In the fall of 1937, patients began to die soon after consuming a new therapy called the Elixir Sulfanilamide. In response, the fledgling agency known as the U.S. Food and Drug Administration (FDA) jumped into action. The agency recovered the remaining 700 bottles and saved the lives of an estimated 4,000 Americans. The FDA also advocated for the landmark Food, Drug, and Cosmetic Act, which, among other major steps, authorized the FDA to establish the world’s first advance review for safety of medications. The story of the Elixir Sulfanilamide exemplifies how much in public health has been shaped by crisis. Strong preparation, a well-managed response, and astute legislative strategy made all the difference in turning crisis to opportunity. If, as Louis Pasteur has famously said, chance favors the prepared mind, then the story of the Elixir Sulfanilamide shows that crisis favors the prepared agency.
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