5 Questions: Susan Wood on quitting the FDA

Susan Wood

Last summer, when top officials at the U.S. Food and Drug Administration overruled the advice of their professional staff and declined to grant over-the-counter status to Plan B emergency contraception, Susan Wood, PhD, made the ultimate protest: she resigned her position as the director of the FDA Office of Women's Health. Tonight Wood will discuss her decision and the FDA's increasing reliance on ideology over science. The free public event will be at 6 p.m. in M104 of the Alway Medical Building. Medical Center Report asked Wood for a preview of her talk.

1. Have you had any second thoughts about walking away from the FDA?

Wood: No. The thing I miss most about the FDA and the federal government is the dedicated colleagues whom I left behind. I wish I didn't have to do that. But I feel it was the best decision for my own credibility in terms of science and public health. It was not a tenable situation. [When the top agency officials decided against allowing Plan B to be sold over the counter,] the scientific and medical evidence was ignored. The process and the professional staff at the FDA who are normally counted on were completely overruled and at certain points completely cut out from discussion.

2. You've said that the religious right has hijacked the FDA. Are there other examples aside from the Plan B controversy?

Wood: The case people have been asking me about lately—which I hope winds up not being a similar case—is the HPV vaccine against cervical cancer. The same people who opposed emergency contraception also oppose the HPV vaccine because it will counter the abstinence message. The issue is pending before the FDA, and the Centers for Disease Control and Prevention is also looking at it. The decisions are due in June. I'm reasonably hopeful that the scientists at the FDA will be allowed to do their job properly, and the decision will be made based on the evidence. But I do worry.

3. Since your resignation, have you seen any evidence of positive changes at the FDA?

Wood: No. Unfortunately, what I'm seeing is that things that aren't controversial at all are being deemed controversial. What was pending before the FDA in August 2005 [with Plan B] was simply timely access to safe and effective contraception for women 17 or older. This is not a controversial subject: The vast majority of people in the United States use contraception and support its access. It's astonishing to me that we're even having this debate.

The issue isn't just about contraception: It's about the credibility of the entire agency and its ability to make its decisions based on science.

4. The dean of the medical school was recently nominated for a White House panel, and during the interview process, he was asked about his political views. What do you think of the administration's vetting of its scientific advisers?

Wood: I'm appalled. He's not the only one—I've heard of similar people going through interviews and being stunned by the types of questions being asked of them, in a way that seems significantly different from those posed to people who were appointed in the past. We've seen appointments at the FDA and the CDC that seem to be based on ideology, not scientific expertise. We have also seen people not being allowed to be on committees because they don't have views consistent with the administration, though those views have little or nothing to do with science or medicine.

5. You've been encouraging scientists to fight against what you call the organized assault on science. But traditionally scientists have been above the fray. Why should they speak out and how is it going to make a difference?

Wood: Scientists need to speak out because the FDA has a broad scope of responsibility: drugs, devices, vaccines, etc. They need to be able to count on its information. The debate that health professionals have with the FDA should be on scientific levels—how to interpret data—not on other issues. Scientists need to push back and say, 'We don't expect our federal agencies to operate like this.' I believe doing that and broadly disseminating knowledge is the best way to restore the independence of the FDA and science-based agencies.