D&IW Associate

Waiting until the waning hours of a lame duck session of Congress, the Senate finally confirmed Andrew von Eschenbach, MD, as commissioner of the FDA last Thursday, filling a post that has been vacant since the abrupt resignation of Lester Crawford in September 2005.

von Eschenbach, 65, a surgeon, became acting commissioner after the surprising resignation of Lester Crawford, MD – who held the post for just two months. Von Eschenbach previously served as chief academic officer at the M. D. Anderson Cancer Center (Houston) and had led the National Cancer Institute.

The head position at the FDA has been a difficult one to keep staffed, particularly over the last decade. In the past 10 years, no commissioner has served more than two years, partly due to the various political pressures on the agency. A report released in September by the Institute of Medicine (Washington), part of the National Academies, deplored a "lack of stable leadership"at the agency citing internal squabbles, poor management and outdated rules.

von Eschenbach was formally nominated to the position of commissioner in March by President Bush, but his confirmation was delayed by a series of objections in the form of "holds"by senators from both parties who said they were protesting everything from the agency's delay of the Plan B emergency contraceptive to the administration's stance on drug reimportation, or the purchase of prescription drugs in countries where they are cheaper.

Before delivering a farewell speech Thursday on the Senate floor, Sen. Bill Frist (R-Tennessee), retiring majority leader, called for a procedural vote to bring von Eschenbach's name before the full Senate for confirmation, ignoring remaining holds from three fellow Republicans. Frist, himself a cardiac surgeon before he joined the Senate, said von Eschenbach had done a "superb"job as acting commissioner.

Von Eschenbach's confirmation, by a vote of 80 to 11, came despite the strong objections of powerful Sen. Charles Grassley (R-Iowa) who has been an outspoken critic of the agency.