The U.S. Food and Drug Administration (FDA), under the leadership of Commissioner Martin Makary, is implementing a policy to remove employees of regulated companies, including pharmaceutical firms, from serving as official members on its advisory committees. This move aims to limit industry influence and restore public trust in the agency. The FDA is also focusing on addressing the root causes of chronic diseases and intends to promote faster drug approvals alongside enhanced post-market surveillance. Additionally, the agency is considering accelerated approval pathways, including one based on a single randomized controlled trial in some cases and a new pathway for rare diseases relying on plausible mechanisms with conditional approval and follow-up. These changes suggest a potential large-scale restructuring of the FDA’s processes related to drug evaluation and approval.