Supercharging a New FDA: Marty Makary on Science, Power & Patients
episodePreviously titled “Can We Trust the FDA? Marty Makary on Science, Power & Patients” — renamed by the publisher on Aug 6, 2026
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How has the FDA changed under Commissioner Marty Makary?
Marty Makary, Commissioner of the FDA. Welcome to San Francisco.
Great to be here, Dave. Good to be with you.
Yeah, thanks. It's JP Morgan Healthcare Conference this week in San Francisco, considered, I think, probably the biggest, most important biotech conference globally. Very important week.
What are the implications of the U.S. losing the biotech race to China?
So you're visiting this week for the conference?
Yeah. 120,000 people. Great conversations. You hear from everybody. Just not enough time to meet with everybody you want to meet with, but it's a great time.
How can drug approval timelines be accelerated safely?
Well, thanks for sitting down with me. You and I have gotten to know each other a little bit over the last year or so. Yeah. And I'm really excited to hear a little bit about how things are going. It's been almost a year since you've been in the role. I think maybe for our audience, you could share a little bit about how you got this role. How did you get involved with this administration? How did you get connected with them? And maybe we can go all the way back to your very outspoken views during the COVID pandemic and maybe how that brought attention to you and your philosophies that drove this role.
Yeah, so my interest in academia, I went to graduate school for public health and served on the faculty of the Johns Hopkins School of Public Health as I also had a clinical practice in GI and cancer surgery at Johns Hopkins. And my interest was always in the root causes of our healthcare system problems, from quality, transparency, and price. And in the work on price, I led sort of a national effort to try to get more price transparency of hospital prices, I wrote a book on it that did very well. It took me to the White House where they had read the book, invited me in. And in that first Trump administration, we had a lot of great conversations. And then they implemented the idea. And I was so impressed.
This makes sense. We want common sense ideas. And so we got the hospital price transparency executive order signed by the president.
What changes are being made to the Food Pyramid and why?
That's where I developed some of the relationships and got to know the folks. And then when President Trump got reelected, he gave me a call days after the election. And I was very honored to be offered this role. So it's been awesome. COVID, you mentioned COVID. It was a crazy time. I mean, the sort of sociology of medical dogma is a fascinating thing. historical thing, and we still suffer from it.
How do GLP-1 drugs address America's obesity epidemic?
Paternalism, the sort of suppressing ideas that are not the legacy ideas, the sort of sacrificing the basic principles of science to question everything, to have no sacred cows. And you saw the worst of that bad behavior during COVID. Cloth masks on toddlers for three years. vaccine mandates for young college students, recommending COVID boosters with such absolutism in young, healthy children, ignoring natural immunity, one of the most scientifically dishonest things a scientist could possibly say about the virus and the immunity. and shutting kids out of school for nearly two years, which I fought tooth and nail, along with Jay Bhattacharya and others, starting in the fall of 2020. Initially, we were OK just doing stuff while we didn't understand it.
But once the data emerged, we made a strong case to reopen the schools. And to some degree, I feel like we lost that battle.
What new perspectives are being considered in vaccine development?
But people now see that the data has caught up with public health officials. And so I'm proud to be in office now to be a part of an effort to rebuild public trust in our health institutions.
And you must be having a lot of conflict then, because you really are fundamentally trying to rewrite the way these institutions operate, have operated. And in some sense, you are degrading the success and the career and the authority that some have vested themselves over time in those roles. How has that been? And what's the pushback been like as you've kind of gone through this exercise?
So I meet with folks at the FDA, and if you meet with them with their bosses and everybody in the room to get a briefing on a topic, then they give you one glowing story. But if you meet with one individual scientific reviewer and give them the safety of anonymity and say, look, I want to hear how is it going on the ground?
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Chapters
8 chapters
1
How has the FDA changed under Commissioner Marty Makary?
0:00–0:15
2
What are the implications of the U.S. losing the biotech race to China?
0:15–0:25
3
How can drug approval timelines be accelerated safely?
0:25–1:49
4
What changes are being made to the Food Pyramid and why?
1:49–2:13
5
How do GLP-1 drugs address America's obesity epidemic?
2:13–3:11
6
What new perspectives are being considered in vaccine development?
3:11–4:22
7
How can AI help in lowering drug prices?
4:22–5:40
8
What are the current theories regarding the causes of autism?
5:40–1:29:27
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