In September, Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. dismissed the two vice chairs of the U.S. Preventive Services Task Force (USPSTF). This advisory body, established by Congress under the Affordable Care Act, is legally mandated to be staffed by individuals with appropriate expertise who are free from political pressure. Its role involves reviewing scientific evidence to recommend whether private insurers must cover services like cancer screenings without cost to patients. C. Joseph Ross Daval and Aaron S. Kesselheim describe this move as both unsurprising and troubling, marking a significant step in the erosion of scientific guidance.
These firings represent the latest phase in a wider effort to eliminate or ignore scientific advisory committees within the federal government. In 2025, the Trump administration terminated 151 such committees across scientific agencies, including 75 within HHS. The administration has also altered or disregarded the remaining bodies. That same year, Secretary Kennedy replaced the entire Advisory Committee on Immunization Practices with individuals who often lack substantial expertise in vaccines and immunology, while showing sympathy to unscientific views. Similarly, at the Food and Drug Administration (FDA), leadership has largely bypassed standing advisory committees for new drug approvals. The FDA convened a record low number of these committees in 2025, substituting them with handpicked "expert panels" that lack collaborative consensus and scientific rigor.
The authors argue that expert advisory committees are essential for two primary reasons: improving decision-making quality and ensuring accountability. Policymakers require independent, high-quality advice to maintain the credibility of agency actions, a need that has grown more acute following staffing cuts at agencies like the EPA, FDA, and CDC. Furthermore, these committees create a public record that allows courts, Congress, and the media to hold the government accountable when it declines to follow expert recommendations.
The importance of this accountability was highlighted in 2021 when the FDA approved the Alzheimer's drug aducanumab despite a near-unanimous vote against approval by its advisory committee. The committee cited conflicting efficacy evidence and significant safety risks, including brain bleeds. This negative vote anchored subsequent debates, leading critics to question the FDA's decision, payers to refuse coverage, and patients to avoid the drug. The episode ultimately triggered investigations revealing improper manufacturer pressure on the agency. Without such committees, policymakers can more easily evade scrutiny regarding unscientific or politically motivated decisions.
The recent dismissals at the USPSTF followed a 2025 Supreme Court ruling stating that the HHS secretary can remove committee members at will, as no statute restricts this power. However, Daval and Kesselheim contend that Congress has the authority to change this dynamic. Potential legislative tools include enacting for-cause removal protections, implementing staggered terms, establishing formal expertise requirements, and enforcing stricter conflict of interest rules. Congress could also mandate more transparent selection processes or vest the power to choose advisers in an independent body.
The authors assert that these reforms would likely withstand constitutional scrutiny because advisory committees do not exercise executive authority; their advice is nonbinding. Unlike agency heads who must be accountable to the president, independent scientific advisers merely provide authoritative input that informs public policy. The current dismantling of scientific advice is described as untenable. If Congress remains committed to evidence-based policy, it must act to insulate expert advice from arbitrary political control.
Sources: STAT News.