The ScienceBlogs Book Club continues the discussion on Mark Pendergrast's Inside the Outbreaks: The Elite Medical Detectives of the Epidemic Intelligence Service. In my post this week, I look at how Congress influences federal agencies' work on public health - an issue that crops up throughout the book. Here's an excerpt:
Congress's creation of federal agencies is clearly a huge achievement, and they've also periodically given new powers to already existing agencies. For instance, Mark Pendergrast tells the story of the Dalkon Shield, an IUD that turned out to cause infections while failing to prevent pregnancy in many of the women who used it; at least 17 pregnant women died with IUDs in their uteruses. The manufacturer, facing lawsuits, eventually took the product off the market, but the episode demonstrated the need to prevent similar problems in the future. Congress responded by passing the Medical Devices Amendment Act, which mandates that medical devices receive FDA approval before being marketed.
Agencies also rely on Congress for their annual appropriations, and public health isn't often the top Congressional priority when it comes to dividing a limited pool of revenue. There are times when Congress responds to a growing health threat by giving an agency more money to address the problem; for instance, after several outbreaks of food-borne illnesses, Congress gave FDA's FY 2010 budget a large increase to help it hire more food inspectors. It seems like more often, though, Congress makes funding decisions that run counter to the advice of public health professionals.