President Obama's nominee for FDA commissioner — Dr. Margaret Hamburg — has held one of the toughest jobs in public health.
From 1991 to 1997, Hamburg was New York City's health commissioner, overseeing what had been a storied but demoralized department facing the HIV epidemic and budget cutbacks. A New York Times editorial credited her with raising agency morale and channeling money back to the department.
Her experience could serve her well at the FDA, as low morale ripples through an agency considered underfunded, even by members of Congress who have criticized the FDA for lax food safety oversight and drug approvals.
Controversial Initiatives In New York
At the New York City health department, Hamburg fought a tuberculosis epidemic by beefing up the city's ability to force treatment on people infected by the TB bacteria.
"As public health officials [we] have to have the power to take more aggressive actions in those cases," she said at the time, "so that we can protect the health of the public."
And she instituted a politically controversisial needle-exchange program to prevent HIV transmission in drug users.
Road To The FDA
Born in 1955, Hamburg grew up on the Stanford University campus, where both her parents were physicians and academics. Her mother was the first African-American to go to Vassar College; Hamburg credits her Jewish father with teaching her values.
With undergraduate and medical degrees from Harvard University, Hamburg went on to do neuroscience research at Rockefeller University and the National Institutes of Health, and later worked on AIDS issues at the National Institute of Allergy and Infectious Diseases.
From New York City, she moved to the federal level, working on policy issues at the Department of Health and Human Services. Hamburg is also a senior scientist at the Nuclear Threat Initiative, where she has been focusing on bioterrorism.
If confirmed by the Senate, Hamburg will be walking into a tough job. Members of Congress are considering giving the agency oversight over tobacco. Congress is also considering legislation that would create a separate food agency.
Health officials say if anyone can pull the agency together and make it work, it's Hamburg. Former FDA Commissioner Dr. Donald Kennedy says he can think of no one better. Dr. Georges Benjamin, head of the American Public Health Association, cites her broad experience in policy, science and administration.
"FDA needs somebody who's highly ethical and can build and lead a team, I think Dr. Hamburg is the right person for that," Benjamin said.
Challenge To The Drug Industry
The Obama administration has also named a deputy FDA administrator, Joshua Sharfstein. He's currently head of the Baltimore City Department of Health. Like Hamburg, he's a physician with undergraduate and graduate degrees from Harvard. Sharfstein worked for several years on Capitol Hill for Rep. Henry Waxman (D-CA), now head of the Energy and Commerce committee, which oversees health issues. Sharfstein worked on health issues and gained a reputation as a very bright go-getter.
He recently made a name for himself by starting a successful movement to limit the use of cold and cough medicines in children, something not likely to make him popular with over-the-counter drug companies. His position as deputy commissioner needs no Senate confirmation.