President Donald Trump has signed off on a plan to remove Marty Makary as commissioner of the U.S. Food and Drug Administration, according to multiple reports from senior administration sources, in what would be the latest high-profile departure from the already turbulent federal health apparatus. The decision follows months of internal frustration with Makary’s management of the agency, pressure from anti-abortion groups, and a dispute over the handling of flavored e-cigarettes. The move would leave yet another critical health leadership role vacant just months before the 2026 midterm elections.
Story Highlights
- Trump has signed off on a plan to oust Makary, though he has not yet formally dismissed him, and aides cautioned the president could still change his mind. CNN
- The White House is considering naming FDA Deputy Commissioner Kyle Diamantas as acting commissioner, while former FDA commissioners Stephen Hahn and Brett Giroir are among names under consideration as permanent nominees. U.S. News & World Report
- Makary’s exit would create another high-profile vacancy atop the health department, which already lacks a permanent CDC director and a surgeon general. Statnews
What Happened
Donald Trump has reportedly approved a plan to dismiss Marty Makary from his position as FDA commissioner, a role Makary has held since being confirmed by the Senate in March 2025. The Wall Street Journal first reported the plan, which was subsequently confirmed by Bloomberg, CNN, Reuters, and other major outlets citing administration insiders. The decision follows months of chaos at one of the country’s most important health agencies. Bloomberg
The move came after mounting criticism from Trump aides and outside allies over Makary’s management of the health agency, controversial drug approval decisions, and his handling of an effort to further restrict access to the abortion pill mifepristone. Social conservative groups had been particularly vocal, warning that the issue could motivate or suppress voter turnout in the upcoming midterms. CNN
Makary’s tenure was ambitious, marked by dozens of new initiatives including efforts to shorten drug review timelines, crack down on misleading pharmaceutical advertising, and pressure the food industry to remove artificial dyes from products. But several high-profile management failures undermined his standing inside the White House. Statnews
Trump was also angered by Makary’s handling of flavored e-cigarettes, a product Trump had pledged to protect during his 2024 campaign. The Wall Street Journal reported that Trump rebuked Makary over the weekend before news of his planned dismissal broke for not approving the products more quickly. U.S. News & World Report
While Makary retained a handful of strong allies at the White House, many aides grew increasingly dissatisfied with his management of the agency, viewing him as constantly generating controversy and distraction in a critical midterm year. CNN
Why It Matters
The FDA is one of the most consequential regulatory bodies in the federal government, responsible for overseeing the safety and approval of prescription drugs, vaccines, medical devices, and the nation’s food supply. Leadership instability at the agency carries real-world implications, including slower drug approvals, uncertainty for pharmaceutical developers, and diminished public confidence in the regulatory process.
The Supreme Court is expected to decide within days whether it will take up a Louisiana case arguing that mail orders of abortion pills undermine state laws banning abortion. Any FDA leadership transition at this moment creates additional legal and procedural uncertainty around an issue already at the center of the national political debate. CNN
Makary has divided the Make America Healthy Again coalition backed by HHS Secretary Robert F. Kennedy Jr. Some vaccine critics have lamented that Makary has not pulled COVID-19 vaccines from the market. Others, particularly those focused on food policy, praised him for removing artificial dyes and cracking down on ultraprocessed foods. His departure will force MAHA advocates to navigate yet another internal realignment over agency direction. CNN
The political dimension is significant. Anti-abortion groups, whose support was pivotal to Republican electoral strength, had been openly calling for Makary’s removal. Susan B. Anthony Pro-Life America President Marjorie Dannenfelser issued a statement days before the White House meeting calling for Makary’s immediate firing, citing “indifference” to pro-life voters’ expectations. CNN
Economic and Global Context
The FDA’s regulatory posture has direct consequences for the U.S. pharmaceutical and biotechnology sectors. Uncertainty about leadership typically causes short-term volatility in biotech stocks, as investors attempt to model how regulatory timelines and approval standards will shift under new management.
The agency under Kennedy and Makary has been mired in high-profile departures, feuds between top leaders, accusations of politicization, and persistently low morale. This institutional turbulence affects not only internal productivity but also the United States’ standing in international pharmaceutical development, where FDA approval remains the global gold standard and delays have cascading effects on drug availability worldwide. U.S. News & World Report
The departure of Makary also follows that of Dr. Vinay Prasad, the FDA’s top vaccine regulator, who left amid separate criticism over his leadership and vaccine policy. The FDA is still without a permanent replacement in that position, compounding the leadership void. For the pharmaceutical industry, this creates an environment where it is difficult to predict regulatory outcomes, deterring some investment in early-stage U.S. drug development. Statnews
International health regulatory bodies closely track FDA decisions and leadership. When the FDA undergoes rapid personnel changes, it can prompt foreign regulators to delay reciprocal approvals or increase independent scrutiny of American pharmaceutical submissions, adding cost and timeline burdens to multinational drug companies.
Implications
The most immediate consequence of Makary’s removal will be a transition period of regulatory uncertainty. If Kyle Diamantas is named acting commissioner, his primary background in food policy — not drugs or vaccines — may create a de facto slowdown in pharmaceutical review activity until a permanent nominee is confirmed by the Senate, a process that typically takes months.
For the MAHA movement, Makary’s exit presents an opportunity to install leadership more aligned with its most assertive positions on vaccines and food policy, but also risks deepening internal fractures over what that agenda should prioritize. Kennedy will face renewed scrutiny over his stewardship of the broader health department, which is increasingly characterized by vacancies and instability.
For Republican candidates in 2026, the Makary situation is a double-edged issue. Pro-life voters may reward the administration for responding to their pressure, while swing-district Republicans may face questions about the administration’s management of public health institutions, particularly given the ongoing measles outbreaks and pandemic-era memory still present among many voters.
The broader pattern — of Trump removing officials perceived as insufficiently loyal or politically inconvenient — reinforces a management style that creates short-term political wins but long-term institutional costs. At an agency charged with protecting public health, that calculation carries higher stakes than in most corners of the federal government.
