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Notes -
I haven't fully fleshed this one out but big pharma appears to have some amount of control over the FDA.
There are effective and unique Russian drugs (https://slatestarcodex.com/2014/08/16/an-iron-curtain-has-descended-upon-psychopharmacology/) that the FDA goes out of their way to keep out the hands of Americans. You can't get them prescribed by US doctors and the FDA has been cracking down on vendors that sell them (https://liftmode.com/product-discontinuation/). It is legal to import and sell them if you market them as 'not intended for human consumption' but they appear to be cracking down on this by arguing that the vendor knows that customers are buying with the intent to consume them.
If the FDA really cared about it's stated goal of 'protecting the public health' then it would create a safe and legal path for these drugs to be obtained by Americans. Since the FDAs actions benefit American big pharma at the expense of public health I would assume that big pharma has some amount of influence/control over the FDA.
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