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Tino Cuellar:  I’d like to think that government agencies are getting better.  I know there are a lot of hardworking people that are working to make agencies more effective and more efficient, but the reality is that agencies vary a great deal.  So we can see agencies that have improved in their ability to keep our food safe for example.  There is new legislation that is being implemented by the FDA that’s important in this regard.  We can see agencies making strides in trying to strike a better and fairer balance in our security policy that takes into account the need to protect people’s civil rights and civil liberties.  The Department of Homeland Security, which is an agency that has had many challenges, is implementing an idea of trying to assess the civil rights and civil liberties impacts of many of its major actions.  This idea of civil rights and civil liberties impact assessment parallels a little bit the more well-know notion of an environmental impact assessment.  So it’s an example of agencies learning over time and sometimes by looking at what each other do. But the truth is that we have a long way to go

It’s very common for people to recognize and often rightly so that public agencies work less quickly and seemingly less efficiently than entities in the private sector.  But what people often forget is that the very basic mission of a public agency is different from day one.  That mission includes satisfying a great many diverse stakeholders. Take an agency that is responsible for food safety, which is an often important and neglected security problem, particularly given that about 48 million Americans get very seriously sick in a single year from a food based pathogen.  Somewhere between 3,000 and 3,500 people by estimates from the CDC die of food borne illness, but when an agency regulates to try to prevent that food borne illness it doesn’t have a single mission.  It can’t focus as a private company often can on the one mission of getting a product that will work, that will sell as much as possible, will make the greatest profit.  Instead it has to ask how can I save lives at reasonable cost and make sure that I do so in a manner the respects the fact that our economy is complicated, the we're an economy of farmers, of food processors that we care about people being employed and we want to do everything possible to make sure that the food gets safer, that people are as protected as possible, but that still means recognizing that there is diverse stakeholders and different imperatives that need to be thought of every single day.

No agency is perfect, but I think we can learn something from watching public health agencies that have dealt with problems like infectious disease and food safety.  So the FDA is an agency that has faced challenges in the past involving the drug approval process and it continues to face a challenge of working faster and dealing with fewer resources, but also maintaining the quality of its approval process.  Nonetheless, I think you can look at the FDA and see some important developments that ought to make people notice what it’s doing.  The FDA is pursuing a regulatory science initiative for example to improve the process through which it approves medical technologies and to basically be in a position to create entire new industries by making sure that regulation does not short shrift safety, but at the same time provides an opportunity for these technologies to develop more quickly.  

The FDA is also making important strides in implementing food safety legislation.  Its partner agency in the Department of Health and Human Services, the Centers for Disease Control played a very critical role in the response to the H1N1 Virus and I think over time has demonstrated that it’s very much one of the best agencies operating in this space. So I'm hopeful that other agencies can recognize over time that there are basic tools that any government agency can use to improve its performance if it does so smartly and it looks at long range goals.  These tools include professional competence, carefully thinking about promotion paths and its internal culture, figuring out how to develop a sense of connection to the public such that there is an opportunity for input from the public, but also a way of leveraging the expert judgment that we want agencies to have that is difficult for people in the general public to maintain.

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Jonathan Fowler & Elizabeth Rodd



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