FDA Funding – When the Audience Changes, the Message Must Change

On March 11, Dr. Margaret Hamburg presented testimony before the House Subcommittee on Agriculture, Rural Development, Food and Drug Administration, and Related Agencies regarding funding for the FDA.  Her remarks did a capable job of outlining what the FDA does and broadly what the accomplishments of the agency were. She did about as much as any FDA Commissioner can do.  With broad brush strokes she covered very well why the FDA serves the greater public health interest by, for example, reducing costs with generic drugs and reducing instances of foodborne illness.  The big picture of FDA’s work was clear.  Her messages were the messages that have served well in the past.

But we have to consider this.  The audience has changed.  Yesterday’s message that appealed to a different majority might have to be adjusted.  Half of good communications is not merely stating what you need to say, but is also saying what you have to say in a way that appeals to your audience.

The subcommittee that oversees FDA appropriations is headed by Rep. Jack Kingston who I recently interviewed for a YouTube video about funding for the Food Safety Modernization Act on the second day of the new Congress.  In our discussion, Rep. Kingston seemed to favor the point of view that (1) government is too big for the amount of money we have to spend, and (2) that it is in the food industry’s best interests to police itself because if something is wrong with their product, people will go elsewhere.  One has to wonder what the effect of words that portray the enormous size and scope of the FDA have on people who come to the table with the mindset that government is too big, that we can’t afford what we have and that industry can largely police itself.

Congress has changed.  The message has to change as well.  How?  The FDA’s role and responsibilities perhaps need to be explained in terms that focus less on the common good that results from FDA’s endeavors, to more specifically demonstrate the impact on individuals – people who are among the constituencies of policymakers to whom we are appealing.  What is at stake in FDA funding needs to be made more real than the lofty (and worthy) public health goals in which advocacy has traditionally been framed.

For example, in February U.S. Marshalls seized food products at a Tennessee company where there had been a rodent infestation as evidenced by “rodent feces, rodent hair, rodent nesting material, and building defects that could allow rodents and other pests to enter food storage areas and other areas”.  Each member of the subcommittee should be made aware of how much of that product could have made its way into the homes of their constituents, bringing home the failure of self-policing.  Last week, the FDA approved a new drug for the treatment of lupus – the first new drug treatment for this condition since 1955.  How many people in the subcommittee’s home state, or home district are living with lupus who will benefit from this new advance?  In other words, making the FDA’s work more real and personal and human is important, but demonstrating further the value it brings to the home district of each and every member.  As an AIDS advocate in the 1990s, I made sure that every member I dealt with understood how many people lived with HIV in their district and how many children were being affected before we began any discussion of funding.  That way, cutting funding was not an abstract, it was concrete and they knew what it meant back home.

In similar ways, the examples of FDA’s impact needs to be made more real for policymakers today. If we continue to rely on the greater good done accomplished by a large government agency to an audience that considers large government agencies as undermining the common good, one is oil and one is water.  There must be a closer blend of message to audience.  The specific impact of FDA’s good work must be broken down to their essential human impact.  Because if we keep talking in terms of supporting a big government institution, we may be talking to yesterday’s audience instead of those who will be making important decisions today.