The Food and Drug Agency (FDA) was established in 1938 to ensure the quality of foods and medications. At the time, many medications and processed foods contained impurities and toxins that were threatening public health. When the FDA took charge of testing and guaranteeing the safety of products it represented the public interest and was funded by the taxpayer, not the pharmaceutical and food companies. That situation began to change in the 1980s when a special arrangement was initiated in which pharmaceutical companies paid fees to the FDA that were meant to expedite the testing and approval of new medications. The public is largely unaware of this partnership between the regulator (FDA) and the regulated (pharma industries). Dr. Kesselheim explains the background and the concerns about this arrangement. Photo credit: Science for the Public