How the FDA Works

Criticisms and Successes
This upper limb prothesis was created for children exposed to the drug thalidomide in utero.
This upper limb prothesis was created for children exposed to the drug thalidomide in utero.
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When you turn on the television news these days, there's a good chance you'll hear two pundits having a heated debate about the merits of government regulation. Some feel it's costly and hampers progress while others feel it's necessary to keep businesses honest. As a regulatory agency, the FDA is certainly no stranger to this controversy. A quick look back at the agency's history shows that both sides of the regulation debate have some valid points.

One instance when critics felt FDA regulations slowed progress was during the AIDS epidemic of the 1980s. Little was known about the disease, and for many it was a death sentence. Activists felt the FDA was dragging its feet through the approval process for promising new drugs. The conflict came to a head Oct. 11, 1988, when 1,000 protesters managed to close down the agency's headquarters in Maryland, some holding posters that read, "Time isn't the only thing the FDA is killing" [source: Crimp].

Others think FDA regulation doesn't go far enough. These critics point to cases like that of Vioxx, a painkiller approved by the agency in 1999. When a 2000 study showed the drug might pose a significant risk for heart attack when compared to a similar painkiller, Vioxx's manufacturer, Merck, shrugged it off. The other drug simply had a highly beneficial effect on the heart, they reasoned. The FDA accepted the argument, and Vioxx remained on the market until 2004, when Merck pulled it amid mounting criticism. By this time, according to one study, Vioxx had caused between 88,000 and 140,000 heart attacks [source: Bhattacharya and Berenson et al.].

Still, the FDA has had some undeniable successes, like its refusal to license the sleeping pill thalidomide in the United States. Developed in Germany, scientists initially viewed the drug as exceedingly safe, approving it for over-the-counter use in most European countries by 1956. In 1961, however, scientists discovered a link between thalidomide and children born with malformed limbs. While such birth defects affected 10,000 children worldwide, the United States was largely spared thanks in large part to resistance from the FDA and, specifically, its drug examiner, Frances Oldham Kelsey [source: Science Museum].

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