View From The Inside: Marty Makary's FDA Hearing
My take on the FDA hearing after watching it from the inside in DC last week.
The Food and Drug Administration (FDA) has long been compromised by its close ties to the pharmaceutical industry, operating more like a tacit business partner than an independent regulator at times. The revolving door between the FDA and Big Pharma incentivizes agency officials to approve drugs and medical devices with the expectation of landing cushy, lucrative industry jobs afterward — creating a clear conflict of interest. The FDA’s track record of fast-tracking high-profit drugs while dragging its feet on cheaper, off-patent treatments exposes its bias toward protecting industry profits over public health. During the pandemic, the agency’s numerous failures — from downplaying myocarditis risks to flip-flopping on booster guidance — only reinforced the public perception that the FDA prioritizes political expediency and corporate interests over scientific integrity.
Against this backdrop, Dr. Marty Makary entered his Senate confirmation hearing before the Health, Education, Labor, and Pensions Committee last week — and delivered a performance that affirmed why he is the ideal candidate to lead the FDA. Federal health agencies have never faced more public scrutiny than they do today, thanks to their overtly political posture during the pandemic. Makary’s performance echoed the strong, principled testimony of Jay Bhattacharya the day before, demonstrating a level of integrity and clarity that has been sorely lacking in the agency’s leadership.
Makary made clear that his leadership at the FDA would mark a significant departure from the status quo. In response to Senator Tommy Tuberville’s questions about the FDA’s food regulations, Makary spoke directly to the growing concerns about toxic chemicals in the food supply, which have been highlighted by the MAHA movement. Makary’s willingness to address these concerns head-on reflects his broader commitment to challenging industry influence and prioritizing public health over corporate interests.
“When we eat foods with a lot of molecules that do not appear in nature, these are chemicals that the industry insists are safe, a subset of which are concerning,” Makary stated. “There’s a body of research now that suggests concern with some of these ingredients. We have to look at those ingredients, and you have my commitment to do so.”
Makary also addressed the growing evidence that certain food additives are contributing to chronic health issues in children. “Some of these additives create an inflammatory response in the gastrointestinal tract and with an altered microbiome lining - that GI tract,” Makary explained. “It's not an acute inflammatory reaction, it's a chronic low-grade reaction, and they don't feel well.”
This level of scientific honesty and willingness to challenge powerful corporate interests sets Makary apart from previous FDA commissioners, who have largely turned a blind eye to these concerns. His remarks signal a shift toward greater scrutiny of the food and pharmaceutical industries — something the FDA has avoided for far too long.
Just last month, the FDA was back in the spotlight when Dr. Patrizia Cavazzoni, the former head of the agency’s Center for Drug Evaluation and Research (CDER), joined Pfizer as its Chief Medical Officer — mere weeks after stepping down from her regulatory post. Cavazzoni’s swift transition reignited concerns over the revolving door between regulatory agencies and the pharmaceutical industry, especially given her involvement in reviewing multiple Pfizer products.
Makary addressed these conflicts directly when responding to Senator Rand Paul’s questions about the agency’s relationship with the pharmaceutical industry.
“People see things that appear to be a cozy relationship between industry and the regulators that are supposed to be regulating the products,” Makary said. “Now, I want American companies to thrive. I want life sciences companies to thrive, but we need to call balls and strikes and keep that independent scientific review process free of any conflicts.”
This statement underscores Makary’s willingness to confront the structural problems at the FDA — something that previous commissioners have been unwilling to do. His commitment to protecting scientific integrity from corporate influence marks a clear break from the agency’s deeply entrenched culture of regulatory capture.
Ironically, Dr. Makary was pressed on his own conflicts of interest by Senator Elizabeth Warren, who had sent a letter urging him to recuse himself from matters involving former clients and employers, such as Sesame Care and Harrow, for at least four years. Makary acknowledged the concerns and assured the committee that he would adhere to strict ethical standards to maintain public trust. Prior to the hearing, Makary had already pledged to sell his stocks in a telehealth company and a medical device company specializing in cataract surgery. Unlike previous FDA commissioners such as Robert Califf, Makary does not hold stock in any Big Pharma companies — a sign that he is truly independent from industry influence.
Makary also deftly handled questions from Democratic senators about recent firings at the FDA, making clear that he had no involvement in those decisions while expressing his desire to improve efficiency at the agency.
"At the same time, I want to make sure that the scientists and food inspectors and staff central to the core mission of the agency have all the resources they need to do their job well,” he added.
Courage Under Fire: Makary’s Covid Record Sets Him Apart
Makary’s moral courage during the Covid-19 pandemic stands as one of the strongest reasons he is the ideal candidate to lead the FDA. While most public health officials toed the government line, Makary spoke out early and often against misguided lockdowns, school closures, and vaccine mandates — even when it was professionally risky to do so. He was one of the most powerful voices to warn about the risks of vaccine-induced myocarditis in young men, long before the CDC and FDA officially acknowledged the issue.
He also pushed back against the scientific groupthink surrounding natural immunity, arguing that Covid recovery offered meaningful protection that should have been factored into public health recommendations. Makary’s willingness to follow the data rather than political narratives — even when it meant standing alone — reflects the kind of principled leadership that the FDA desperately needs.
Unlike many in the public health establishment, Makary never relied on fear-based messaging. He consistently advocated for balanced, evidence-based policies, resisting the pressure to silence dissenting voices or enforce scientific orthodoxy.
The Right Person at the Right Time
Makary’s combination of scientific expertise, independence from industry, and moral courage makes him the ideal candidate to lead the FDA at this pivotal moment. His willingness to take on Big Pharma and clean up the FDA’s cozy relationship with industry is exactly what the agency needs to restore public trust. At the same time, his track record of standing up for medical truth during the pandemic proves that he has the backbone to lead with integrity — even when the political winds are blowing against him.
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This piece is jointly published on RealClearAffairs.
Well done, Rav. I enjoyed reading this well-written report on Marty Makary's Senate hearing.
Not to mention his immense knowledge and research into the corruption and terrible state of the US Healthcare system…pages and pages could be written about this.