WASHINGTON -- Four months after the White House appointed Dr. Andrew C. von Eschenbach to be acting commissioner of the Food and Drug Administration, he remains just that - temporary head of an agency that has become accustomed to fill-in leaders under the Bush administration.
The FDA's top post has seen no fewer than four interim commissioners over all but 18 months of the Bush presidency, generating growing concern from members of Congress from both parties, various interest groups and industry.
A permanent leader, they contend, would be more focused on long-term strategic planning and could help the FDA gain more funding from Congress for prompt approval of new drugs and medical devices.
"Now we have a temp from NIH standing sentry over our food and our drugs. We need to have a full-time, competent person who's doing this," Sen. Barbara A. Mikulski, a Maryland Democrat, said in a recent radio address.
Senate Finance Chairman Charles E. Grassley of Iowa and Health Committee Chairman Michael B. Enzi of Wyoming, both Republicans, have urged President Bush to pick a permanent commissioner.
Rep. Mark E. Souder, a Republican from Indiana, blamed the absence of a permanent commissioner for the FDA's failure to tackle such public health issues as the diversion of prescription drugs for illegal use and the potential sale of the morning-after pill without a prescription.
"A continuous `interim director' at FDA is like a baby sitter left in charge of the children indefinitely - you don't want to leave important decisions to that person," Souder, who chairs a House subcommittee on drug policy, said through a spokesman.
Erin Healy, a White House spokeswoman, said the administration was moving forward on nominating someone as soon as possible. Von Eschenbach, she said, was "fully engaged" in the FDA and carries the same authority as a permanent commissioner.
During the Bush administration, the agency has been led by an interim chief much longer than by a permanent one - for 42 of Bush's 60 months as president. Some former agency officials say that reflects a lack of enthusiasm for food and drug regulation at the White House.
"This White House has, from the beginning, shown very little interest in the health establishment," said William W. Vodra, a former FDA associate chief counsel for drugs, who now represents pharmaceutical companies. "They came here with an agenda that did not include FDA issues as major items."
