I spent a decade in FDA compliance related work on the generics side of pharmaceuticals under the umbrella of the Center for Drug Evaluation and Research (CDER). When Marty Makary MD walked into the FDA, I actually felt something I hadn’t in a long time — hope that someone who understood the science and the pervasive rot would finally cut through it. And he did. Then the same people who talk a big game about “draining the swamp” pushed him out and I’m furious.
Makary was the first commissioner who looked at the menopausal hormone therapy black-box warning — the one that scared millions of women off a treatment that reduces heart attacks and significantly improves quality of life in most women. He had the cojones to call it what it was – a system failure built on a faulty haphazard study that was grossly misinterpreted. He moved to strip the fear-mongering FDA warning labels so women could make informed decisions with their doctors instead of being lectured by outdated dogma.
That is one of the most concrete, high-impact things any FDA leader has done for women’s health in decades. And the storytelling belonged to him alone. Republicans are terrible at telling stories that actually land with normal people, but Makary was excellent at it. His wall-to-wall coverage of this historical announcement was crucial for the medical community (both healthcare suppliers and providers alike) and life changing for patients.
Then he was gone, after thirteen months, amid the White House pressure over things like FDA approval of flavored vapes. Vinay Prasad MD, who was trying to apply actual skepticism to gene therapies and other biologics instead of rubber-stamping whatever the companies wanted, got the same treatment. It begs the question — what exactly happened to the MAHA movement?
Calley Means, who has been in this fight since day one, laid out the corporate capture on Rogan’s show this week. He is now being hit with the legal threat routine after his podcast appearance. If you haven’t had a chance to watch this yet, I implore you to do so (and so does Sen. Johnson). The swamp is alive and well inside Washington, “in spite Trump’s efforts to drain” it, Johnson said.
Meanwhile, the February 18 executive order invoking the Defense Production Act to treat elemental phosphorus and glyphosate-based herbicides as “critical national-defense materials” landed like a brick. Iowa has the second highest cancer rate in the country and is one of the few states where cancer rates are still rising. The links to the agricultural chemicals are not a conspiracy theory; they’re in the data.
MAHA supporters like me who thought the 2024 mandate meant confronting chronic diseases and eliminating harmful/toxic chemicals in our food and drug products, not protecting the status quo while invoking “national security” provisions to hide the appearance of betrayal — a throwback to the George W. Bush era of political maneuvering to escape reproach.
The agencies are still full of people whose careers, speaking invitations, and future consulting gigs depend on staying on the right side of the very multinational corporations MAHA is working to rein in. FDA officials and medical journals play the same game. It’s incestuous. I watched the revolving door from the inside for years.
Which brings us to the Senate. Tuesday’s results were an extinction level event for the Republican majority. We lost the chamber after failing to push back on the war in Iran, failure to meaningfully reform Obamacare yet again, (after John McCain tanked the deal in 2017), and the failure to pass the SAVE Act that sat on the floor and never cleared the 60-vote threshold because leadership refused to put up a fight.
Then there was the failure to stop years of Susie Wiles’ front office prioritizing donors over the promises that got Trump elected in the first place. John Thune and the feckless Senate leadership cabal squandered its majority, acting as if lawmaking was some sort of an inconvenience to these elitists who didn’t want to waste their valuable time squabbling over petty issues like securing our elections or fixing the broken healthcare system they helped create. The 2024 mandate was a chance to deliver a real generational change to a massively broken and corrupt system. Now they want to crown Thune minority leader without a real postmortem.
Well, screw them.
Ron Johnson is the one Senator who has consistently asked the hard questions about government corruption, about COVID, about the vaccine safety signals, about the data, about the incentives — without flinching. He is gathering signatures right now to force a conference meeting before any leadership vote, and the people signing on include Mike Lee, John Kennedy, and Rick Scott. Pair him with Rand Paul and you have a core that actually wants to examine these failures instead of papering it over.
Johnson is the firewall we need in Washington. He’s a fighter. Not another weak Senator who oscillates and capitulates to the political cowardice inside the GOP.
Thune, et al. is more of the same. Polite letters and failure to pass bills while feigning outrage on awful programs like Sean Hannity in a pathetic attempt to reassure constituents they tried their hardest.
Sens. Murkowski, Collins, Tillis and “The Turtle” McConnel (is he still kicking?) will remain in their cul de sac of self-grandeur while spending 90% of their time on donor management and close out the session with another round of “we’ll get to it later.” Agencies like the FDA slide back to business as usual.
I was excited when the MAHA team arrived in the Trump administration. Watching them get forced out while the same old relationships reassert themselves is not a surprise, but it is infuriating. Put Johnson in charge of the minority now and find a way to get Makary back in the FDA. Work with the Senators who still act like the 2024 mandate mattered. Or start writing the 2028 concession speech today.
