The FDA vs. the NCI – Roots of Rivalry between Two Health Giants

The FDA vs. the NCI – Roots of Rivalry between Two Health GiantsItai Bavli and Shifra ShvartsWhat is at the root of the ongoing tension between the FDA and the NCI? Does competition between two national health agencies operating in a close and sometimes overlapping policy area have positive or negative implications for the public? This study addresses the rivalry between the FDA and the NCI that arose in the early 1970s and its impact on public health until the present. The research presents in detail the first two instances of conflict between the FDA and the NCI that led to ongoing rivalry between the two organizations.The first case of tension was sparked in 1970 by the NCI's desire to oversee new clinical trials of a new class of chemotherapeutic treatments. In response, FDA officials, concerned with maintaining their authority over all clinical trials, aggressively attempted to rewrite regulations governing clinical trials for combination chemotherapy. The second case arose in 1973 when a study at the University of Chicago confirmed suspicions linking thyroid cancer in adulthood to irradiation treatment for a variety of infectious and inflammatory diseases in childhood such as enlargement of the thymus gland, hypertrophy of tonsils and adenoids, ringworm and acne. The NCI responded with a media campaign warning the public of the long-term risks of therapeutic irradiation. Both cases were linked to cancer-related issues which resulted in conflict between the two agencies. Based on official protocols, formal announcements, court rulings, newspaper archives, and other documentary evidence, this study describes how competition developed between the FDA and the NCI – rivalry rooted in their closely-related and sometimes overlapping policy areas. The findings raise three questions addressed in the study: 1. What effects do health agencies operating in a closely related policy area have on each other? 2. What obligation do medical institutions have to warn their patients of the possible consequences of medical treatment even after a long period of time has elapsed? 3. What was the sequence of events that led public health organizations such as the NCI to expose the risks of radiation treatment to the public, and why did the FDA avoid taking such an action