Makary, nominated by President Donald Trump to lead the Food and Drug Administration (FDA), addressed concerns about staffing levels during a Senate confirmation hearing. Emphasizing his commitment to ensuring the agency has the necessary resources, Makary highlighted the importance of evaluating current personnel needs. He expressed a strong belief in the professional capabilities of the FDA's career staff and promised an independent assessment if confirmed. Makary acknowledged recent layoffs but stressed the need for a comprehensive evaluation of the agency's workforce, which has nearly doubled since 2007.

The expansion of the FDA's workforce has been accompanied by a significant increase in user fees collected from pharmaceutical companies, tripling since 2007. This influx of funding has enabled the agency to focus on new areas of technology, such as artificial intelligence and genetic medicine. However, some employees working in these cutting-edge fields were among those initially laid off, raising questions about the strategic approach to workforce management. Senators voiced concerns over the decision to target probationary employees, who have fewer protections, and emphasized the need for a more thoughtful personnel policy. Makary responded with a promise of a "surgical" approach to addressing these issues.

Industry stakeholders and investors are closely watching the situation, wary of potential disruptions to the FDA's review processes. Trade groups like BIO have warned against indiscriminate cuts, advocating for a more strategic reform of the agency. The emphasis is now on maintaining the efficiency and integrity of the FDA's operations while ensuring that it remains equipped to handle its expanding responsibilities. Ultimately, Makary's nomination signals a critical juncture for the FDA, where careful consideration of workforce policies will be essential to uphold public health standards and foster innovation.