Dr. Jeffrey Brosco Appointed to HHS Advisory Committee on Disorders in Newborns and Children

Jeffrey P. Brosco, M.D., Ph.D., a nationally recognized pediatrician and scholar at the Miller School of Medicine, has been appointed to the U.S. Department of Health and Human Services Secretary’s Advisory Committee on Heritable Disorders in Newborns and Children.

Brosco, who is professor of clinical pediatrics and Associate Director of the Mailman Center for Child Development, will serve a four-year term on the committee, which advises the HHS secretary on policies related to the Recommended Uniform Screening Panel of tests given to newborns to detect serious genetic and metabolic conditions.

“Evidence-based newborn screening is one of the things American medicine has gotten right,” said Brosco, a board-certified developmental and behavioral pediatrician with a doctorate in the history of medicine. “Screening every baby regardless of race, ethnicity, family income or location allows serious problems to be identified at the start of life, when immediate treatment can make a dramatic improvement in a child’s health.”

The advisory committee meets four times a year to review potential new screening tools and make recommendations to the HHS secretary. Its 15 members include the directors of the National Institutes of Health, Centers for Disease Control and Prevention, Food and Drug Administration, and the federal Health Resources and Services Administration.

“This is a tremendous honor that reflects Dr. Brosco’s decades-long efforts in the areas of bioethics and child health policy,” said F. Daniel Armstrong, Ph.D., professor and Executive Vice Chair of the Department of Pediatrics, and Director of the Mailman Center for Child Development.

Judy Schaechter, M.D., M.B.A., associate professor and Chair of the Department of Pediatrics, Chief of Service at Holtz Children’s Hospital at Jackson Memorial Hospital, and the George E. Batchelor Endowed Chair in Pediatrics, said Brosco’s appointment “continues the strong influence of Miller School faculty on federal policy related to newborn screening.” She noted that R. Rodney Howell, M.D., Chair emeritus of the Department of Pediatrics, was the founding chair of the HHS secretary’s advisory committee and played a key role in developing the uniform panel of newborn screening.

Brosco said newborn screening started on a state-by-state basis in the 1960s, beginning with phenylketonuria (PKU), a readily treated genetic condition. The nationwide Recommended Uniform Screening Panel now includes more than 30 different conditions, including critical congenital heart disease and severe combined immunodeficiency (SCID), a rare but fatal genetic condition that leaves children without a functioning immune system. “A bone marrow transplant can cure this disease, but treatment needs to begin before the infant’s body weakens from constant infections,” Brosco said.

Data from the first two years of screening for SCID in California revealed rates among black, Hispanic and Asian-American children that were much higher than would be predicted by birth rates, according to Brosco, who noted that prior to screening, SCID was believed to be a condition that primarily affected white, non-Hispanic infants, because those newborns typically had better access to care.

“The initial reason for a national newborn screening panel was to reduce disparities based on geography,” said Brosco, who was the lead author of an editorial, “Universal State Newborn Screening Programs Can Reduce Health Disparities,” published in 2015 in JAMA [Journal of the American Medical Association] Pediatrics. “Why should infants in one state receive the benefits while those in neighboring states do not?” he wrote.

“Because state newborn screening provides universal access to certain types of medical care,” Brosco and his co-authors concluded, “such programs can also reduce health disparities based on race/ethnicity and other minority status in the U.S.”

Brosco is Director of Population Health Ethics at the University of Miami Institute for Bioethics and Health Policy, and recently completed an Arsht Distinguished Ethics Faculty Fellowship (2012-2015) at UM. He serves as Chair of the Pediatric Bioethics Committee at Jackson Memorial Hospital. Among his state and national leadership roles, Brosco is the Title V Consultant for the state of Florida, a member of the NIH NeuroBioBank External Ethics and Scientific Advisory Panel, and he co-chairs the Newborn Screening Translational Research Network at the American College of Medical Genetics.

His publications include “Child Rights and Clinical Bioethics: Historical Reflections on Modern Medicine and Ethics” (2016) and The PKU Paradox: A Short History of a Genetic Disease (Johns Hopkins Press, 2013), a book supported by an Arsht Ethics Initiatives Distinguished Faculty Award at the University of Miami.

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