Next FDA commissioner must tackle health disparities and barriers to care



As a practicing obstetrician-gynecologist and activist for improving access to reproductive and sexual health and resources, I have seen firsthand how our health care system too often fails to those who have the greatest barriers to accessing health care and services.

The Biden administration has a unique opportunity to appoint a Food and Drug Administration (FDA) commissioner who will boldly tackle biases and systemic barriers in healthcare, champion evidence-based science, and advance the equity in health. The next FDA commissioner will play a pivotal role in determining the direction of health care in our country. The administration must take into account the needs of individuals and communities and their capacity to access health care. The pandemic has demonstrated how important it is to have leaders in place who are driven by science and committed to fairness; however, these principles are also relevant to ameliorating long-standing and recalcitrant health disparities.

For example, despite the gains brought about by the Affordable Care Act and advances in contraceptive technology, access to contraception remains a significant challenge for far too many Americans. FDA Commissioner will have the opportunity to drive a major breakthrough in women’s health and access to contraceptives by ensuring that proven contraceptive methods meet the same requirements as other over-the-counter drugs become available for purchase free. He was 60 years ever since the FDA approved birth control for all, but people continue to face medically unnecessary prescribing hurdles. The ability to access the contraceptive pill without a prescription would provide a safe and inexpensive contraceptive option.

It is also essential that the FDA commissioner commit to an evidence-based and timely review of the proposed shift from prescription to over-the-counter (OTC). For years, medical associations and physicians across the country have urged the FDA to consider the possibility of over-the-counter access to the pill. In fact, the American College of Obstetricians and Gynecologists has officially approved such access for all ages.

Additionally, any candidate for FDA commissioner must have a clear understanding of the inequalities in our health care system and their effects on the reproductive health of people of color, people struggling to make ends meet, and those in areas. rural. In fact, people of limited means who have medical coverage through Medicaid are more likely to know of any gaps in their ability to access contraception. Black women and girls, regardless of their income, are also very likely to experience gaps in access to contraception. It is essential that the Commissioner understands the role of the FDA in resolving these disparities.

Additionally, women of childbearing age have historically been excluded or under-represented in clinical trials for studies of medical conditions such as diabetes and heart disease – and that exclusion has been even worse for women of color. The lack of inclusion is reflected in incomplete data sets, which prevent some people from making informed decisions about their health care. So any potential candidate should have a plan for how the FDA can improve and modernize clinical trials and ensure the equitable inclusion of people of color and people who are capable of reproduction.

A potential candidate needs to trust people to make their own decisions about their reproductive health – 70 percent of women of childbearing age support the possibility of having the pill available on store shelves. It is high time the FDA took the lead in removing unnecessary barriers. We look forward to working with a Commissioner who is preparing to meet the challenges of all, especially those who have been underserved by our health care system for too long.

Raegan McDonald-Mosley, MD, MPH, FACOG, is CEO of Power to decide, Chief Medical Officer of the Contraception Access Initiative, and a practicing obstetrician-gynecologist. Follow her on Twitter @DrRaegan.



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