Before he was pushed out as commissioner of the Food and Drug Administration, Dr. Marty Makary managed to alienate an impressively large and diverse array of interests.
Makary officially resigned Tuesday after leading the agency for only 13 months. President Trump reportedly approved a plan to fire him prior to that decision, though Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. made the final call to end his tenure. The move had been developing over several months.
Makary received a rare and amicable sendoff from Trump, whose chief of staff reportedly urged him to oust the FDA chief. Trump called Makary a “wonderful man” and shared on his Truth Social channel the resignation text message he sent the president on Tuesday. In it, Makary claimed that under his leadership, the FDA implemented 50 reforms, including reducing drug reviews from one year to no more than two months, new guidance for psychedelics, a “new plausible mechanism” pathway for rare disease drugs, and updated estrogen labels to provide women with truthful information about menopausal hormone replacement.
During Makary’s tenure, the FDA took action against food dyes by working with manufacturers of ultraprocessed foods to gradually eliminate artificial colors by 2027. The agency also ended blanket approval for the Covid-19 “vaccine,” restricting it to individuals over 65 years old—a move that sparked concern among members of Congress, who later grilled Kennedy during hearings.
Kennedy, Makary’s former boss, offered a complimentary sendoff on social media: “Marty, you took on entrenched interests, challenged the status quo, and never lost sight of the American people we serve,” he wrote. “You pushed forward critical reforms and helped advance our mission to Make America Healthy Again. I’m grateful for your courage and your friendship. Wishing you the very best in your next chapter.”
Despite this, the niceties ended quickly. Republican Missouri Senator Josh Hawley publicly celebrated Makary’s resignation on social media, labeling it “welcome news.” Hawley’s criticism reflected frustrations within the anti-abortion community, which accused Makary of attempting to place pro-abortion lawyers in key positions, slowing a critical review of the abortion drug mifepristone, approving an abortion drug with data showing 1 in 10 women are sent to emergency rooms, and freezing out prolife leaders while repeatedly stonewalling Congress.
Susan B. Anthony Pro-Life America President Marjorie Dannenfelser also expressed relief, stating earlier this month that Makary should be “fired immediately.”
Dr. Robert Malone, a prominent critic of the Medical Mafia during the pandemic, was another who turned on Makary. Malone previously served as vice chair of the Advisory Committee on Immunization Practices (ACIP), the federal committee responsible for vaccine recommendations. He resigned at the end of March.
In February, Malone publicly criticized Makary’s refusal to remove Covid “vaccines” from the market, calling him the obstacle to eliminating the jab. The MAHA coalition identified this as one of the biggest failures under Kennedy’s leadership in HHS. Later, Malone told a podcast that Makary was suppressing statistics about child deaths linked to the covid vaccine, expressing frustration over “the suppression of key findings such as pediatric deaths that are not being allowed to be released to the public.” When asked who was standing in the way, he identified Makary.
President Trump reportedly grew increasingly dissatisfied with Makary, complaining that the FDA chief had not worked hard enough to facilitate “Right to Try” legislation for terminally ill patients. Sources indicated Trump repeatedly brought up a cancer drug he claimed Makary would not approve.
Pharmaceutical industry insiders also sought Makary’s removal. Executives from Massachusetts-based Replimune Group recently met with Trump and raised concerns about his leadership, prompting calls for dismissal.
Vaping regulations became another major point of contention. Executive representatives from Reynolds American visited Trump on the golf course to complain about the FDA’s refusal to approve their products. An anonymous insider described Makary’s ousting as being “largely due to disagreements over the vape issue,” which they characterized as the final straw.
One final battle centered on flavored vapes, with advisers telling Trump these products were critical for retaining young MAGA voters. However, Makary had overruled scientific staff at the FDA to delay authorization of blueberry- and mango-flavored vapes from a U.S. manufacturer, citing public health risks.
Senior HHS officials also wanted Makary gone. An anonymous FDA staffer described him as someone “he will not be missed by a single career person” and who would only be regretted once the agency found someone worse.
Makary’s exit is part of an ongoing pattern at the agency, with several high-profile figures aligned with Kennedy recently leaving. These include HHS Deputy Secretary Jim O’Neill (who resigned in February); Dr. Ralph Abraham, who stepped down as principal deputy director of the Centers for Disease Control and Prevention (also in February); and former FDA Center for Biologics Evaluation and Research (CBER) director Dr. Vinay Prasad (who left in April).
Although Makary initially supported pandemic lockdowns and masking, he later turned against them after observing their economic and social harms. He also criticized the CDC for inflating covid death counts and the government’s forced vaccination efforts, though he did not oppose the vaccines themselves.
FDA Deputy Commissioner for Food Kyle Diamantas is now serving as acting commissioner while the agency searches for a permanent replacement. Kennedy praised Diamantas’ leadership, stating it “has already delivered remarkable wins on the MAHA food agenda.” Diamantas is a corporate lawyer by trade; unlike most FDA officials, he does not hold a medical degree.