Since R.F.K. Jr. was confirmed as President Trump’s health secretary in February, the Food and Drug Administration has been buffeted by staff cuts that have crippled divisions and gutted the agency. Thousands of scientists and other experts have left or been let go, putting the storied agency’s mission at risk.
The F.D.A. was created to protect consumers from contaminated food and unsafe or ineffective medical products. But in recent years, American confidence in the agency has plummeted, as mis- and disinformation further undermine the agency’s authority.
The agency’s many watchdogs have been pushing for years to reverse the policies that have contributed to the decline in public trust. But experts say there is a fundamental difference between what agency reformers have long been calling for and what Kennedy is trying to do. As Kennedy warned on social media, even before his appointment: “If you work for the FDA and are part of this corrupt system, I have two messages for you. 1. Preserve your records, and 2. Pack your bags.”
Here are the key takeaways from the full Times Magazine story about the F.D.A.:
The F.D.A. has long been underfunded and outgunned.
The F.D.A.’s regulators have an enormous remit: drugs, medical devices, food, cosmetics and nicotine products. But the agency receives less money from Congress than the Centers for Disease Control and Prevention and the National Institutes of Health.
It is also constrained by laws that protect the rights of corporations, often at the expense of agency authority. This dynamic forces the F.D.A. to weigh every potential regulation against the almost certain legal challenges it will face and the steep cost of defending its measures in court.
Under Kennedy, the agency has lost 20 percent of its work force.
Beginning in late February, the health secretary and representatives of the so-called Department of Government Efficiency initiated mass firings across H.H.S. that by their own projections would ultimately include 10,000 people, 3,500 of them from the F.D.A. Among the hardest hit was the food division, the staff members most needed for the health secretary’s stated priorities: combating chronic disease by changing the American diet, curbing dyes and other chemical additives in what we eat and highlighting the ingredients of ultraprocessed food.
In the end, the agency’s offices for medical devices, tobacco products and generic drugs were all but eviscerated. Faced with chaos and uncertainty, many of the civil servants who remained were looking for new jobs outside of government.
Critics have warned about the F.D.A.’s fast-tracked drug approvals. They are about to get even faster.
In the early 1990s, to give patients access to new and sometimes lifesaving medications, the F.D.A. began requiring fewer clinical trials for some drugs. By the 2000s, a majority of new drugs were being routed through expedited approval processes.
Kennedy and his Make America Healthy Again movement railed against this practice. “They criticized expedited drug reviews for years, especially with respect to Covid vaccines, saying that it turned the F.D.A. into a rubber stamp,” says Reshma Ramachandran, a Yale physician and agency watchdog. “But now they want to do the exact same thing for as many other drugs as possible.”
Kennedy’s moves to remake the F.D.A. have blown past agency guardrails.
In his first visit to the agency as health secretary, Kennedy referred to the F.D.A. as a mere “sock puppet” for industry. But so far, his calls for “radical transparency” have been undercut by opaque practices, including unilateral cancellation of vaccine contracts, firing of vaccine advisers and the implementation of new policies without the customary public input. Promises to curb industry influence have been followed by closed-door meetings with pharmaceutical companies and policies that prioritize industry goals over the concerns of doctors and patients.
Kennedy, a known vaccine skeptic, wants the agency to embrace supplements and fringe treatments.
In his confirmation hearing, Kennedy said he wanted “gold standard” science to guide the nation’s health policies. But even as he demands more evidence to justify the use of long-proven vaccines, he is clearing the way for a roster of alternative therapies that doctors and scientists say are unproven and even dangerous. “If you want to take an experimental drug — you can do that, you ought to be able to do that,” Kennedy said on a podcast.
Jeneen Interlandi writes about health and science for Opinion and is a staff writer at The New York Times Magazine. She writes primarily about public health.
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