The Food and Drug Administration (FDA) has been criticized for its lack of transparency regarding experimental therapies treating rare diseases, particularly in relation to new protocols to speed approvals. The agency has faced increased criticism recently, with Congressman Jake Auchincloss (D–MA) accusing FDA Commissioner Marty Makary of replacing standards of safety and efficacy with "fear and favor". Former FDA Commissioner and Pfizer board member Dr. Scott Gottlieb warned that the agency is losing key staff and potentially jeopardizing America's health. The FDA has experienced significant staff reductions over the past two years, with major departures in the Center for Drug Evaluation and Research department. Gottliebb warned that while the loss of experienced experienced expertise, the loss is likely to have a significant impact on the agency's response to complete communications letters.