Marty Makary, the head of the United States Food and Drug Administration (FDA), has resigned after just 13 months in the role, following mounting pressure from industry figures, conservative activists, and the Trump administration itself. President Donald Trump confirmed the departure on Tuesday, saying Makary "was having some difficulty" but would "move on and have a good life." Kyle Diamantas, the FDA's top food official and a lawyer with reported personal ties to Donald Trump Jr., will take over on an acting basis.
Makary, a surgeon and former Fox News analyst who rose to prominence in Trump circles as a vocal critic of COVID-era public health measures, found himself at odds with a remarkably broad coalition of detractors. His most immediate flashpoint was his reluctance to approve flavoured e-cigarettes. Vaping industry executives complained directly to President Trump that Makary was blocking authorisation of their products, leading to direct presidential pressure on the FDA chief to green-light them. He also drew fire from anti-abortion groups, who accused him of moving too slowly on an internal safety review of mifepristone — a drug approved in the United States for roughly 25 years and used to terminate pregnancies — and from conservative activists seeking to end rules allowing the medication to be distributed by mail.
His tenure was also marked by friction with pharmaceutical companies. More than six manufacturers developing treatments for rare or serious diseases reported receiving rejection letters or demands for additional studies on drugs that had previously received technical approval from FDA experts before Makary's arrival. A sharp rise in staff layoffs and departures added to internal turbulence, with the majority of the agency's senior career officials leaving through resignation, retirement, or dismissal during the first year of Trump's second term.
The resignation is seen as a further setback for the broader health agenda being pursued under Health Secretary Robert F. Kennedy Jr., whose stewardship of the US health bureaucracy has itself been deeply controversial. Makary's departure underscores the difficulty of navigating competing political demands within an agency that must balance commercial pressures, public health responsibilities, and ideological expectations from the administration it serves. With Diamantas stepping in temporarily, the question of who will lead the FDA on a permanent basis — and under what priorities — remains unresolved.