Arthur Daemmrich and Joanna Radin (eds), Perspectives on risk and regulation: the FDA at 100, Philadelphia, Chemical Heritage Foundation, 2007, pp. xvii, 163, $12.00 (paperback 978-0-941901-41-0).

Abstract

This collection of short essays is derived from a conference at the Chemical Heritage Foundation in Philadelphia in May 2006 to mark the centenary of the US Food and Drug Administration (FDA). The editors, senior research fellow and research fellow respectively at the Chemical Heritage Foundation, bring together FDA officials, including nutritional scientists, and industry scientists, in what is styled as a collaborative enterprise between regulator and business. This is perhaps designed to emphasize the FDA's role in partnering rather than simply policing business activity. Some important industry figures are here: the global nutrition director of Heinz; the vice-president of regulatory affairs at Johnson and Johnson; the senior vice-president and chief medical officer for GlaxoSmithKline; and the volume closes with comments from Andrew C von Eschenbach, the current (and twentieth) FDA commissioner. These and five of the book's other contributors concentrate essentially on current concerns in the regulation of food, food supplements, drugs and medical devices. Some interesting insights are offered, chiefly relating to the apparently accelerating nature of advances in scientific and medical knowledge, but generally there is a limited engagement with scientific and indeed social scientific debates, especially in relation to the key issues of risk and regulation which are flagged in the book's title. Surprisingly too, perhaps, given the centenary that is being marked, there is relatively little historical insight. The editors provide a short introduction, subtitled ‘Historical and contemporary perspectives’, which glides over the former in a single paragraph (p. 4). Peter Barton Hutt, a Washington lawyer and former chief counsel for the FDA, then provides a discussion of ten ‘Turning points in FDA history’. This is useful, drawing attention to the very wide range of the organization's remit and responsibilities over the course of its first century, but in this slightly truncated “highlights package” form it does not really do justice to the FDA's highly contested origins and early decades. The 1906 Food and Drugs and Meat Inspection Acts provided improved consumer protection but offered a blanket to business also, legitimizing the methods of food and pharmaceutical producers. The meat packers, who were arguably the worst offenders against food consumers, and whose practices were vividly exposed in Upton Sinclair's socialist novel, The jungle (1906), were also excused from the burden of funding the inspection and regulation regime. This was borne instead, to the producers’ satisfaction, by the Federal government. This important tale also highlights the fact that global food security has deep historical roots. The jungle precipitated a crisis in the export market for US meat products, and this in large part accelerated the drive towards Federal regulation. Yet elsewhere in the volume the current director of the FDA Center for Food Safety and Applied Nutrition, making otherwise sensible observations about the problems of food security in the contemporary globalized market, seeks to present the issue as very largely an unprecedented phenomenon, which clearly it is not. Difficult issues and problems, it should be emphasized, are not ignored in the book. There are references to the absence in the US of a comprehensive system of national health care, which is not unrelated to the activities of pharmaceutical companies, and the still contested nature of the FDA is alluded to, with the struggle to secure continued Federal funding leading the organization into the problematic practice of charging user fees for new drugs and medical devices. These lively and ongoing concerns are well presented in the book, which would—it bears repeating—have been considerably strengthened with more robust and extensive historical perspective.