Experts Urge Reforms at FDA or Rebuild Trust

Updated on November 16, 2023

 In a new report aimed at rebuilding trust in health care and science, leading experts urge the U.S. Food and Drug Administration to adopt five reforms to rebuild public trust amid controversies around vaccine approvals. 

In Securing the Trustworthiness of the FDA to Build Public Trust in Vaccines, Leah Z. Rand, Daniel P. Carpenter, Aaron Kesselheim, Anushka Bhaskar, Jonathan J. Darrow, and William B. Feldman recommend the FDA consider five major factors to maintain its trustworthiness as an organization and to enhance public trust in its decisions, including: 

  • Making decisions that are consistent with its existing rules 
  • Employing expert decision-makers 
  • Avoiding problematic interference from politicians
  • Staying connected to public preference
  • Providing transparency in its decision-making process

“The pandemic revealed that the FDA must navigate political interests, and its responsibilities to be accountable and make evidence-informed decisions, with missteps leading to a lack of trust,” said Leah Rand, one of the authors who is a research scientist at Brigham and Women’s Hospital and Harvard Medical School. 

The authors state that “these five conditions, both procedural and substantive, are necessary for FDA trustworthiness, particularly when it conducts reviews and issues approvals, given that it is a government agency subject to political control.”

“The scientific community must rebuild trust, and the authors of this article have given us five clear conditions for the FDA to regain the confidence of the American public,” said Gregory E. Kaebnick, a senior research scholar at The Hastings Center and an editor of the report.

The essay is part of a new special report, Time to Rebuild, published by The Hastings Center, the ethics institute. The report explores the causes of the decline in trust in health and science and proposes pathways to rebuild in a series of articles. 

The report was edited by Lauren A. Taylor, assistant professor at the New York University Grossman School of Medicine, Kaebnick, and Mildred Z. Solomon, president emerita of The Hastings Center.

The special report is the product of a collaboration between The Hastings Center and the American Board of Internal Medicine Foundation Building Trust initiative, with support from The Gil Omenn and Martha Darling Fund for Trusted and Trustworthy Scientific Innovation and by the ABIM Foundation.

The Hastings Center is a pioneer in collaborative interdisciplinary research and dialogue on the ethical and social impact of advances in health, science, and technology. The Center draws on a worldwide network of experts to frame and examine issues that inform professional practice, public conversation, and social policy. Learn more about The Hastings Center at

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