Trump’s pressure on the FDA will erode public trust

There’s a good argument to be made that the Food and Drug Administration has been far too slow to approve the new vaccine from Pfizer-BioNTech. Indeed, I’ve made that argument more than once. So you might think I’d be pleased at the report that the White House told FDA chief Scott Hahn to either approve the vaccine by day’s end on Friday, or submit his resignation.

But if the reports are true, this is the wrong solution to a real problem. Or rather, it’s not a solution at all, and runs a real risk of making things worse.

For one thing, the threat reportedly goaded Hahn into shifting the approval back to Friday night from . . . Saturday morning. (In a statement, Hahn disputed the characterization of a threat; he said that “the FDA was encouraged to continue working expeditiously” on the vaccine’s approval.) Now, I firmly believe that we could have saved lives if we’d started administering vaccines days ago. But even I am hard-pressed to argue that an extra 12 hours or so – during most of which the country would be asleep – is going to make a meaningful difference.

The costs, meanwhile, are potentially hefty, because the very act of issuing the order signals that politicians are overriding the FDA’s experts. The last thing we need now is for people to believe this was a political rather than a technical decision.

Already, too many people on the left are worried that these vaccines were rushed out without adequate testing, so that President Donald Trump would have something to campaign on. I think those fears are misplaced and have said so. I’ve also had some very unkind words for the Democratic politicians, including our next vice president, who have irresponsibly and unpatriotically tried to score political points by inflaming those fears.

But even though I think people are mistaken to worry, I have to acknowledge that they are worried. One of Donald Trump’s main jobs right now is to help people get over those fears, even - especially - if they’re groundless. And if you want to counteract fears about political interference in the approval process, the best place to start would be by not proving them right.

The best defense of the White House is that it simply doesn’t matter much; such a short delay could have made no substantial practical difference in the approval process. I agree with that. But to say that is to admit that a shift from Saturday morning to Friday night doesn’t make a substantial practical difference. When you’ve eliminated that practical benefit, what’s left is how it looks - and the way this looks hardly improves the odds of anyone taking this vaccine.

Of course, I can already hear the questioners tapping the mic to interrogate me. “The president can’t catch a break from you,” they are saying. “You complain the FDA is moving too slowly, but then when the president does something about it, you castigate him over optics?”

Well, I’d have felt differently if he’d made this move a week ago. As is, this is too much, too late. And it’s hard to insist that we only critique Trump on substance, rather than appearances, when his political career is 95 percent optics.

Indeed, I can’t help but suspect that Trump is less concerned about vaccines than about positioning himself for 2024 as the Bane of the Bureaucracy. Moreover, I think that this sort of positioning is why Trump has failed to fulfill his promises about changing the way Washington works. I’m a longtime critic of the FDA’s chronic lack of urgency when it comes to drug approvals. I’d love it if Trump had gut-renovated the agency into a supersonic innovation machine. Yet, I also recognize that rebuilding organizational culture is the kind of work that can only be accomplished over time and through attentive, hands-on leadership. In Scott Gottlieb, Trump’s first FDA commissioner, Trump had someone who focused on that kind of thankless and largely invisible work. But it’s hard to say that even before Gottlieb left, FDA reform was really a central part of the Trump agenda.

Even Trump’s defenders, looking back at his promises of revolution, might ask why it now looks so likely that come January, the ancien regime will almost completely resurrect itself. And they might also notice that this is not the first time that Trump, having neglected the “administrative” side of his administration, is now trying to substitute an aggressive blitzkrieg for dull-but-steady improvement - dropping tweets from on high, and apparently when that failed, dropping threats through his chief of staff.

Alas, I’m afraid that as is all too typical in these cases, this won’t have any meaningful practical effect, except possibly for the negative ones we’re now also so familiar with: a pointless squandering of institutional capital that took decades to accumulate, in an exchange where everyone loses except, possibly, Donald Trump.