MSNBC asked me to share my thoughts on the FDA and sunscreen. I think the episode came out very well. Here are the key graphs:
…In the European Union, sunscreens are regulated as cosmetics, which means more flexibility in approving active ingredients. In the US, sunscreens are regulated like drugs, which means getting new ingredients approved is an expensive and time-consuming process. Because they are treated as cosmetics, sunscreens made in Europe can draw on a variety of ingredients that offer better protection and are less greasy, chalky and long-lasting. Does the FDA’s long and demanding approval process mean that US sunscreens are safer than their European counterparts? Not at all. In fact, American sunscreens may be Underneath it is safe.
Sunscreens protect by blocking ultraviolet rays from penetrating the skin. Ultraviolet B (UVB) rays, with their short wavelength, mainly affect the outer layer of the skin and are the main cause of sunburn. In contrast, ultraviolet A (UVA) rays have longer wavelengths, penetrate deeper into the skin and contribute to wrinkling, aging and the development of melanoma, the deadliest form of skin cancer. In many ways, UVA rays are more dangerous than UVB rays because they are subtle. UVB rays hit when the sun is shining, and because they burn they come with an environmental warning. However, UVA rays can pass through clouds and cause skin cancer without causing obvious skin damage.
The problem is that American sunscreens are more effective against UVB rays than the more dangerous UVA rays. That is, they are better at preventing sunburn than skin cancer. In fact, most US sunscreens will fail European standards for UVA protection. Precisely because European sunscreens can absorb more ingredients, they can protect better from UVA rays. So, instead of being safe, US sunscreens may be more dangerous.
Most op-eds on the sunscreen issue stop there but I like to put the delay of sunscreen in a big place:
Risk monitoring should be a routine matter. During the Covid pandemic, Europe approved rapid antigen testing much faster than the US. As a result, the US wandered for months while infected people unknowingly spread the disease. By one conservative estimate, more than 100,000 lives could be saved if rapid tests were available in the US sooner.
I also discuss cough medicine in an op-ed and, of course, suggest a solution:
If a medical drug or device is approved by another developed country, a country that the World Health Organization recognizes as a strong regulatory authority, it must be fast-tracked for approval in the US…Americans traveling to Europe do not hesitate to use European sunscreens, rapid tests or cough medicine, because they know that the European Medicines Agency is a careful regulator, at least on par with the FDA. But if Americans in Europe do not hesitate to use drugs approved by Europe, why are these same drugs banned for Americans in America?
Peer approval applies to other regulatory fields. A German driver’s license, for example, is recognized as valid – that is, there is no need to take another driving test – in most US states and vice versa. And the FDA recognizes their peers. When it comes to food regulation, for example, the FDA sees the Canadian Food Inspection Agency as a peer. Peer approval means that food imports from and to Canada can be expedited through regulatory documents, bringing benefits to both Canadians and Americans.
In short, the FDA’s overzealous approach to sunscreens is a lesson in how overzealous can be. By adopting a peer review system, we can prevent fatal delays and provide Americans with better sunscreens, faster effective tests and better cold medicine. This approach, supported by both sides of the political spectrum, would modernize our laws and ensure that Americans have timely access to the best health products. It’s time to step up and turn caution into action for the sake of public health and a less dangerous time in the sun.
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