Thinking Citizen Blog — FDA, CDC, NIH: A Little History

Thinking Citizen Blog — Thursday is Health, Health Care, Health Insurance and Global Health Policy Day

Today’s Topic: FDA, CDC, NIH: A Little History

The FDA, CDC, and NIH are in the news a lot. Today, I decided to learn a little about the history of each and found a concise article in National Geographic. Below, a few extracts. Also some statistics culled from other sources. All three agencies are part of the Department of Health and Human Services. Spoiler: the NIH dates back to 1798, the FDA to 1906, and the CDC to 1942. Questions: how much power does each have (in fact and in law)? how much should each have? What grade would you give each agency for its recent performance? Experts — please chime in. Correct, elaborate, elucidate.

THE FDA — 1906, Harvey Washington Wiley, “the Crusading Chemist”

1. “The U.S. government began its first investigations into food and other consumable products in response to a 19th-century wave of adulterated or counterfeit patent medicines and poisonous food additives.”

2.“In the 1880s, Harvey Washington Wiley,” a scientist with the U.S. Department of Agriculture’s Bureau of Chemistry — he was known as the “Crusading Chemist” — pushed for tighter regulations over food and medicine, even conducting highly publicized experiments in which he fed healthy men tainted food.”

3. “As a result of intense lobbying by Wiley and other reformers, legislators passed the Pure Food and Drug Acts of 1906, which made it a crime to sell adulterated or poisonous food or drugs. The U.S. Department of Agriculture’s Bureau of Chemistry was tasked with regulation, and the Food and Drug Administration was born.”

NB: 2020 Budget — $5.9 billion. 55% funded by federal authorization, 45% by user fees. About 18,000 full time equivalent employees. FDA monitors 270,000 registered facilities, more than half of which are overseas. “80 percent of active pharmaceutical ingredients manufacturers are located outside of the U.S.” (see third link for a mind-blowing set of statistics)

NIH — from 1798 to 1870 to 1930 to Anthony Fauci

1. “The National Institutes of Health has roots in the nation’s earliest health law, a 1798 statute deducting money from seamen’s salaries for medical care and hospitals. In 1870, the nation’s 31 marine hospitals were consolidated under the Marine Hospital Service (MHS) to create the Public Health Service, a commissioned corps of medical officers devoted to public health. The MHS’s mandate ballooned in the late 19th century, when it took over the inspection of incoming ships and immigrants to U.S. ports. Tasked with examining passengers for signs of cholera and other highly contagious diseases and enforcing quarantines, its physicians became increasingly interested in the emerging science of infectious disease.”

2. “During subsequent health crises, the agency became more involved in medical research. It began to award research grants, and in 1930 changed its name to the National Institute of Health (the plural was adopted in 1948, reflecting the addition of research arms for everything from cancer to heart disease). Today, the organization has 27 different institutes and centers, including the National Library of Medicine and National Institute of Mental Health. One of them, the National Institute of Allergy and Infectious Diseases, led by Anthony Fauci, has been in the spotlight during the COVID-19 pandemic.”

3. The total NIH budget for 2021 is $43 billion. Biggest item — cancer research ($6.6 bn). Fauci’s budget: $6.1 bn.

THE CDC — from Malaria (1942–1951), to Polio (1950s), Rabies to Covid-19 and the Supreme Court

1. “Although today it’s the most visible federal agency devoted to public health, the Centers for Disease Control and Prevention (CDC) has humble roots. It started out as the Office of Malaria Control in War Areas, an obscure branch of the Public Health Service founded in 1942. At the time, malaria was still common in the South, where many military bases were located. The agency eliminated mosquito hotspots, trained local officials, educated the public, and developed malaria prevention techniques for troops deployed to the Pacific Theater during World War II. The initiative was so effective that, in 1946, a Communicable Disease Center (CDC) was opened in Atlanta.”

2. “At first, the organization was devoted purely to malaria prevention, and its efforts helped eradicate the disease from the U.S. by 1951. Then the CDC expanded, addressing everything from polio to rabies and becoming the official agency to deal with health in public disasters. Today, it’s the nation’s official health protection agency, tasked with informing the public, gathering statistics, detecting and responding to health threats, and eliminating disease.”

3. The head of the CDC is Rochelle Walensky, former chief of infectious diseases at Mass General Hospital and a professor at Harvard Medical School.

NB: “On August 3, 2021, Walensky instituted a 60-day extension of a federal COVID-related ban, which had just expired, on landlords evicting their tenants. The extended ban applied only to “counties experiencing substantial and high levels of community transmission levels”, but under the criteria of the ban this covered an area holding 90% of the U.S. population. On August 26… the US Supreme Court struck down the extension as unconstitutional, ruling that only the U.S. Congress had the authority to issue such a moratorium.” Parenthetically, her appointment did not require Congressional approval.

CDC, FDA, NIH — what’s the difference?

Food and Drug Administration

Fact Sheet: FDA at a Glance

Anthony Fauci

https://en.wikipedia.org/wiki/Centers_for_Disease_Control_and_Prevention

https://en.wikipedia.org/wiki/Rochelle_Walensky

For the last three years of posts organized by theme:

PDF with headlines — Google Drive

YOUR TURN

Please share the most interesting thing you learned in the last week related to health, health care or health care policy — the ethics, economics, politics, history…. Or the coolest, most important thing you learned in your life related to health are or health care policy that the rest of us may have missed. Or just some random health-related fact that blew you away.

This is your chance to make some one’s day. Or to cement in your mind something really important you might otherwise forget. Or to think more deeply than you otherwise would about something that matters.