Trump Signs Off on Plan to Fire FDA Commissioner Marty Makary Amid Clashes Over Vaping, Abortion, and Drug Policy

President Trump has approved a plan to fire FDA Commissioner Marty Makary, the former Johns Hopkins surgeon who rose to prominence as a Make America Healthy Again surrogate on cable news. Makary's 18-month tenure has been marked by internal turmoil, frequent clashes with Health and Human Services Secretary Robert F. Kennedy Jr. and other administration officials, and mounting complaints from the pharmaceutical and biotech industries. The firing would make Makary the latest high-level casualty under Kennedy, following the ouster of CDC Director Susan Monarez last summer and HHS Deputy Secretary Jim O'Neill in February.

The decision to remove Makary stems from multiple friction points. Most recently, Trump became frustrated with Makary for moving too slowly on approving flavored vape products—after initially refusing to authorize blueberry and mango flavors from Los Angeles manufacturer Glas in February over youth vaping concerns, Makary reversed course under White House pressure. Beyond vaping, he's drawn fire from antiabortion activists (particularly Marjorie Dannenfelser of Susan B. Anthony Pro-Life America) over his handling of the generic abortion pill, and from biotech companies and rare-disease advocates who say his aggressive regulatory approach has stifled innovation and harmed patients. Administration insiders view him as operating as a "rogue agent," and Kennedy had even considered replacing him while keeping him as a figurehead.

Makary's downfall is particularly striking given his initial appeal to Trump and the MAHA movement. He was tapped for the FDA post in November 2024 after bonding with Kennedy and other health influencers at Mehmet Oz's oceanfront Florida mansion, and Kennedy publicly described him as a trusted "friend." But his tenure has been plagued by the aftereffects of Department of Government Efficiency layoffs, rapid leadership turnover, and Makary's reported reliance on a small inner circle of advisers as he searched for quick "wins" to tout to the White House. One rare-disease advocate and former senator, Rick Santorum, claimed Makary "immediately fired the best leaders at the FDA" and replaced them with what he called "anti-Trump leftists," though supporters defend him as bringing "actual scientific scrutiny" to the agency. Trump's plan is not yet finalized and could theoretically change, though the direction is clear.