Setting Standards and Gaining Perspective — A Conversation on Government in Action with Dr. Margaret Hamburg
By Sohini Mukherjee
While no position of power in government is easy, making decisions that serve everyone’s interests is perhaps most difficult when those decisions effect every aspect of a consumer’s life. Dr. Margaret Hamburg, the 21st Commissioner of the US Food and Drug Administration, does not disagree — working at the FDA, at the intersection of public health, science, medicine, and politics, requires deep commitment and dedicated leadership. An internationally recognized leader in public health in medicine and a graduate of both Harvard College and Harvard Medical School, Dr. Margaret Hamburg is best known for advancing regulatory science and modernizing regulatory pathways. Dr. Hamburg has served as the Assistant Secretary for Planning and Evaluation, Health Commissioner for New York City, and Assistant Director of the National Institute of Allergy and Infectious Disease, before leading the FDA from 2009 to 2015.
As Foreign Secretary for the National Academy of Medicine, she is the senior adviser on international matters and liaisons with other academies of medicine around the world. In addition to her numerous awards and honorary degrees, she has also been named one of 100 Most Powerful Women in the World by Forbes magazine, though her real joy comes from being one of the 20 Most Powerful Moms. Joining the Voices in Leadership Series, Dr. Margaret Hamburg spoke to Dr. Michelle Williams, Dean of Faculty at the Harvard T.H. Chan School of Public Health, about her important, and yet often underappreciated, role in consumers’ lives, and the lessons she learned along the way to becoming one of the most powerful and influential women in medicine.
Commitment to the Mission
While the FDA is a great example of government in action to serve the people, Dr. Hamburg shared how difficult her job was in leading such an important and unique administration. She described the pressure of working in this underappreciated agency as “operating in a fishbowl,” given that the decisions made make a “huge and enduring difference in the lives of individuals and families” and for stakeholders in companies.
It was Dr. Hamburg’s commitment to the public health mission of the FDA, to promote and protect the health of the American people, that enabled her to do her job. Coming on board during a politically charged moment when the FDA was under intense scrutiny, she quickly realized that the only way forward was to open up the agency to questions and inquiries. She emphasized the importance of transparency, saying,
“If people can’t see what you’re doing, don’t understand what you’re all about, then they are more likely to revert to suspicion. But if they understand, even if they don’t like the decisions you make, I think that it does build trust and confidence.”
Making Evidence-based, Bold Decisions
For Dr. Hamburg, it was crucially important that the work of the FDA was driven by the best possible science, and worked tirelessly to engage academics and industry scientists to extend a stronger scientific foundation for the FDA’s work. Making data-based decisions, even controversial ones, to inform policy, was a lesson she had learned as commissioner at the Health Department of New York. By presenting quantitative evidence on the efficacy of needle exchange programs to Mayor Dinkins, who at first opposed these programs, Dr. Hamburg became instrumental in instituting programs that helped addicts access necessary resources and protect themselves from infection.
Trust and Collaboration in a Globalized World
One of the greatest contributions made by Dr. Hamburg to the FDA was the shift in perspective that re-positioned the administration in a globalized economy for the 21st century. She warned against letting a “strong, nationalistic focus” cloud the decisions that needed to be made in a world where health is not only affected by national policy but international governance. She continued,
“If we were going to fulfill our mission of promoting, protecting the health of the American public, we could only do it by finding new ways of working globally.”
Dr. Hamburg described that the only way to make a difference was to reach outside of America’s borders and collaborate with counterpart regulatory authorities and industry, particularly in developing economies where a surprisingly large percentage of consumer products come from.
Setting A Standard and Gaining Perspective
As a woman with great commitments to both the nation and her family, Dr. Hamburg emphasized the necessity of delegating tasks, not only to balance a complex workload, but to allow new leaders to grow and recognize their accomplishments and capabilities. She was emphatic that it was a leader’s role to show that a complex workload did not mean that other priorities should be neglected, and that tasks and crises must be put in perspective, saying,
“I saw a lot of people burn out constantly going crazy over crises that weren’t truly crises…I think the leader can set a standard also that there’s no shame in caring for your family.”
As a decision-maker, a leader, a mentor, and a mother, Dr. Hamburg ended by underlining that a good character was necessary for success, saying,
“You can’t get away from the importance of being trustworthy and having integrity about who you are, about the work you do, about how you make decisions and how you lead.”
Story by Sohini Mukherjee, a first year student in the Master of Science program in Global Health and Population at the Harvard T.H. Chan School of Public Health, interested in gender equity, maternal health, and health policy and governance.