An analysis by Morgan Treadwell and Gloria Major
The sudden mass terminations at the Food and Drug Administration represent more than a routine bureaucratic reshuffling. They signify a profound governance shift with implications extending far beyond partisan policy preferences. What we are witnessing is the systematic dismantling of institutional knowledge and scientific expertise in service of an ideological agenda, a pattern consistent with broader governance approaches that prioritize loyalty and conformity over professional qualifications and evidence-based decision-making.
The scale and scope of the FDA decimation
Tuesday’s terminations at the FDA have been described by former FDA Commissioner Dr. Robert Califf as nothing short of institutional destruction. “The FDA as we’ve known it is finished, with most of the leaders with institutional knowledge and a deep understanding of product development and safety no longer employed,” Califf wrote.
The scale is significant, part of broader cuts of up to 10,000 positions across public health agencies announced by Health and Human Services Secretary Robert F. Kennedy Jr., including 3,500 at the FDA alone. But the pattern of removals reveals more than mere budget-cutting. Those targeted include senior officials with decades of scientific and regulatory expertise, including Dr. Peter Stein, longtime head of the Office of New Drugs, the critical division responsible for reviewing new medicine applications.
Stein’s account of his removal is particularly revealing. Rather than standard termination, he was offered what he termed a “nonsensical position,” an approach consistent with efforts to push out expertise while maintaining plausible deniability about targeting scientific professionals. Similarly, the resignation of Dr. Peter Marks, who led FDA vaccine regulation through the COVID-19 pandemic, came after what Marks described as Kennedy’s demands for “subservient confirmation of his misinformation and lies” about vaccine safety.
These removals follow a consistent pattern: scientific experts who maintain independent judgment based on evidence are being systematically replaced or removed, regardless of their critical institutional knowledge or professional qualifications.
Market response: economic recognition of institutional damage
Financial markets, which typically respond positively to deregulatory actions, instead registered immediate concern. The S&P 500 Pharmaceuticals industry index fell 2.3% even as the broader market traded positively, with major companies like Pfizer and Merck down 2.5%. Biotech stocks similarly declined, with the SPDR S&P Biotech ETF dropping 2.5%.
This market response reflects recognition that the FDA’s stability and expertise provide essential foundations for pharmaceutical innovation and investment. The drug development process depends on regulatory predictability, scientific rigor, and institutional continuity, precisely the qualities being undermined by the current purge.
As Cantor Fitzgerald analysts noted in calling for Kennedy’s removal: “RFK Jr. is undermining the trusted leadership of healthcare in this country.” The analysts’ observation that “HHS cannot be led by an anti-vax, conspiracy theorist with inadequate training” represents not partisan criticism but recognition of the fundamental disconnect between Kennedy’s qualifications and the institutional requirements of evidence-based public health governance.
This market reaction aligns with a consistent pattern across sectors: when governance shifts from expertise-based institutional management to ideologically-driven personalized control, economic stability suffers despite superficial pro-business positioning.
Unqualified leadership: RFK Jr.’s Fitness to lead HHS
Kennedy’s appointment as HHS Secretary represented from the outset a prioritization of ideological alignment over relevant qualifications. His background includes no public health administration experience, no medical training, and no scientific credentials relevant to the complex health agencies he now oversees.
What Kennedy does bring is a well-documented history of promoting scientifically discredited medical theories:
- Anti-vaccine activism: Kennedy has been one of America’s most prominent anti-vaccine voices for nearly two decades. His 2014 book “Thimerosal: Let the Science Speak” advanced thoroughly debunked theories about vaccine preservatives. He has repeatedly claimed vaccines cause autism despite overwhelming scientific evidence refuting this connection, including a 2015 study of over 95,000 children published in JAMA showing no link.
- Conspiracy promotion: Kennedy has promoted conspiracy theories suggesting government agencies collude with pharmaceutical companies to hide vaccine dangers. In 2021, he published “The Real Anthony Fauci,” which claimed without evidence that Dr. Fauci was involved in a “historic coup d’état against Western democracy.” His Children’s Health Defense organization has been identified by the Center for Countering Digital Hate as one of the leading sources of vaccine misinformation online.
