From kaisernetwork.org Daily Reports.
Feb. 8,2000

ADMINISTRATION WATCH

"Bush Working To Balance Pressures from Drug Industry, Advocates in
Selecting FDA Head

The New York Times examines the "political quandary" President Bush faces
as he attempts to appoint an FDA commissioner, a position that has
remained empty for more than a year (Stolberg, New York Times, 2/8).  The
last FDA commissioner, Jane Henney, resigned in January 2001 (Kaiser
Daily Health Policy Report, 12/21/01).

According to the Times, legislators and drug industry executives have
criticized Bush for "not plac[ing] a high enough priority on filling" the
position.  Sen. Ron Wyden (D-Ore.) said, "It is critically important that
the president get names up on the Hill so that we can begin the
confirmation process.  I'm hearing an unprecedented coalition of public
interest groups, entrepreneurs and scientists saying that, at a critical
time when we are about to spend billions of dollars fighting
bioterrorism, there just isn't anybody home at these key agencies."

 However, the Times reports that Bush faces a "dilemma."  If he names a
candidate from the drug industry, he may face the "wrath" of Senate
Democrats.  However, a nominee from outside the drug industry could upset
pharmaceutical companies, who gave Bush "considerable campaign support"
in the last election.  According to the Times, the conflict has already
"scuttled" one possible candidate.  In July, the administration put
forward the name of Michael Astrue, general counsel for the Cambridge,
Mass.-based biotech company Transkaryotic Therapies, as a possible
commissioner.  Seven Democratic senators, including Senate Health,
Education, Labor and Pensions Committee Chair Edward Kennedy (D-Mass.),
objected (New York Times, 2/8).  Kennedy said he would not hold
confirmation hearings if Astrue were nominated, surprising White House
officials who expected the Massachusetts lawmaker to "welcome" an FDA
nominee from his home state (Kaiser Daily Health Policy Report,
10/31/01).  "It would be unprecedented for anyone to be appointed from an
industry regulated by the FDA, and now is not the time to start," Kennedy
spokesperson James Manley said.

Concerns Over Wood

        Currently, Vanderbilt University drug safety expert Dr. Alistair Wood is
a "leading candidate," according to the Times.  However, the Times
reports that the conflict of interests "is playing out again," as
executives from the drug industry "are not keen" on Wood.  According to
the Times, drug executives see Wood as a potentially "overly aggressive
regulator" after a "string" of drug recalls and patient deaths led him to
call for the FDA to be "more aggressive" in drug monitoring.  According
to the Times, HHS Secretary Tommy Thompson on Feb. 4 sent Bush a list of
three candidates each for the FDA position and the unfilled NIH director
position.  The Times reports that Bush is seeking a candidate who
"understands the drug approval process" and could "streamline the
agency's bureaucracy."  Dr. David Kessler, a former FDA commissioner in
the previous Bush administration, said, "The president is getting
squeezed from all sides.  The job of the agency is to protect public
health, and it needs leadership" (New York Times, 2/8).

Carmona Recommended for Surgeon General

        Meanwhile, the
Arizona Daily Star reports that Dr. Richard Carmona, a trauma surgeon in
Tucson, Ariz., has been recommended as a candidate to replace Surgeon
General David Satcher, whose term ends this month.  According to the
Star, U.S. Rep. Jim Kolbe (R-Ariz.) and Dr. Edmund Krasinski, president
of the Pima County Medical Society, have written letters to President
Bush recommending Carmona for the position.  In addition, Carmona said he
has been contacted by the White House regarding the position.  A White
House spokesperson refused to comment, the Star reports.  Carmona
currently works as the chair and medical director of the Southern Arizona
Emergency Medical System Council and is a professor of surgery, public
health and family and community medicine for the University of Arizona.
"He is a rugged gem from the streets of New York who found his way to the
Arizona desert.  He will shine in Washington," Krasinski wrote in his
letter (Salkowski, Arizona Daily Star, 2/8)."

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