Marty Makary's Fatal Mistakes: WSJ Editorial Board Calls for FDA Chief's Ouster

The Wall Street Journal's Editorial Board is endorsing reports that President Trump plans to fire FDA Commissioner Marty Makary — and they're not being diplomatic about it. The board, which initially backed Makary's 2025 appointment with hopes he'd restore credibility to a Biden-damaged agency, now says his tenure has been a disaster for patients denied access to life-saving therapies.

The core indictment: Makary and his deputy Vinay Prasad overcorrected from Biden-era Covid vaccine overreach into a sweeping skepticism of drug approvals that is now costing lives. While their criticism of rushed Covid vaccine approvals for children — based on antibody studies with little safety follow-up — had merit, they applied that same extreme scrutiny to treatments for deadly diseases. They demanded large randomized controlled trials for debilitating conditions, a standard that could take years to meet, during which patients deteriorate and die.

The board calls out the ethical contradiction directly: it's wrong to give placebo treatments to patients with fatal diseases when a drug has already shown early-stage promise. This stance, they argue, directly contradicts Trump's first-term "right to try" philosophy. Worse, Makary repeatedly moved goalposts — approving clinical trial protocols only to later reject drugs because the methodology was no longer deemed sufficient. The board asks the obvious question: why would a company spend hundreds of millions on a trial if the FDA might simply change the rules afterward?

The personal conduct allegations are sharp. The board says Makary made false statements in TV interviews about rejected drugs and — citing sources — misled a Republican senator about a rare disease drug rejection. When rejections drew fire, his political dodge was to attack Big Pharma rather than engage with patients and doctors pleading for approvals. Meanwhile, Prasad reportedly overruled career staff who supported approvals, then Makary blamed those same career staff for the rejections.

The editorial's conclusion is unsparing: Makary presided over a "toxic culture" that drove out scientists who didn't share Prasad's mission of restricting drug access based on his personal cost-benefit judgments — the same paternalism, the board writes, that destroyed public trust in Biden's vaccine policies. Whoever replaces him, the board says, should start by reversing the agency's "arbitrary and callous" rejections of rare disease and cancer treatments.