- Rejection of scientific consensus: Kennedy has consistently rejected scientific consensus across multiple public health domains. He has questioned water fluoridation, promoted unproven alternative treatments, and suggested that 5G technology poses health risks, positions contradicted by overwhelming scientific evidence.
- Misrepresentation of research: Multiple scientists have publicly stated that Kennedy has misrepresented their research to support his claims. In a 2017 open letter, 350 medical and academic organizations condemned Kennedy’s “misinformed and unscientific” views on vaccines.
These are not merely policy disagreements but fundamental rejections of evidence-based approaches to public health. The World Health Organization has identified vaccine hesitancy, fueled by the type of misinformation Kennedy has promoted, as one of the top ten threats to global health.
The conflict with Dr. Marks illustrates this pattern clearly. Marks wrote in his resignation letter that while he was willing to address Kennedy’s concerns about vaccine safety, he could not provide “subservient confirmation of his misinformation and lies.” The demand wasn’t for evidence examination but for expert confirmation of pre-existing beliefs, the inverse of evidence-based governance.
This unprecedented situation places someone who has spent decades undermining public trust in vaccines and medical institutions in charge of the very agencies responsible for vaccine approval, drug regulation, and public health guidance. The pharmaceutical industry’s immediate negative market reaction reflects recognition that scientific credibility, not just regulatory approach, is essential for a functioning healthcare system.
Pattern of convenience: Kennedy’s appointment in context
Kennedy’s selection as HHS Secretary fits within a broader pattern of Trump administration appointments that prioritize personal loyalty, media profile, and ideological alignment over relevant qualifications and expertise. This approach to staffing government represents a fundamental shift from traditional appointment criteria focused on professional experience and domain knowledge.
The Kennedy appointment appears driven primarily by political convenience rather than public health considerations. Despite having no healthcare administration experience, Kennedy brought significant political value: his famous name carries weight with certain voters, his vaccine skepticism appeals to a specific constituency, and his willingness to publicly defend Trump during the campaign demonstrated the personal loyalty that has become the administration’s primary qualification for office.
This reflects the same pattern visible across numerous high-profile appointments:
The nomination of Pete Hegseth for Secretary of Defense prioritized his Fox News platform and unwavering support for Trump over defense expertise. Similarly, the selection of Tulsi Gabbard as Director of National Intelligence valued her campaign support and media presence over intelligence experience. Matt Gaetz’s Attorney General nomination followed his vocal defense of Trump during legal challenges rather than traditional legal qualifications.
The common thread across these appointments isn’t policy expertise but perceived personal loyalty to Trump himself. As Trump explicitly stated regarding his cabinet selection philosophy in January 2025: “I’ve had the so-called experts before. This time I want people who are loyal.” This represents a governance approach where institutional knowledge and professional qualifications are secondary to personal allegiance.
For agencies like HHS and FDA, which deal with complex scientific and public health challenges, this approach creates particularly severe risks. Public health governance requires not just political direction but substantial technical expertise and understanding of complex systems. When appointees lack this foundation, they must either defer to career officials (whose expertise they often distrust) or make decisions without adequate understanding of their implications.
The pattern suggests an approach to governance where institutions exist not to provide expert implementation of policy directions, but primarily as vehicles for the personal authority and ideological preferences of leadership, regardless of statutory missions or established evidence.
Democratic backsliding: the banana republic warning signs
The FDA purge and broader pattern of institutional destabilization bear disturbing resemblances to governance approaches typically associated with what political scientists euphemistically call “illiberal democracies” or what the public more bluntly terms “banana republics.” These parallels deserve serious attention.
The hallmarks of such systems include: the systematic replacement of professional civil servants with loyalists, the public humiliation of experts who maintain independence, the elevation of personal connections over professional qualifications, and the transformation of state institutions into personal tools of those in power.
