In the heart of the nation’s capital, Washington, its power corridors were abuzz on Tuesday with the news of Marty Makary’s resignation as the Commissioner of the Food and Drug Administration (FDA). According to two sources privy to the developments, Makary decided to step down amidst a flurry of reports suggesting his tenure was drawing to a close due to internal policy disagreements.
Makary’s departure follows reports of conflict and tension over the FDA’s agenda. The FDA, on May 6, approved some flavored e-cigarettes from Glas Inc., a vaping company. The agency highlighted its safety restrictions aimed at curbing usage among young people. According to a report by The Wall Street Journal, the approval was granted only after President Trump exerted pressure on Makary to green-light the fruit-flavored vapes, a move that Makary had been resisting.
One of the sources attributed Makary’s exit to the dispute over e-cigarettes. The source revealed that Makary had been reluctant to approve the flavored variants, but was pressured into doing so by other members of the administration. CBS News and other media outlets had reported in recent days that President Trump had endorsed a plan to terminate Makary’s tenure. Makary was conspicuously absent from a recent event on maternal health which took place in the Oval Office and was attended by the President and other top public health officials.
Speaking to reporters on the South Lawn of the White House on Tuesday afternoon, President Trump refrained from discussing the circumstances surrounding Makary’s departure. Nonetheless, he lauded Makary, calling him a “great guy” and a “friend of mine.” The president added, “Marty’s a terrific guy, but he’s going to go on and he’s going to lead a good life. He was having some difficulty. You know, he’s a great doctor. And he was having some difficulty. But he’s going to go on and he’s going to do well.”
Makary’s resignation marks the latest shakeup within the Department of Health and Human Services, which oversees the FDA. Vaccines chief Vinay Prasad, an ally of Makary, recently departed for a second time. Makary was due to testify on Capitol Hill on Wednesday. However, Kyle Diamantas, who is expected to assume the role of acting commissioner, will testify in Makary’s stead, according to one source.
The FDA commissioner’s responsibilities include overseeing and regulating drugs, vaccines, and tobacco, among other things. The FDA regulates one-fifth of consumer spending in the U.S., making it a powerful agency within American public health.
Dr. Scott Gottlieb, who served as FDA commissioner for two years during Mr. Trump’s first term, told “Face the Nation with Margaret Brennan” on Sunday that the role is a “very difficult job.” He noted that the upheaval at the FDA since last year has been detrimental. “There’s been a lot of departures from the agency. You’ve seen political appointees take over what are typically career leadership positions, running the medical product centers, the drug center and the biologics center,” Gottlieb said. “So, I think cumulatively, that’s taken a toll on the agency, and this continued speculation that we saw on Friday, I think is just going to be another step downward.”
Makary, a British-American surgeon, was confirmed to lead the FDA in March 2025. He was an ardent supporter of the Make America Healthy Again movement and had been highly critical of the federal response to the COVID-19 pandemic. However, the vaping issue wasn’t the only one that caused friction for Makary. Conservatives and anti-abortion groups also sought Makary’s removal after pressing the FDA to take action on the abortion drug mifepristone.
In 2021, the Biden administration made it possible for women to receive the pills via telehealth and by mail. The majority of women who terminate pregnancies do so through medication abortions. Last June, Health and Human Services Secretary Robert F. Kennedy Jr. asked Makary to review mifepristone to examine “real-world outcomes and evidence, relating to the safety and efficacy of the drug.” In December, there were reports he had slow-walked the study, and soon afterward, Susan B. Anthony Pro-Life America and other conservatives called for Makary’s firing. The group called for an immediate study and accused Makary of “severely undermining” Mr. Trump and Vance on the issue. “Makary must go,” SBA Pro-Life America said at the time.
This report was compiled with contributions from Kristin Brown, Alan He, and Dr. Céline Gounder.
In the aftermath of Makary’s resignation, there is increased scrutiny on the FDA and its future direction. His tenure at the helm of the agency was marked with tumult and controversy, which has inevitably raised questions about its stability. As the organization responsible for regulating a significant portion of consumer spending in the U.S., the FDA’s actions and decisions have far-reaching implications on American public health. The next commissioner will inherit a challenging role, further complicated by the recent upheavals within the agency.
