What Chairman Hoeven Said, and Why

In his opening statement at this week’s subcommittee hearing, Chairman Hoeven noted that:

In every budget cycle, there are winners and losers. I think it’s fair to say that once again FDA is one of the winners this time around. For FY 2020, the FDA’s budget request for appropriated funds is a 5.5% increase over FY 2019. This is one of the highest percentage increases in all of the Department of Health and Human Services, especially when you factor in that for FY 2019, the Congress provided the FDA with a $268.6 million, or 9.6% increase.

Prior to the creation of the Alliance, more than a decade ago, FDA was massively underfunded and sentiments such as Chairman Hoeven’s were rarely expressed in Congress.In fact, FDA’s standing in 2005 could hardly have been worse. It had little money and no way to makes its case. There was no voice for the agency. Stakeholders had come together in the past, but it was always parochial. Food was for boosting food and various medical products stakeholders spoke only for themselves. Any successes were usually at the expense of other parts of the agency. Nothing was being done to alleviate the chronic, agency-wide underfunding or to advocate for funding the entire agency. The Alliance stood for the proposition that “a rising tide lifts all boats.” Strengthening FDA needed to mean “strengthening all of the agency,” with new monies allocated to areas of highest needs (of which there were many).When we did due diligence before forming the Alliance, one of the things we heard most often was that FDA’s problem was that it was in the Agriculture appropriations subcommittee, instead of with the other public health agencies in Labor-HHS appropriations. From our standpoint, that was never a possibility and we never took it seriously. Instead, it was clear that we needed to focus on making agriculture appropriators (and other Member of Congress) more aware of FDA’s important role and the connection between underfunding the agency and putting the American people at risk.We had a good case, but it is really a credit to appropriators that they listened seriously. Over time, they saw that many of FDA’s problems were caused by a lack of funding (and staff) to do the job given to it by Congress.  And they saw that FDA’s success or failure mattered. They also saw that evolving national needs, new laws, increasing scientific complexity, and globalization required many further increases in FDA funding.I have observed that a dozen years ago, appropriators saw FDA as the answer to the Sesame Street question: which one is not like the other ones? Being different was not helping FDA’s cause. Today, FDA is still unlike any other federal agency, but we have been embraced -- particularly by agriculture appropriators -- as a special responsibility. To all who contributed to this -- Members of Congress and staff, OMB, HHS and FDA, and the FDA stakeholder community -- thank you for what you have done to assure Americans of safe foods and safe and effective medical products. And a special thank you to Chairman Hoeven for expressing it so well at the March 28 hearing.

Editorial note: The Analysis and Commentary section is written by Steven Grossman, Deputy Executive Director of the Alliance for a Stronger FDA.