Q & A: FDA on course for strategic changes, commissioner says

Key Points

FDA Commissioner Andrew C. von Eschenbach, MD has had a storied career that began as a urology resident at the University of Pennsylvania in Philadelphia. He later joined M.D. Anderson in Houston as a urologic oncology fellow and, within 6 years, became chairman of its department of urology. After serving as executive vice president and chief academic officer of the University of Texas M.D. Anderson Cancer Center, he was appointed to lead the National Cancer Institute in 2002. In December 2006, Dr. von Eschenbach was sworn in as the 20th commissioner of the FDA. His diverse background, along with his experiences as a cancer survivor, have uniquely shaped Dr. von Eschenbach's beliefs and work ethic. In this exclusive article, Urology Times Editorial Consultant Philip M. Hanno, MD, professor of urology at the University of Pennsylvania, asks Dr. von Eschenbach about his role at FDA, his priorities and goals, and issues facing the agency and the U.S. health care system.

Q. You've had a fascinating career spanning urology practice, academia, and the leadership of two of the nation's top health care agencies. Did you ever anticipate such a career pathway when you were a urology resident?

A. I was blessed by the fact that I arrived at an agency that had unbelievable people. They are incredibly dedicated public servants who are brilliant and knowledgeable. As often is the case in our careers, we learn to depend on the experts and listen to them. I leave decisions about specific drugs to the scientists, for example.

Q. Having such a giant organization to move must be like steering an aircraft carrier. How do you approach that?

A. First, you need a plan. It is very important to step back and take a careful look at the environment that we are now facing. We're living in a rapidly, radically changing world. When you think about the implications of globalization and the incredible explosion of science and technology, you have to ask what that means to an agency like FDA and its regulatory process. Based on that, we began to look at where we needed to refine that process. It's important to look at an agency and an organization and reflect on the magnitude and the pace with which it can accept change and manage it appropriately.