Former FDA Biologics Chief Vinay Prasad Says He and Makary Changed 2 to 4 Percent of the Agency

Vinay Prasad spent roughly a year running the FDA's Center for Biologics Evaluation and Research. His own estimate of what he changed is small.

"Maybe we changed 4 percent, 2 percent of the FDA," Prasad told Reason's Zach Weissmueller in an August interview. "The FDA is an 18,000-person agency. There's tens of thousands of people still there."

A short, bumpy tenure

Prasad is a physician and professor at the University of California, San Francisco. He was a prominent critic of the COVID-era public health response before he was tapped to lead the biologics center in May 2025.

His time there was not smooth. He resigned abruptly in July 2025 and returned a few weeks later. He left for good in April 2026.

He was part of a group of COVID-response critics who moved into government, alongside former FDA Commissioner Marty Makary and National Institutes of Health Director Jay Bhattacharya.

"The system is largely the same"

Prasad said the Department of Government Efficiency had already cut a couple thousand FDA staffers before he and Makary arrived. Even so, he described the agency's basic machinery as intact.

"The system is largely the same as it's always been," he said.

He also separated himself from the most aggressive pandemic critics. "Although Marty, Jay, and I are critics of many aspects of the response, we don't go as far as some of the most extreme critics out there," Prasad said.

He said he has no regrets about going in. "I learned more in one year than I'd learned in the prior decade about how the world works," he said.

He claimed some improvements "which I think will be enduring." He conceded that he "at least tried to improve other aspects of government, which may not be enduring."

Prasad on Fauci

Weissmueller's question put Anthony Fauci at the center of the old guard and noted that Fauci recently appeared before Congress and pleaded the Fifth. According to that question, this followed Sen. Rand Paul (R-Ky.) publishing Fauci's diary.

Prasad did not dwell on the legal episode. He went after Fauci's legacy and how it has been treated.

"Probably the greatest news story is that the mainstream media refuses to be honest about his legacy," Prasad said.

His argument was about timing. Fauci was in his late 70s when the pandemic began. "Had he retired at a ripe old age of 75, he'd be leaving behind a stellar legacy," Prasad said. "But he continued. He pushed it. He stayed through the whole pandemic."

Prasad then made a pointed claim about the diaries. Fauci, he said, "was the face of many things that his diaries get into, what he privately thought while he was publicly saying different things."

That is Prasad's characterization. It is the view of a former colleague of the people now running the agencies Fauci once helped shape, and it is not an adjudicated finding.

What else the conversation covered

The interview also ranges across the origins of COVID-19, vaccine policy, regulatory barriers at the FDA, and whether the agency is ready for AI-driven medicine. Reason's introduction says Prasad has developed a growing sympathy for libertarian critiques of the FDA.

The title Reason gave the piece quotes him: "Public Health in This Country Is So Broken."

The open question

Prasad's own numbers frame the issue. By his account, the people who came in to challenge the public health establishment moved a few percent of an 18,000-person agency, and he is unsure which of those changes will outlast his departure.

With both he and Makary now out of the FDA, whether any of that work survives is a question his successors will answer.