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Confused and Worried

US President Donald Trump wants the Food and Drug Administration to hasten its approvals of drugs, but Vox's Julia Belluz reports that new policies have instead sown confusion at the agency.

Belluz notes that the Trump administration has put a hiring freeze into effect, announced that for every new regulation two existing ones have to be eliminated, and that an FDA commissioner has yet to be named.

"Having uncertainty on three fronts at once is especially difficult," Johns Hopkins School of Public Health's Josh Sharfstein, a former deputy commissioner of the FDA, tells her. "People spend time worrying instead of doing their work, they spend time planning for different contingencies that may never happen."

Former FDA commissioner David Kessler points out that one way to ensure that FDA is moving along as quick as it can is to staff it properly, though a hiring freeze would prevent that. At the same time, it's unclear how the new order on eliminating regulations would affect provisions in the 21st Century Cures Act that also aim to speed drug approvals.

In addition, there's ambiguity regarding how the new as-yet-unnamed commissioner would shape the agency. Names being floated for the position have supported overhauling the agency so that it no longer requires drugs to be effective, Belluz says.