Dr. Marty Makary resigned as Commissioner of the Food and Drug Administration on Tuesday, May 12, becoming the fourth high-profile departure from President Donald Trump’s administration this year amid a cascade of internal policy disputes, leadership turmoil, and external political pressure.
Trump confirmed the resignation while speaking to reporters before departing for his state visit to China, saying of Makary: “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.”
Kyle Diamantas, the FDA’s top food regulator and a lawyer without a medical degree, will take over as acting commissioner and is expected to testify before Congress on Wednesday in Makary’s place.
Health and Human Services Secretary Robert F. Kennedy Jr. made the decision to replace Makary, according to a senior administration official, who said the resignation followed a buildup of many problems rather than any single decisive incident.
One of the most acute flashpoints was an e-cigarette dispute: on May 6, the FDA approved flavoured vapes from Glas Inc., a decision that reportedly came only after Trump pressured Makary to authorise the fruit-flavoured products, which Makary had been refusing to approve, according to The Wall Street Journal.
Makary also faced sustained pressure from conservative and anti-abortion groups over the FDA’s handling of the abortion pill mifepristone, with organisations including Susan B. Anthony Pro-Life America calling for his removal after he reportedly slow-walked a safety review of the drug that RFK Jr. had requested last June.
His tenure was also characterised by internal dysfunction at the FDA, with political appointees taking over what have traditionally been career leadership positions running major drug and biologics review centres, a trend that former FDA Commissioner Scott Gottlieb described as having taken a cumulative toll on the agency.
Vaccines chief Vinay Prasad, an ally of Makary, also departed the agency recently, further hollowing out the senior leadership team at a time when the FDA faces the hantavirus outbreak monitoring effort and ongoing regulatory negotiations with the pharmaceutical industry over user fee reauthorisation.
The resignation is the fourth major departure from Trump’s cabinet this year, following former Homeland Security Secretary Kristi Noem, former Attorney General Pam Bondi, and former Labour Secretary Lori Chavez-DeRemer, who resigned amid a misconduct probe in April.
Makary, a British-American surgical oncologist and professor emeritus at Johns Hopkins, was confirmed to lead the FDA in March 2025 and had been a prominent critic of the federal government’s handling of the COVID-19 pandemic before taking the role.
