The FDA: Protecting and Promoting Public Health – From the Foods We Eat to the Medicines We Take
In her 23-year career as a physician, scientist and public health executive, Margaret Hamburg has gained a solid reputation as an innovator in the effort to prevent and reduce the threat of a wide range of serious diseases, including pandemic flu, tuberculosis, HIV, and illness resulting from bioterrorism. So it came as no surprise to many when she was tapped in 2009 to head the Food and Drug Administration (FDA), the high-profile federal government agency charged with ensuring and promoting the public health and safety of many facets of our lives -- from the foods we eat to the medicines we take.
Tackling such challenges with both zest and aplomb, Margaret, as FDA Commissioner (the second woman to be nominated to this position), is charting new courses for the agency. These include strengthening FDA programs and policies aimed at protecting the safety of our food supply; giving greater public access to safe and effective medical products, and finding new ways to prevent illness and promote health.
Says Margaret: "A strong FDA is an agency that the American public can count on. I think my greatest accomplishment thus far has really been to reposition the FDA for the challenges of the 21st century and beyond. It has been an interesting challenge because it has involved institutional change in a way I hadn't anticipated–but I think that it is making a very real difference."
One item that is high on her agenda at the FDA is to effectively use FDA's new authorities to regulate tobacco products.
"Tobacco is the leading cause of preventable disease and death in this country and around the world," says Margaret, "and through routine use, it not only harms the individual who chooses to smoke, but potentially harms others as well. It's an issue we have to take seriously from a public health perspective."
Another top issue under her leadership is preparing the FDA to assume more of a global presence in regulating the growing volume of food and medical products being imported to the U.S. from foreign countries.
Regardless of the challenges ahead, "this is a very interesting time to be with the FDA," she says. While policymaking in such an environment can be quite complex and involve interacting with multiple stakeholders, including the U.S. Congress, "I am very committed to running an agency where science and data drive our decision-making."
Margaret had not really contemplated a career in government service until medical school, when she became very intrigued by the emergence of the AIDS epidemic. "When I started medical school, nobody was aware of this new disease," says Margaret, who grew up near the campus of Stanford University Medical School where her parents (both physicians) were professors.
"As I went on to do internal medicine training in New York City," she says, "I saw a lot of AIDS patients but I wasn't able to offer them anything. I also saw how this disease was causing so much disruption in a variety of social, legal, and political issues. That's when I decided I wanted to work at the intersection of medicine and social and public policy."
She graduated from Harvard Medical School and completed her residency in internal medicine at what is now New York–Presbyterian Hospital/Weill Cornell Medical Center. She conducted research on neuroscience at Rockefeller University, studied neuropharmacology at the National Institute of Mental Health, and later focused on AIDS research as assistant director of the National Institute of Allergy and Infectious Diseases.
From 2005 to 2009, she was the senior scientist at the Nuclear Threat Initiative, a foundation dedicated to reducing the threat to public safety from nuclear, chemical, and biological weapons. From 2001 to 2005, as the foundation's vice president for biological programs, she advocated for broad reforms to confront the dangers of modern bioterrorism as well as the threats of naturally occurring infectious diseases such as pandemic flu.
From 1991 to 1997, Margaret served as commissioner of the New York City Department of Health and Mental Hygiene. In this position, she improved services for women and children, promoted needle-exchange programs to reduce the spread of HIV, and initiated the nation's first public health bioterrorism defense program. Her most celebrated achievement was curbing the spread of tuberculosis, which resurged as a major public health threat in the 1990s. As a result of Dr. Hamburg's reforms, New York City's TB rate fell significantly over a five-year span. Her innovative approach, which included sending health care workers to patients' homes to make sure they completed the drug regimen, is now a model for health departments worldwide.
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