FDA Commissioner Marty Makary warned in a CNBC interview that the U.S. is falling behind China on early‑stage drug development, pointing to bottlenecks in hospital contracting, ethical reviews, and the IND submission and clearance process. Makary suggested partnering with health systems and academic centers to streamline pre‑IND interactions and accelerate trial starts. His comments add to political and regulatory pressure to reform clinical trial startup timelines and could spur policy shifts aimed at improving U.S. competitiveness in first‑in‑human research.