By GARDINER HARRIS
Published: May 6, 2009
WASHINGTON — Appointed in 1991 to serve as acting health commissioner of New York City, Dr. Margaret A. Hamburg inherited urgent problems, a spare budget and a divided and demoralized staff.
The Food and Drug Administration could have a familiar feel for her.
The turnaround that she engineered is exactly what the Obama administration is hoping she will achieve at the drug agency, which is reeling from a host of similar problems.
On Thursday, the Senate Health, Education, Labor and Pensions Committee will consider whether to confirm Dr. Hamburg as F.D.A. commissioner. The hearing was moved up a week in the wake of the swine flu outbreak, which has given her nomination urgency. She is expected to be confirmed.
Although she lacks deep experience in drug- or food-safety issues, Dr. Hamburg was an infectious disease researcher and is an expert in bioterrorism and public preparedness, both of which seem keenly relevant. Her leadership in New York has won her admirers among public health advocates, many of whom said she would be a good leader to an agency a previous commissioner had likened to a cancer patient.
The Food and Drug Agency regulates more than $1 trillion worth of consumer goods, including a third of all imported goods. It is widely thought to need major reforms, particularly to its oversight of food safety. An unusual group of internal whistle-blowers has claimed that the agency’s oversight of medical devices is deeply flawed.
Dr. Hamburg was born to tackle such problems, said her mother, Dr. Beatrix Hamburg. Her father is a former president of the Institute of Medicine. Shortly after Margaret Hamburg’s second birthday, her mother learned that her daughter had a fiercely independent streak and “was just not going to be pushed around,” Dr. Beatrix Hamburg said.
So her mother, a psychiatrist, gave her daughter difficult tasks with significant obstacles. “She took to it like a duck to water,” Dr. Beatrix Hamburg said. Dr. Margaret Hamburg has been tackling difficult tasks ever since.
The toughest was a growing epidemic of drug-resistant tuberculosis in New York City during a fiscal crisis. H.I.V. infections, drug abuse and homelessness had caused tuberculosis to come roaring back from dormancy. Solving the problem seemed beyond the powers of the health department, divided and demoralized in the wake of the abrupt departure of her predecessor.
A key problem was that many of those infected failed to take their medicines until cured, leading to the creation of drug-resistant disease strains. Dr. Hamburg pushed for the power to civilly detain until cured tuberculosis patients, many with mental illnesses or drug addictions.
The request for such broad powers could have led to opposition from advocacy and other organizations, but Dr. Hamburg was quietly persuasive, said Mark Barnes, an associate health commissioner at the time.
She turned her attention to Rikers Island, where scores of the island’s huge jail population were infected with TB.
“A number of us became aware that we were sitting on a ticking time bomb at Rikers,” said Dr. Steven M. Safyer, who was then the medical director of the Montefiore Rikers Island Medical Center.
Despite the city’s financial problems, Dr. Hamburg got the city to construct in 90 days a top-notch tuberculosis hospital on the island and to screen all inmates for the disease — as many as 125,000 people in a year. Dr. Safyer said Dr. Hamburg had managed, with calm and persuasive arguments, to get citywide backing for her TB efforts.
“It’s not rocket science, but three health commissioners before her had not done it,” Mr. Barnes said. The tuberculosis epidemic subsided.
Dr. Hamburg also persuaded Mayor David N. Dinkins to support a successful needle-exchange program to slow the spread of H.I.V. infections among drug addicts. When she first proposed the program, “I said, ‘You’ve got to be kidding,’ ” Mr. Dinkins remembered. “You’ve got to appreciate how extreme of an idea that was. But I listened to her. She’s got that ability.”
As a teenager, Dr. Hamburg spent a semester in Africa working with the renowned primatologist Jane Goodall. She has two children. She attended Harvard with her husband, Peter Brown, a mathematician and financial analyst.
Family, friends and coworkers all describe Dr. Hamburg as bright, funny and unusually calm. Dr. David Hamburg told of a speech his daughter was scheduled to give in New York City two years ago. Just before the talk, Dr. Hamburg’s husband called to tell her that their house had caught fire, although there were no injuries. She delivered the speech anyway.
“You would have never known that anything was wrong in her life,” Dr. David Hamburg said in an interview. “That’s vintage Peggy. She can carry on in a cool, organized way under heavy pressure.”
A version of this article appeared in print on May 7, 2009, on page A22 of the New York edition.
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