By Rekhu Basu
Des Moines Register
January 4, 2006

Before the firestorm that led her to quit the Bush administration in protest, Susan Wood was a self-described career civil servant, working to advance women's health.

As a professional staffer for the bipartisan Congressional Caucus for Women's Issues in the early 1990s, she'd lobbied on breast-cancer research and for more women to be included in clinical trials. She'd served as a research scientist at the prestigious Johns Hopkins University and in the federal Department of Health and Human Services. Most recently, she headed the Food and Drug Administration's Office of Women's Health and also was assistant commissioner there.

She wasn't political, she says. But then, women's health issues were not supposed to be political, either.

Then in August, the FDA failed for a second time to approve over-the-counter sales of the emergency contraceptive Plan B, going against the recommendations of its scientific staff in four or five levels of review.

"I was flabbergasted," said Wood, "because it was clearly overruling science and medicine."

With her resignation, Wood, who's speaking in Des Moines on Thursday, has become the most visible symbol of resistance to governmental interference in health decisions.

Wood says stalling tactics were used as a way of "saying no without saying no." She calls that "a complete abuse of the process."

Plan B uses a high dose of progestin, a hormone in birth-control pills, to prevent pregnancy after intercourse. It's been available by prescription since 1999 and, according to Wood, is safe and free of side effects. It works, she says, by: a) preventing ovulation, b) impeding the movement of sperm to egg and c) possibly making changes in the uterine lining so the fertilized egg won't implant - the same way birth-control pills and IUDs work. The sooner it's taken, the more effective it is, which is the main argument for making it available without a doctor's prescription.

In a telephone interview Monday from Baltimore, Wood said the FDA's actions were not in the interests of women and families.

The first decision, in May 2004, required teenagers to still get Plan B only by prescription. Wood says that was the first time any age group was singled out for differential treatment, and there was no scientific reason. Then in August, the agency withheld approval even for sales to adults, sending the matter back for what she called an unnecessary rule-making process, which could take years more.

While Wood isn't speculating on how high up the decision was made, she says, "I don't believe the FDA was acting independently." In fact, it's consistent with a Bush administration decision in 2002 to freeze $3 million in funding to the World Health Organization reproductive health program because it had researched the morning-after pill.

Wood warns that the credibility of trusted institutions that are supposed to serve the public interest has been compromised, and she's urging Congress to step up its oversight of the FDA. Though Iowa's Sen. Charles Grassley has shown an interest in FDA accountability, Wood says her efforts to speak with him or his staff have been fruitless. "They haven't been interested in meeting with us," she said.

Grassley spokeswoman Beth Levine said his office had a record of only one request to meet with staff, which came just before a staff vacation. Asked if the staff or senator was interested in meeting with Wood, Levine said, "I think so," but added that the senator "meets with Iowans first."

Now Wood is traveling the country, speaking at pharmacy, medical and law schools, and to women's groups, to sound the alarm on government interference with health decisions. She says it's up to people outside the beltway to hold the administration's feet to the fire.

Much is at stake here. If the goal is to reduce abortions, preventing unwanted pregnancies ought to be a priority of both pro-choice and anti-abortion groups. Instead we're going in the other direction, when pharmacists refuse to fill birth-control prescriptions, and the federal government refuses to clear Plan B.

Reproductive health is often the touchstone for controversy, but the implications of allowing extraneous factors like religion and business to influence scientific decisions spill into many areas of life, including nutritional, educational and environmental policies.

Wood showed courage by walking away from a high-level job and going public with her concerns. Iowans should heed her warnings — and her call to action.

Hear Wood speak Thursday

Susan Wood, former head of the Food and Drug Administration's Office of Women's Health, will speak Thursday at Drake University's Bulldog Theater. The speech, which begins at 5 p.m., is free and open to the public. It's sponsored by Family Planning Council of Iowa, Planned Parenthood of Greater Iowa, Drake University's College of Pharmacy, the Iowa Pharmacy Association and the Iowa Commission on the Status of Women.