Whether you liked [Marty] Makary or not …, the purge or whatever this was is not somehow going to miraculously lead to new better leadership. The future permanent (dare I even use the word “permanent” at this FDA?) commissioner, whoever they are, is already in a box and they haven’t even been appointed, let alone confirmed. For however long the new commissioner lasts, they will be steering (sort of) an agency through dark times.
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As more big leadership changes quickly ensued, it crystalized for me that the FDA is almost certainly going to let many patients down in a big way moving forward. A chaotic and politically driven FDA whose decisions are often untethered from good data can’t coherently provide real hope. And patients don’t need more false hope.
Another scenario is that we see a seemingly much less chaotic FDA moving forward, but just with token leadership, and the White House or health secretary Robert F. Kennedy Jr. pulling the strings. A docile, puppet FDA is no solution either.
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Overall, it’s not easy to see a positive path forward for the agency at this moment.
