The year in health news for 2004 could be captured in just one word: drugs.

From the recall of the popular prescription painkiller Vioxx (search) to the shortage of flu vaccine, from the controversy of prescribing anti-depressants (search) to children to the nearly daily revelations, at year's end, of the health risks posed by other widely used prescription and over-the-counter pain medications, the ramifications of Americans’ appetite for pharmaceuticals was the dominant health story of 2004.

From a global perspective, however, the word for 2004 would be epidemic. As Africa continued to be ravaged by the virus, Asia became the new AIDS front in 2004. Health officials in Asia were already monitoring a bird flu outbreak that had jumped species to infect humans. In December, the World Health Organization issued a warning that a global influenza epidemic was inevitable.

Epidemic was also the word used to describe American’s ongoing struggle with obesity.

As the year came to a close, a tsunami devastated a vast region of south Asia, setting the stage for what the WHO said could be an epidemic of cholera and malaria that could claim as many lives as the more than 100,000 killed by the giant wave. That outbreak could be one of the major public health stories of 2005.

With 2004 an election year, it was little surprise that many of the year’s biggest health stories, such as stem cell research and the cost of prescription drugs for senior citizens, were also not political ones.

Here are the top stories in health news for 2004:

Painkiller Panic

On Sept. 30, pharmaceutical giant Merck pulled its popular arthritis drug Vioxx, a painkiller used by two million people, from the market after a three-year trial of the drug revealed that it increased the risk of heart attack and stroke. A month later, Swiss scientists reported that evidence of Vioxx’s health risks existed as early as 2000, and that Merck should have pulled the drug four years ago.

Vioxx belonged to a class of drugs known as Cox-2 inhibitors, and its competitors in that class would soon follow suit. On Nov. 11, a leading heart researcher released a study claiming that Bextra increased the risk of heart attacks and strokes, a claim the manufacturer, Pfizer, denied. News that Pfizer’s other Cox-2 inhibitor, Celebrex, more than doubled the risk of heart attack, was reported Dec. 17. Neither Bextra nor Celebrex were pulled from the market, but the FDA issued a warning advising caution in taking either drug.

Also in December, a National Institutes of Health study linked heart problems with naproxen, an anti-inflammatory over-the-counter painkiller sold as Aleve and Naprosyn.

Kids, Suicide and Antidepressants

The painkiller panic wasn’t the only drug controversy of 2004. In October, the FDA ordered “black box” labeling—the strongest the FDA can issue-- on antidepressant drugs, warning of increased suicide risk in children who use them.

FDA Under Fire

The Vioxx scandal coming on the heels of the antidepressant warning shifted a critical focus on the FDA’s drug approval and safety monitoring process. Critics accused the agency of having a “culture of silence,” a “culture of denial,” of ignoring staff concerns about the safety of both Vioxx and antidepressants, and for having a too cozy relationship with drug companies.

During Senate hearings on Vioxx in November, FDA scientist David J. Graham (search) testified that he had serious safety concerns about five drugs currently on the market: Bextra, the cholesterol drug Crestor, the weight loss drug Meridia, the acne medication Accutane and the asthma drug Serevent.

The FDA has pledged to review the agency’s drug monitoring policies and said it would install new procedures for scientists to formally challenge regulatory decisions and express safety concerns. This Monday, the FDA ordered a review of all prevention studies involving prescription pain drugs like Bextra and Celebrex and urged the public to limit the use of over-the-counter pain medications.

Flu Fears

The discovery in the fall of 2004 that half of the nation’s supply of flu vaccine had been contaminated in the lab of its British manufacturer exposed serious flaws in the nation’s public health program—specifically, the United States’ dependence on a limited number of foreign suppliers for the vaccination. The government imposed a strict rationing of the vaccine while scrambling to obtain more doses from Canada and Europe.

Some communities enacted flu shot lotteries.

Federal officials announced a multi-agency task force to prevent future shortages, and the flu shot shortage briefly became an issue in the final weeks of the presidential campaign. By year’s end, with an influx of doses from British and German suppliers, the government was able to lift restrictions on who could get the shot.

Meanwhile, the World Health Organization, already monitoring a bird flu epidemic (search) in Asia, warned of an inevitable global influenza epidemic.

Stem Cell Stand-Off

Defying federal policy restricting funding of embryonic stem cell study (search), California voters overwhelmingly passed a ballot initiative providing $3 billion in state funding for the controversial research. Breaking from the Bush administration, California’s Republican Gov. Arnold Schwarzenegger supported the proposition.

While both opponents and supporters of stem cell research concede that cures may be years away, 2004 did see some promising developments. Scientists at the University of Pennsylvania grew sperm-producing stem cells, suggesting future male infertility treatments. Research at Johns Hopkins University found that stem cells can repair heart tissue damaged by heart attack; other studies found that stem cells could hold the secret to future cures of incontinence and multiple sclerosis.

Perhaps the biggest stem cell news of 2004 was the December report that, at the University of California, Irvine, paralyzed rats walked again after being injected with healthy brain cells grown from human embryonic stem cells.

Bigger Isn’t Better

The Centers for Disease Control announced in October that Americans have grown “dramatically” heavier over the past 40 years, a trend that extends to the nation's children. America's epidemic obesity gripped the media as the food industry, the government, Americans' sedentary life style and cuts in physical education were blamed.

Senior Drug Costs

Washington made some progress in 2004 in curbing the prescription drug costs for senior citizens. Medicare launched its prescription drug card program (search), offering discounts ranging from 15-30 percent and even larger savings to low income seniors. Yet, in 2004, most seniors paid substantially more for prescription drugs than they did in 2003.

Almost all of the most widely used drugs by seniors saw price hikes in 2004, while some of the nation's largest companies raised the premiums and co-payments for retirees with company-sponsored drug benefits. Only one in seven of seniors eligible for Medicare's prescription discount cards had signed up for them by the end of 2004.

Tsunami Disease

The most tragic news story of 2004--the tsunami (search) that devastated South Asia on Dec. 26--may have also set the stage for what could be a major public health crisis for 2005. Health officials fear that diseases such as cholera, dysentery and malaria could kill as many as the more than 100,000 claimed by the deadly wave.