Op-ed: The need to strengthen the US Food and Drug Administration: US cuts threaten health care at home and abroad

Since January 2025, the administration of US president Donald Trump has taken a series of measures that could have far-reaching consequences for global health. These include deep cuts to development aid, staffing reductions at key health agencies like the US Food and Drug Administration (FDA) and the launch of a tariff war that threatens to impede the supply of lifesaving products. 

In her Lancet article, Jayasree emphasises that these developments are especially concerning for regulatory oversight. With the FDA losing 3,500 staff in particular, product approvals, inspections and access to effective new treatments may be postponed or subject to reduced oversight, threatening essential safeguards for drug quality, product safety and batch validation. 

She also warns that the FDA’s reduced capacity puts the broader ecosystem of innovation at risk, undermining efforts to discover and deliver new medicines. As she notes, this was already a concern in high-risk areas like antimicrobial resistance (AMR) and emerging infectious diseases, with declining industry engagement documented in the 2024 Access to Medicine Index and AMR programme research. 

Furthermore, Jayasree highlights the need for a strong FDA to manage global disease outbreaks, support affordable access through new models and set a global standard for approvals that are essential for ensuring access to medicines in low- income and middle-income countries.