When Dr. Peter Stein describes being offered a “nonsensical position” as an alternative to his role leading new drug evaluations, it echoes the experiences of civil servants in countries where expertise is viewed with suspicion and institutional independence as a threat. Similarly, the forced resignation of Dr. Peter Marks for refusing to confirm “misinformation and lies” reflects a governance approach where loyalty to leadership narratives outweighs scientific truth, a pattern seen repeatedly in countries with deteriorating democratic institutions.
These are not isolated incidents but components of a recognizable pattern documented by democracy scholars. Harvard professors Steven Levitsky and Daniel Ziblatt identify key warning signs of democratic erosion in their work “How Democracies Die,” including the politicization of independent institutions, the delegitimization of technical expertise, and the demand for personal loyalty over institutional mission. The current transformation of America’s public health infrastructure displays these warning signs with alarming clarity.
What makes this pattern particularly concerning is how it erodes democratic accountability from within. Institutions like the FDA were designed with deliberate insulation from political pressure precisely because their scientific missions require evidence-based decision-making rather than political calculation. When this insulation breaks down, the consequences extend beyond policy disagreements to the fundamental function of democratic governance.
As citizens witness institutions traditionally respected for their expertise and independence transform into vehicles for ideological agendas regardless of evidence, faith in government itself inevitably diminishes. This erosion of trust creates fertile ground for further democratic backsliding, as the guardrails of professional norms and institutional independence weaken with each violation that goes unchallenged.
The institutional consequences
The FDA’s effectiveness depends on institutional knowledge accumulated over decades: understanding of clinical trial design, biostatistical analysis, post-marketing surveillance systems, and complex regulatory frameworks. This expertise cannot be rapidly replaced once dispersed.
The consequences extend beyond immediate disruption to long-term institutional damage:
- Regulatory uncertainty: Pharmaceutical companies rely on clear, science-based guidance for drug development. Uncertainty in the regulatory process will delay new therapies and increase development costs.
- Loss of institutional memory: The departing officials carry decades of experience navigating complex scientific and regulatory challenges. This knowledge loss will affect the agency’s ability to evaluate new therapies effectively.
- Scientific brain drain: The purge signals to scientists throughout the agency that evidence-based positions may be professionally hazardous, likely accelerating departures of remaining expertise.
- Compromised safety monitoring: FDA’s post-approval safety monitoring depends on sophisticated systems developed over decades. Disruption to these systems could delay identification of emerging safety concerns.
- International standing diminished: The FDA has traditionally set global standards for regulatory science. Its diminishment weakens America’s leadership in international health governance.
As former FDA Commissioner Califf noted, “The loss of staff with huge experience, dedication, and expertise in essential roles will undermine critical functions at FDA. It’s hard to imagine more foolish, poorly considered, and thoughtless actions, actions that will hurt Americans.”
Beyond partisan framing: the governance pattern
This institutional transformation transcends standard partisan policy shifts. Democratic and Republican administrations have maintained the FDA’s scientific independence despite policy differences on specific regulatory approaches. Previous administrations of both parties recognized that drug approval processes and safety monitoring require scientific expertise insulated from political pressure.
The current approach represents something qualitatively different: systematic replacement of evidence-based governance with ideological governance. This pattern appears across multiple domains in the current administration, from environmental regulation to economic policy to national security, but its manifestation in public health institutions carries particularly immediate risks.
The removal of career officials with deep scientific expertise, replacing them with individuals selected primarily for ideological alignment, threatens the fundamental capability of these institutions to fulfill their statutory missions. This isn’t about policy direction but about institutional functionality and the scientific foundations of public health governance.
Public health implications
Beyond institutional damage and market impacts lies the most significant concern: potential harm to public health outcomes. The FDA’s role in ensuring drug safety and efficacy directly affects patient welfare across every medical condition.
