What Dr. Pazdur Said....What I Heard: The Threat of “CDC-ification” Is Real
In the early morning hours of January 13, STAT broke the story of Dr. Pazdur’s remarks at the JP Morgan conference in San Francisco. Read the entire story here. The full video is here.
Pazdur speaks, people listen. And they should. The headline gives you the gist: “Pazdur warns that politics, ‘chaos’ are damaging FDA.”
My latest column (below) was sitting on an editor’s desk. It anticipates what Dr. Pazdur said....and it provides a broader context for the concerns every FDA stakeholder should have.
It concludes:
It will be difficult to persuade the White House, HHS, and FDA to preserve FDA as a meaningful agency capable of sustaining its prior level of success and value. Even still, the effort must be made because the stakes are so high.
FDA at a Crossroads in 2026 – The Threat of CDC-ification
Along with most of the federal government, FDA has undergone massive changes since January 2025. These include a nearly 20% cut in staffing, the loss of almost all of its senior leadership, and the abandonment of a decision-making culture based on public input, expert advice, and heavy reliance on staff. Despite these setbacks, FDA is still mostly recognizable as the FDA that existed before the 2024 election.
Not every federal agency has been so fortunate. FDA’s sister public health agency, the Centers for Disease Control and Prevention (CDC), is not recognizable as the CDC of the past and is barely functional.
In recognition of CDC’s experience in 2025, I offer a new definition to add to the lexicon of American government and policy:
“CDC-ification”: The destruction of a well-respected organization by a series of restraints, cuts, politicization, and leadership changes that, cumulatively, leave the organization without the staffing, budget, expertise, structure, policies, or committed leadership to sustain its prior levels of success and value.
For FDA stakeholders, the most pressing question for 2026 is whether CDC-ification is likely or unlikely and whether the agency can avoid it.
The Case for FDA Not Being At-Risk for CDC-ification
While CDC and FDA are both public health agencies, their missions and structures differ significantly.
FDA is a regulatory agency whose mission is grounded in interstate commerce and consumer protection, and which oversees tangible products with commercial value. There are hundreds of thousands of vendors, manufacturers, producers, suppliers, and investors, and millions of consumers who benefit from FDA’s predictability and global respect. All of them will be impacted if FDA becomes less dependable or less effective because of CDC-ification.
In contrast, CDC provides critical support for our nation’s public health network, coordinates disease surveillance, and spearheads federal disease prevention activities. Its focus is on population health--resulting in relatively little interface with investors and commercial interests. Diminishing CDC’s capacity and reputation have severe long-term consequences for the American public and beyond. But the day-to-day impact on industry and consumers is often unnoticed and unquantified.
In sum, the FDA could be subject to CDC-ification. However, the commercial and investment interests, as well as the agency’s stakeholders generally, are likely to have more traction than CDC advocates. Further, the FDA community is aware of the threat, while much of the CDC fight was lost before advocates were fully aware.
The Case that CDC-ification at FDA Is Inevitable
CDC-ification can be rapid—as it has been at CDC—but it also can be accomplished via the proverbial “death by a thousand cuts.” Enough seemingly small changes...and suddenly it is no longer the FDA that oversees 20% of US consumer spending, amounting to nearly $4 trillion in goods and services each year (here).
As noted, in the first part of 2025, total agency staff was diminished by nearly 20%. Staff departures have continued and an additional bump in January is likely due to end-of-year retirements. The loss of institutional knowledge has been profound.
Meantime, the twenty or so positions that collectively constitute “senior agency leadership” have experienced nearly 100% turn-over. Typically, only three or four such positions need to be filled each year, even at the beginning of a new administration.
Historically, FDA has prided itself on science-based decisionmaking based on a broad, inclusive process. Right now, decisions are being made by a limited number of newly appointed senior leaders, with little or no input from internal or external experts. Worse, those decisions seem increasingly based on predetermined conclusions rather than on scientific analysis of existing and pending data.
Can the FDA Avoid CDC-ification?
FDA needs broad stakeholder support to avoid CDC-ification of the agency. Here are some vital areas stakeholders need to focus on:
First, process matters. Stakeholders need to express support for changes at FDA — but insist that those changes be developed and implemented in a way that protects consumers and patients, advances innovation, and is fair and predictable for industry. I am one of a handful of FDA commentators who have written favorably, albeit cautiously, about the Commissioner’s National Priority Review Vouchers. However, I can’t defend the program if — as has been alleged — expert FDA staff are not playing a meaningful role, and the final decisions are being made in consultation with a transactionally oriented White House.
Second, stakeholders need to upgrade their defense of sound science. HHS no longer respects seemingly-immutable rules of scientific analysis, such as: “correlation is not causation,” “anecdotes are not proof, and they cannot be generalized,” and “you can’t prove a negative.” (here). If FDA policy and regulatory decisions are no longer based on sound scientific thinking, then stakeholders need to speak more about the consequences.
Third, the combined economic impact of FDA activities on food, medical products, and tobacco is significant and immediate, as is our nation’s global leadership in those areas. Missteps at the FDA affect health, wellness, food safety, and nutrition. They also play a role in inflation, balance of trade, workplace productivity, and public confidence in everyday products that are at the core of the economy.
The future of the FDA--as well as the safety, quality, and effectiveness of food and medical products--will be determined by whether CDC-ification occurs at FDA.
It will be difficult to persuade the White House, HHS, and FDA to preserve FDA as a meaningful agency capable of sustaining its prior level of success and value. Even still, the effort must be made because the stakes are so high.
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Steven Grossman, JD, is a policy analyst and regulatory expert, and author of the FDA Matters blog (www.fdamatters.com). Earlier in his career, he served as a deputy assistant secretary for health at HHS and health staff director on the Senate HELP Committee. Mr. Grossman’s advocacy and policy leadership has been recognized by the Reagan-Udall Foundation for the FDA, which honored him with its 2024 Innovations in Regulatory Science Award.