Good News From Crawford

On Friday afternoon, amid the runup to another big hurricane in the Gulf Coast area and a big protest here in D.C., FDA Commissioner Lester Crawford quietly resigned [1]. The surprise announcement—apparently his staff had no idea it was coming—might be a result of the flak the FDA has received lately surrounding its stalling over Plan B, the emergency contraceptive. Or it could be something else entirely: An anonymous government official told The New York Times [2]  that the resignation was related to a financial issue Crawford hadn't revealed at his confirmation hearings. Another anonymous source said the White House had asked Crawford to resign. One thing is clear, however: Public health will be in better hands now that Crawford is gone.

Although Crawford was only officially confirmed as FDA director in July 2005, he had been the acting director of the agency for two years. During his tenure, the agency has faced other crises besides the Plan B debacle, including serious safety questions surrounding the pain medication Vioxx and implanted heart devices, and an overall disregard for the scientific recommendations of the agency's expert advisors. In general, the FDA's credibility and ability to manage life-and-death health issues was called into question multiple times during Crawford's tenure. Even the relatively staid, peer-reviewed  New England Journal of Medicine published a piece last week [3]  in which it charged that the FDA had "made a mockery of the process of evaluating scientific evidence," and "squandered the public trust and tarnished the agency's image."

Women's health advocates are hailing Crawford's resignation as a chance for the FDA to make a clean start. Women's ENews called Crawford's departure as a 'cheer' for the week [4]. At Planned Parenthood, president Karen Pearl said she hoped Crawford's resignation would signal a "new day" for the FDA and a renewed focus on science. Under Crawford's tenure, she said, "The FDA has led an ideologically motivated effort to keep a safe and effective drug out of women's hands." Legalizing Plan B could have prevented 1.6 million abortions [5] in the past two years.

But, as Nancy Keenan of NARAL pointed out, Crawford's departure could also be used as an excuse [6]  to stall yet again on a Plan B decision. While the new director, Dr. Andrew C. von Eschenbach, is a cancer specialist, little is known so far about his ideological bent—or if he won't have one and will let science prevail. It shows how little we've come to expect from our federal agencies that a lack of ideology by a scientific leader is now considered a best-case scenario.