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Dr. Hamburg Meet Dr. Collins

FDA and NIH are natural allies, with closely-related purposes as public health agencies. They share a similar worldview that “medical and scientific knowledge derived from random clinical trials” is superior to all other sources. I explored this in an earlier column at: http://www.fdamatters.com/?p=299.

Last week’s announcement of Dr. Francis Collins to be NIH director provides a unique opportunity for FDA. Dr. Hamburg needs to meet Dr. Collins….and create a shared vision.

Government agencies are no different than corporate divisions: they crave positive attention, fight to accumulate bigger budgets and more personnel, and resist any attempts to lessen their autonomy. Tribal rules apply. Outsiders—no matter how well-meaning—cannot be assumed to have your organization’s best interests at heart.

One could ask: why should FDA and NIH be different than this grim picture of organizational behavior? The answer is: they aren’t. Except in rare cases, having a noble organizational purpose does not suspend the accumulative and suspicious culture that is inherent in any group.

There are countless joint initiatives and working groups that link FDA and NIH. Common purposes and a similar world view often push them together…but I am told that many of these meetings are productive only in a very narrow sense. Although the work gets done, the spirit of common purpose is often weak. Enthusiasm for power-sharing is low. Extending projects to related areas is sometimes never discussed. But opportunity is everywhere.

FDA and CMS relate in a different way. As described in my earlier article, the agencies do not have common purpose and do not have a shared view of what knowledge is important. Because of these fundamental differences, opportunities for shared initiative are limited and relations will always be strained. For FDA and CMS, good will and occasional joint successes can never overcome the distance between them.

Not so FDA and NIH. The two agencies working together are powerfully synergistic….and boundless in the benefits it could bring to Americans. The interest of NIH Institute and FDA Center directors is essential to building a better, more productive relationship. But it will never happen if it rests on their ability to overcome the cultural and tribal impediments.

Only Dr. Hamburg and Dr. Collins can set the proper tone, provide guidance and break down the barriers. Dr. Hamburg, meet Dr. Collins. Please.


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