Several specific risks emerge from the current institutional disruption:
- Delayed drug approvals: The loss of experienced reviewers will likely slow the evaluation of new therapies, delaying patient access to potentially lifesaving treatments.
- Increased safety risks: Compromised safety monitoring could allow dangerous side effects to persist undetected or inadequately addressed.
- Vaccine hesitancy amplified: Kennedy’s well-documented anti-vaccine positions, now elevated through institutional authority, may further erode public confidence in proven vaccines, potentially leading to preventable disease outbreaks.
- Misinformation legitimized: When evidence-rejecting positions receive institutional endorsement, it creates broader societal permission for choosing ideology over evidence in health decisions.
- Global health leadership undermined: America’s leadership in global health security depends on strong, credible public health institutions trusted by international partners.
These concerns reflect not partisan preference but recognition that effective public health governance requires adherence to scientific evidence and methodological rigor, principles being systematically undermined in the current institutional transformation.
In our view
The dismantling of scientific expertise at the FDA represents one of the most alarming manifestations of the loyalty-based governance model we have consistently documented across the administration. The Kennedy appointment and subsequent FDA purge exemplify how the elevation of ideological alignment and personal loyalty over professional qualifications creates institutional damage with far-reaching consequences.
What makes this pattern particularly concerning is its application to agencies where expertise isn’t just bureaucratic formality but essential for public safety. While policy disagreements about regulatory approaches are normal in democratic transitions, the wholesale removal of career scientific experts suggests something far more concerning: a fundamental rejection of evidence-based governance in favor of ideological conformity and personal loyalty.
We find particularly troubling the implication that scientific expertise itself is viewed as an obstacle rather than an asset. The pattern of removals suggests not a shift in regulatory philosophy but an attempt to eliminate institutional capacity for independent, evidence-based assessment. This represents a direct threat to public health that transcends normal political divisions.
The market reaction is telling: even the pharmaceutical industry, which typically benefits from regulatory easing, recognizes that scientific integrity and institutional stability are essential for innovation and investment. When ideology and loyalty trump expertise in matters of public health, everyone ultimately loses, regardless of political affiliation.
This episode demonstrates why governance patterns matter more than personalities or parties. Institutional independence, professional expertise, and evidence-based decision-making aren’t partisan values but essential foundations for effective governance in complex domains. The FDA purge represents not merely a policy disagreement but an assault on these foundational principles, with consequences that will extend far beyond any single administration.
Looking forward: institutional resilience and recovery
While the current institutional damage is severe, America’s public health infrastructure retains significant resilience factors. Career scientists throughout these agencies maintain deep expertise and commitment to public health missions. Professional organizations like the American Medical Association, the National Academy of Medicine, and scientific societies provide external scaffolding for evidence-based standards.
Additionally, congressional oversight, legal challenges, and public accountability mechanisms create potential checks on the most extreme institutional transformations. The market reaction itself demonstrates that economic stakeholders recognize the value of stable, expertise-based regulatory frameworks.
The question isn’t whether these institutions will completely collapse, but how much capacity they will retain through this period and how quickly they can recover their effectiveness once institutional norms of scientific independence are restored. Similar episodes in other domains suggest that while institutional damage can occur rapidly, recovery requires sustained attention to rebuilding expertise, restoring morale, and reestablishing evidence-based governance norms.
For citizens concerned about these institutions, attention should focus less on partisan framing and more on the fundamental governance question: Should public health decisions be guided by scientific evidence and professional expertise, or by ideological commitments and personal loyalty? This question transcends traditional political divides and speaks to the basic functionality of institutions essential for public welfare.
The FDA decimation represents more than a policy shift; it signals a fundamental governance transformation with implications for drug safety, medical innovation, and public health outcomes. Looking beyond the spectacle of political theater to the institutional consequences reveals concerning patterns that deserve attention regardless of partisan affiliation.
Morgan Treadwell, Taylor Veritatis, and Gloria Major are the founding editors of Beyond the Spectacle, an independent platform examining governance patterns and their implications for democratic institutions.
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