Questioning the FDA: A Bold Move by Panama’s Health Director

Dr. Reina Roa, who leads health efforts in Panama and is set to head the World Health Organization’s anti-Tobacco Treaty Summit, recently raised eyebrows by critiquing the credibility of the U.S. Food and Drug Administration (FDA). This is quite a striking stance, especially coming from someone in her position.

In an official communication dated July 8th, Roa dismissed the FDA’s evidence-based evaluations of nicotine products considered lower risk, like e-cigarettes. She suggested, quite boldly, that the FDA’s credibility is questionable—primarily because its findings don’t align with the WHO’s ideological framework.

“If the global public health community genuinely wants to minimize the impact of smoking, it needs to uphold the integrity of scientific bodies like the FDA,” Roa stated.

This isn’t just a minor bureaucratic blunder; it’s a serious oversight and, frankly, an insult to one of the world’s preeminent regulatory entities. Moreover, it seems she’s ignoring a mounting body of scientific evidence indicating that non-combustible nicotine products are significantly less harmful than traditional smoking.

Roa’s assertion that “there is no independent scientific consensus that disaffiliates from the tobacco industry to substantiate that these products are notably less risky” is, simply put, inaccurate. This consensus is not only widespread but spans various global regions, schools of thought, and public health orientations.

The Science Behind the Debate

In a landmark report released in 2016, the UK’s Royal College of Physicians stated that the health risks linked to long-term vaping are probably less than 5% of those associated with smoking cigarettes. Public Health England also concluded that vaping is “at least 95% less harmful than smoking.”

Further, in 2018, the National Academy of Sciences, Engineering, and Medicine found substantial evidence indicating that the toxic exposure from e-cigarettes is significantly lower than that from combustible tobacco. Organizations such as Cancer Research UK have reiterated that e-cigarettes are much less harmful than traditional smoking.

Globally, numerous health agencies, including New Zealand’s Ministry of Health and Australia’s National Centre for Epidemiology and Population Health, have publicly acknowledged that vaping poses less risk than smoking.

This perspective isn’t outlandish; it is central to responsible, evidence-based policymaking aimed at reducing harm.

Deliberate Ignorance?

Roa’s belief that these scientific stances don’t reflect authentic consensus suggests either a lack of awareness or an attempt to mislead. Moreover, insinuating that the FDA might be influenced or manipulated by the tobacco industry is a serious charge bordering on slander.

Back in 2015, the WHO’s Research Group recommended using the FDA’s regulatory strategies as a guide for best practices. Fast forward to today, and the FDA has approved various non-burning nicotine products as “suitable for public health,” raising questions about the WHO’s apparent shift in stance.

If these exaggerated claims are merely the opinions of fringe elements, that’s one thing. But when they stem from the Panama Ministry of Health and involve a significant global assembly for tobacco policy, it raises alarms.

The incoming chairperson of the 11th Conference of the Parties should prioritize evidence-based leadership, aiming to unite countries in preventing smoking-related deaths. Instead, Roa’s dismissal of well-established facts suggests a troubling reluctance to engage with real-world data and an aversion to the urgent need for accurate information for smokers, particularly in developing nations.

Science Deserves Better

Challenging the FDA’s independence not only offends American regulators and health organizations but also jeopardizes the trustworthiness of the WHO. The goal of reducing tobacco-related harm isn’t a U.S.-centric invention nor simply a ploy from the tobacco sector; it is anchored in the principle of minimizing risks for individuals who can’t or won’t completely quit nicotine. The WHO’s own Framework Convention on Tobacco Control explicitly mentions the importance of harm reduction, yet it appears hesitant to fully embrace this approach.

By undervaluing the FDA and disregarding broad scientific agreement, Roa undermines faith in public health agencies globally. Ironically, while questioning the independence of others, she inadvertently casts doubt on her objectivity—especially as she prepares to lead a pivotal international public health conference.

Ultimately, Roa’s statements contradict the very mission of the WHO and the Framework Convention on Tobacco Control. If the global health community genuinely aims to lessen the smoking burden, it must respect the integrity of organizations like the FDA, acknowledge credible evidence, and recognize that harm reduction is not a threat; it’s an opportunity.