FDA Commissioner Marty Makary resigns amid internal and external pressures
Food and Drug Administration Commissioner Marty Makary is leaving the Trump administration after President Donald Trump approved a plan for his dismissal last week, reports BritPanorama.
Makary faced considerable pressure both from within the administration, particularly over his reluctance to approve flavored e-cigarettes, and from external allies in the pharmaceutical industry as well as anti-abortion groups. His tenure has been marked by frequent turnover in the agency’s senior staff, raising concerns about stability and direction at the FDA.
Trump is expected to appoint Kyle Diamantas, a deputy commissioner and head of the agency’s food program, as acting FDA chief, according to sources familiar with the decision.
Makary’s resignation has heightened scrutiny on the Trump administration’s ability to fill key vacancies within the Department of Health and Human Services, including those at the Centers for Disease Control and Prevention and for the position of surgeon general, which traditionally oversees public health initiatives.
A source familiar with the circumstances surrounding Makary’s departure indicated that his inability to resolve disputes regarding the sale of vape products was a significant factor. “He doesn’t want to approve youth-appealing flavors, but has been forced to by the powers that be,” the source stated.
Interestingly, his resignation comes just a day before he was scheduled to testify regarding the FDA’s proposed budget before the Senate Appropriations Committee.
Reports of Makary’s potential exit had been circulating for days, fueled by a faction of White House and HHS officials dissatisfied with his leadership. They criticized the FDA for the chaos and conflict that seemingly characterized his administration.
In the week leading up to his resignation, Makary reportedly made attempts to secure Trump’s support, believing the president still had confidence in him. However, news of Trump’s approval for a dismissal plan caught both Makary and his associates off guard, instigating speculation about the motivations behind the push for his removal.
While discontent with Makary’s performance was pervasive, some Trump advisers cautioned that firing another senior health official could represent a political mistake, particularly ahead of the midterm elections. This concern was rooted in fears that the action might further aggravate segments of the administration’s base advocating for health reforms.
Nevertheless, it seems many within the White House welcomed Makary’s departure as an opportunity to reset leadership dynamics at the FDA and improve relations with critical constituencies, particularly in the anti-abortion and pharmaceutical sectors.
In addition to seeking Makary’s ouster, discussions were also underway regarding a restructuring of the FDA’s senior staff, possibly reflecting a broader strategy to stabilize the agency moving forward.
Since his confirmation in March 2025, Makary, a surgeon and author, had vowed to enhance the speed of FDA approvals for drugs and vaccines. Yet his term often veered into controversy over various issues, involving not only pharmaceutical companies dissatisfied with the approval process but also administration officials questioning his handling of tobacco regulation.
One key flashpoint involved his resistance to internal directives to approve flavored e-cigarettes, an issue that reportedly angered Trump and led to confusion regarding FDA policies. Just last week, the agency reversed its stance on flavored e-cigarettes, further illustrating the internal conflicts at play.
In connection with a broader push against abortion, influential figures like Marjorie Dannenfelser of Susan B. Anthony Pro-Life America met with White House officials, advocating for the FDA to reconsider its regulations on the abortion pill mifepristone, which could reverberate nationally, affecting access to the procedure.
The repercussions of potential regulatory changes are significant, as medication abortion now constitutes approximately two-thirds of all abortions in the US and saw a rise following the Supreme Court’s 2022 decision that ended federal protections for abortion rights.
Social conservatives have indicated that this is a pressing issue ahead of the midterm elections, and with the Supreme Court signaling a willingness to revisit abortion regulations, activists have long held Makary partly responsible for the current state of affairs.
“FDA Commissioner Makary should be fired immediately,” Dannenfelser stated shortly before meeting with White House officials. “Indifference is completely unacceptable to millions of pro-life voters expecting the administration to act to save lives.”
Makary’s time in office has also polarized the “Make America Healthy Again” coalition. Vaccine critics have criticized him for not recalling Covid-19 vaccines, while advocates for improved food standards have lauded his initiatives against artificial food dyes and ultraprocessed foods.
This unfolding situation reflects the intricate balances and ongoing tensions within the Trump administration’s health policies, with significant implications for public health regulation as the political landscape shifts.
