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Meatless Monday and the Washington Monument syndrome

September 28, 2012

I have spent a number of weeks (and am likely to spend many more) writing about the devastating impact of sequestration on FDA.

As a result of that devastating impact, we are asking Congress for three sane and sensible things that should help FDA:

  • Recognize and properly fund the special and growing role of FDA as a protector of food and drug safety and a gateway to medical innovation and science.
  • Find alternative means to reduce the budget deficit and avoid the across-the-board sequestration of 8.2% of federal agency funding on January 2, 2013.
  • Return federal budget-making to a process under which national priorities (such as FDA) are adequately funded.

If we succeed, FDA will not face sequester. However, the danger doesn’t go away. The House budget plan would balance the federal budget by 2035 — and it’s controversial — so it is not crazy to suggest that the pressure on federal spending will continue far beyond the immediate future, perhaps for decades.

The Alliance’s call for a return to funding based on national priorities is a statement of faith: that FDA is a core function of national government and that we can demonstrate that funding the agency is essential. We should not, however, delude ourselves that this is self-evident to everyone.

We will need to convince policymakers, the media, and the public that we belong in the elite group of programs that need to grow, even as other important programs suffer cutbacks and some even wither and die. Implicitly, the responsibilities of the federal government are going to be redefined — whether consciously or as the residual of decisions that will be forced on the President and Congress.

How well will FDA compete for scarce dollars, assuming that the situation is not pre-determined by across-the-board cuts? The elite tier of federal programs has some heavy-hitters, and the absence of funding in their areas often has more concrete and immediate consequences than a lack of funding for FDA.

We know that sequester of FDA funding (or any large or sustained agency cuts) has consequences: food will be less safe; drug and device approvals will be slower; problems with imports and globalization will become more numerous; and FDA modernization will be severely slowed. The precise impact is hard to quantify because FDA will try to prioritize its remaining manpower to avoid immediate disasters and any visible failure to approve life-saving therapies.

How well does this image of a decimated FDA (and its consequences) compare to some other federal programs that — absent sequestration — would be thought to be untouchable? Leading judges have painted a picture of a post-sequestration world where there will be “trial-less Tuesdays,” actually an entire day where everyone in the federal judiciary will be furloughed in order to preserve the system’s ability to fully function on the four other days of the week.

Similarly, one hears bandied about the notion of “flight-less Fridays” if there are not funds to sustain and (as necessary) grow the number of air-traffic controllers. One can imagine the military (“platoons without people”) and the USDA Food Safety Inspection Service (“meatless Monday”) taking similar approaches.

In DC, this is known as “The Washington Monument syndrome.” It is premised on the fable that, faced with a cutback, the US Park Service will announce dramatic cutbacks in visiting hours at the Washington Monument (highly visible) rather than offer to close some obscure park stations in the Alaskan wilderness. Despite the transparency of the gambit, it is a highly effective approach.

With FDA funds being used to oversee products and services that mount in the trillions and encompass one-fourth of consumer spending … our case is equally compelling. However, what is our concrete, visual, dramatic (and preferably alliterative) symbol of the consequences of cutting FDA? We are working on ideas, but suggestions are clearly welcome.

Note: This analysis and commentary is written by Steven Grossman, the Deputy Executive Director of the Alliance for a Stronger FDA.

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