Senator. I would say weeks.

SILBERNER: If the agency decides by September, as promised, it will be 24 weeks.

Crawford's nomination was also complicated by an anonymous staffer who accused him of an inappropriate relationship with an employee. An internal investigation cleared Crawford of the most serious charges. Crawford also has plenty of supporters. Kennedy, in fact, voted in favor of the nomination and strongly urged others to do so. The vote was an overwhelming 78-to-16. Republican Mike Enzi said it was about time.

Senator MIKE ENZI (Republican): I think we can all agree that we need a strong leader at the FDA right now and one who has a mandate to act. We must be forward-looking. There are many items before the FDA that require the immediate attention to an FDA commissioner vested with full authority.

SILBERNER: Enzi and Kennedy and several others said that Crawford had been hampered by his position as acting commissioner instead of permanent commissioner and that the FDA needs more power to be fully effective.

Off Capitol Hill, there are high concerns about politics entering into the FDA's decisions. Kirsten Moore heads the Reproductive Health Technologies Project.

Ms. KIRSTEN MOORE (Reproductive Health Technologies Project): The Senate debate showed that there--that Crawford still has a lot of work to do to convince the public and policy-makers that he is committed to putting the public health interests above political agendas.

SILBERNER: There had been another hold on the Senate vote by Republican Tom Coburn, who was concerned that the FDA has failed to require condom boxes to include a warning saying that condoms don't offer complete protection against sexually transmitted diseases. A Coburn spokesperson said last Friday that the senator has been assured by the administration that the agency will act soon.

Joanne Silberner, NPR News, Washington.

MONTAGNE: This is NPR News. Transcript provided by NPR, Copyright NPR.

Joanne Silberner is a health policy correspondent for National Public Radio. She covers medicine, health reform, and changes in the health care marketplace.