A couple of weeks later, Kennedy made his first in-person visit to FDA headquarters. In a speech broadcast from a private room to a large hall where the agency’s staff had gathered, he doubled down on the sentiments expressed in his October post. The Deep State was real, he said. And the F.D.A. was a mere industry “sock puppet.”
At first blush, Kennedy’s remarks appeared to dovetail with the critiques leveled by experts like Ramachandran. So many of the F.D.A.’s missteps seemed — to both agency watchdogs and the MAHA faithful — to come down to the undue influence of industry over the institution.
But where Kennedy and his ilk saw conspiracy or corruption, Ramachandran and other watchdogs saw something far more complicated. For one thing, it was not just the agency that had been captured by industry. Congress, doctors, patient-advocacy groups and a regulation-wary public had all played a role in weakening the F.D.A.
For another, those who had served on both sides of the watchdog-regulator divide knew firsthand how mission-driven most of the agency’s rank and file were and how irrelevant political considerations were to their actual work.
Everyone, regardless of whom they represented (industry, patients, doctors, consumers), hated the F.D.A. And different organizations often had the exact opposite idea of what regulators were doing wrong and why. If one group said that the agency was too slow or that people were dying for want of cures while bureaucrats dotted I’s and crossed T’s, the next would accuse them of rushing products to market without sufficient regard for safety or effectiveness.
