FDA Commissioner: The Job Everybody and Nobody Wants

The twists and turns the FDA has experienced in the commissioner's office have been pretty remarkable over the last several years. After the resignation of Jane Henney in 2000, the agency has been on a rollercoaster ride.

First, there was a long search, which included a number of people that had been employed by pharmaceutical and biotech companies. Former HHS Secretary Tommy Thompson finally found his man: Lester Crawford. But the White House put the kibosh on Thompson's choice and instead went with someone close to home in Mark McClellan. McClellan was one of those rare political appointments that appeared to make everyone happy. But the Bush Administration needed someone to sell the Medicare benefit so McClellan, a health economist at heart, was moved over to CMS. Re-enter Lester Crawford. It is painfully obvious that Crawford has wanted all along to be FDA Commissioner. He suffered through a number of crises, and to be quite frank, indignities, to get permanently appointed. And Crawford finally did it.

I can tell you from talking to Crawford on several occassions, he is as good a person as you'll ever meet, and old McClellanites would say the same. So it's a shame that after such a long journey to that plush Rockville office, Crawford was forced to resign last Friday after just a few months with the title.

Now, former NCI Director Andrew von Eschenbach has been named "acting" FDA Commissioner. Aren't we all getting a little tired of this? It looks like the von Eschenbach Era won't last long, either. Comments made by Senate HELP Committee Chairman Michael Enzi (R-Wyo) clearly indicate that von Eschenbach's tenure at FDA will be very temporary.

http://help.senate.gov/vonesc.htm

It's obvious that the old NCI chief went up the road and didn't like the new digs. There is some watercooler talk that von Eschenbach is still the guy and he could be put in place permanently in February. But I wouldn't bet on it. Now the question is: who's next in line for the commissioner carousel?

Career staff and old agency hands are clearly - and rightfully - demoralized. But with FDA in its current situation, it's becoming quite clear: nobody wants this job.