Rousing and readable: sure to brings smiles at the FDA and howls of protest from industry lobbyists.

PROTECTING AMERICA’S HEALTH

THE FDA, BUSINESS, AND ONE HUNDRED YEARS OF REGULATION

Chicanery, greed, politics, battles won and lost: welcome to the Food and Drug Administration.

New York Times science reporter Hilts (Memory’s Ghost, 1998, etc.) has no doubts about the need for an independent FDA to protect the public’s health, and he has no qualms about identifying the forces that have attempted to thwart its mission. From passage of the Food and Drug Act of 1906, shortly after Upton Sinclair’s The Jungle aroused public outrage over the meatpacking industry, to passage of the Kefauver-Harris amendments in 1962, spurred by furor over the thalidomide disaster, Hilts shows how commerce, politics, and events have shaped the evolving role of the FDA. Born in the Progressive Era as the US Department of Agriculture’s Bureau of Chemistry but hobbled by minimal budgets and authority, the FDA had little effectiveness until the Food, Drug, and Cosmetic Act of 1938, sparked by public concern over children’s deaths caused by sulfanilamide, gave it the job of checking drugs before they went to market. Hilts examines the growth of the giant pharmaceutical industry, the rise of a conservative movement opposed to government regulation, and the policies and styles of FDA commissioners. He shows how controlled scientific studies became the standard for determining a drug’s safety and effectiveness and how the often-beleaguered agency’s professionalism was established. Among the many battles he recounts were those over package-insert information, nutrition labeling on processed foods, silicone breast implants, development of AIDS drugs, and recall of drugs hazardous to health but profitable to pharmaceutical companies. Common sense, says Hilts, demands that businesses, whose first job is profits, be countered by a regulatory agency whose first job is public safety. As imperfect as the FDA is, he states, duly noting the payoff scandals of the late 1980s, its work remains essential.

Rousing and readable: sure to brings smiles at the FDA and howls of protest from industry lobbyists.

Pub Date: April 2, 2003

ISBN: 0-375-40466-X

Page Count: 352

Publisher: Knopf

Review Posted Online: May 20, 2010

Kirkus Reviews Issue: March 1, 2003

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Useful but disappointingly commonplace tips.

A SHORT GUIDE TO A LONG LIFE

In a follow-up to The End of Illness (2012), which explored how technological advances will transform medicine, Agus (Medicine and Engineering/Univ. of Southern California) restates time-tested but too often overlooked principles for healthy living.

The author outlines simple measures that average citizens can take to live healthier lives and extend their life spans by taking advantage of modern technology to develop personalized records. These would include a list of medical tests and recommended treatments. Agus also suggests keeping track of indicators that can be observed at home on a regular basis—e.g., changes in energy, weight, appetite and blood pressure, blood sugar and general appearance. He advises that all of this information be made available online, and it is also helpful to investigate family history and consider DNA testing where indicated. Along with maintaining a healthy weight, Agus emphasizes the importance of eating a balanced diet, with plenty of fresh fruits and vegetables and a minimum of red meat. Avoid packaged vitamins and food supplements, and if possible, grow your own vegetables or buy frozen vegetables, which will generally be fresher than those on supermarket shelves. The author also warns against processed foods that make health claims but contain additives or excessive amounts of sugar or fat. Regular mealtimes and plenty of sleep, frequent hand-washing and oral hygiene are a must; smoking and excessive time in the sun should also be avoided. Agus recommends that adults should consider taking statins and baby aspirin as preventative measures. He concludes with a decade-by-decade checklist of annual medical examinations that should be routine—e.g. blood pressure, diabetes and cholesterol screenings, from one’s 20s on; colonoscopies, prostate exams and mammograms later—and a variety of top-10 lists (for example, “Top 10 Reasons to Take a Walk”).

Useful but disappointingly commonplace tips.

Pub Date: Jan. 7, 2014

ISBN: 978-1-4767-3095-0

Page Count: 128

Publisher: Simon & Schuster

Review Posted Online: Oct. 1, 2013

Kirkus Reviews Issue: Oct. 15, 2013

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THE END OF ILLNESS

Oncologist Agus (Medicine and Engineering/Univ. of Southern California) predicts that the application of advanced technology for modeling complex systems will transform 21st-century medicine.

The author writes that a remark Nobel Laureate Murray Gell-Mann made to him in 2009—“Look at cancer as a system"—transformed the way he views his own specialty and the entire field of preventative medicine. It made him realize that “[r]ather than honoring the body as the exceedingly complex system that it is, we keep looking for the individual gene that has gone awry, or for the one ‘secret’ that can improve our health.” Agus writes that although the ability to sequence the entire human genome is a great step forward, it is insufficient for achieving a significant breakthrough. Even though it may start with a mutation, cancer “is a dynamic process that's happening…far from the confines of a static piece of DNA”—it involves the body's immune system, its ability to regulate cell growth, metabolism and more. Agus directs his university’s Center for Applied Molecular Medicine and is the co-founder of two personalized medicine companies, Applied Proteomics and Navigenics. His hope is that their research will contribute to developing better analytical tools for preventative medicine and for the treatment of cancers. These will address the functioning of the body as a whole, applying digital technology already used by physicists to provide virtual models of cancers and model the action of proteins that regulate cell communication in the body. He also hopes to develop tools that will provide information on the concentration of different proteins in a drop of blood taken from a patient, which may reveal the onset of disease. The author also includes some guiding principles and warnings about certain healthy practices that may not be so healthy. A refreshing change of pace in the medical field, but by venturing beyond his field of expertise to pontificate on a wide range of subjects, Agus makes his otherwise intriguing narrative difficult to follow.  

 

Pub Date: Jan. 1, 2012

ISBN: 978-1-4516-1017-8

Page Count: 288

Publisher: Free Press

Review Posted Online: Nov. 6, 2011

Kirkus Reviews Issue: Nov. 15, 2011

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