Four years later, Congress passed the 1906 Pure Food and Drugs Act, which established FDA's predecessor, the Drug Laboratory in the Bureau of Chemistry of the Department of Agriculture. This law authorized testing drug product strength and purity, but did not establish premarket approval requirements and gave the government little authority to remove even ineffective drugs from the market. FDA was established around 1930, at the same time that the Hygienic Laboratory became the National Institutes of Health (NIH); biologics control remained part of NIH until it was transferred to FDA in 1972 (see Coordination Challenges).
Vaccine development rapidly moved forward during this period. In the 1940s, government researchers developed methods to determine vaccine potency, which led to improvements in vaccines for pertussis (whooping cough) and influenza. A major success was realized with the development and testing of the Salk polio vaccine in the mid-1950s. And in 1966, agency researchers developed the first effective experimental vaccine for rubella (German measles). The safety of blood and blood plasma products also improved during World War II and beyond with the development of tests to detect hepatitis.
A major regulatory change occurred in 1962 when the dangers of Thalidomide use prompted Congress to adopt the Kefauver-Harris Amendments. The new law required manufacturers to prove that drugs are safe and effective before marketing; it also formalized good manufacturing practices, required adverse event reporting, and called for sponsors of clinical trials to obtain informed consent from study participants.
AIDS SPARKS REVOLUTION
The 1980s was a time of important social and biomedical change in the US, with major consequences for FDA and biotech companies. The first reports of HIV/AIDS cases appeared in 1981, prompting coordinated efforts to develop and approve immunoassay tests and test kits to screen donated blood for the AIDS virus. AZT, the first drug to treat AIDS, was approved by FDA in 1987, along with additional treatments for certain opportunistic infections. Demands from AIDS advocates for quicker access to promising therapies also spurred a more risk-averse attitude at FDA, leading to rules expanding access to experimental drugs for seriously ill patients, and permitting FDA approval of AIDS and cancer treatments based on early clinical results.
At the same time, policy makers encouraged development of innovative treatments for rare diseases by enacting the Orphan Drug Act of 1983. The legislation provided extended market exclusivity for therapies that treat diseases affecting less than 200,000 people in the US, which has led to approval of nearly 300 drugs and biological products. These policies spurred development of new therapeutic proteins and monoclonal antibodies able to target cancer cells more effectively, clear clots from coronary arteries, and prevent anemia in ill patients.