An Interview with Dr. von Eschenbach

J0302922The Sunday New York Times Magazine carried an interview with FDA’s Commissioner,  Dr. Andrew C. von Eschenbach that was noteworthy simply for the fact that the questions were more interesting than the answers.  The questions, in some respects, said a lot.  The answers in most cases, said little.   The interview is accompanied by a photograph of a furtive-looking Commissioner appearing as if he is desperately searching for something.  Vision?  Answers?

For example, the first question "As the newly confirmed head of the FDA, you are presiding over an agency that is probably better known for its failures than its achievements.  For starters, the department lacked a Senate-confirmed commissioner for most of the Bush Administration." 

That is quite a statement and one that offers an opportunity to shake the presumption in it with a powerful outline of the robust direction in which the agency is going to go under his leadership, an acknowledgment of problems and the enunciation of a pathway to a better future. 

Instead, Dr. von Eschenbach stated "I actually came here in the fall of 2005 as "acting commissioner".  I don’t know what an acting surgeon is.  You go into the operating room and take charge of what needs to get done." 

I have no idea what that was supposed to mean. 

When asked about the new safety initiative, the response was also not very interesting.  He did state that the effort was more than post-marketing surveillance, and included a "whole host of things."  But there was no effort to plant the seed that this marks a new departure and new promise that will help reassure a doubtful public and skeptical policy makers.

Also, the interview provided no real insights into emerging issues.  Take for example this question – "You are a former director of the National Cancer Institute.  Do you think nicotine should be regulated as a drug?"

Dr. von Eschenbach’s non-response was "As cancer doctors, we have looked at the consequences of tobacco, of which nicotine is one component, but in which there are many other components."  This is not an answer to the question, it is an avoidance of an answer.

On the question of greater regulation of trans-fats in fast food chains, Dr. von Eschenbach said that he had seen a "significant" effort on the part of fast food chains to find alternatives to trans fats.  That prompted the Times reporter to suggest he seemed "pretty laissez-faire" in his approach to regulation to which he responded that he wouldn’t call it that, he termed his approach "incremental". 

Such an interview was certain a missed opportunity, but more importantly, it demonstrates that at the FDA there either continues to be a lack of vision or an inability to enunciate it.  The FDA really needs to develop a communications plan here – develop a robust playbook and messaging architecture and media plan.  Only in that way is the agency going to shed the failure image characterized by this interview’s first question and only then will the answers the agency gives be more interesting than the questions it is asked. 

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