Health Care

Marty Makary’s tenure as head of FDA ends with ‘difficulty’

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by Nathaniel Weixel and Joseph Choi - 05/12/26 6:03 PM ET

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by Nathaniel Weixel and Joseph Choi - 05/12/26 6:03 PM ET

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Food and Drug Administration (FDA) Commissioner Marty Makary stepped down on Tuesday, capping weeks of pressure and rumors that his job was in jeopardy.

The agency’s top food regulator, Kyle Diamantas, will take over, President Trump wrote on Truth Social.

Trump told reporters ahead of his trip to China on Tuesday that Makary had been “having some difficulty” in the role.

“Marty’s a terrific guy, but he’s going to go on and he’s going to lead a good life,” Trump said. “He was having some difficulty. You know, he’s a great doctor and he was having some difficulty.”

The Department of Health and Human Services (HHS) and the White House did not respond to requests for further comment, though the White House’s official rapid response account shared Makary’s resignation by text on the social media platform X.

“Dr. President Trump, Please accept my resignation, effective today,” Makary wrote.

“During my tenure, I announced 50 major FDA reforms. Joe Biden’s FDA had none. I’m extremely proud that we reduced drug review times from a year to 1-2 months, wrote new guidance to advance psychedelics, introduced a new ‘plausible mechanism’ pathway for rare disease drugs, and changed estrogen labels to tell women the truth about menopausal hormone replacement.”

Makary’s resignation comes on the heels of reports of internal tension between him and the White House.

Last week, FDA announced authorization of fruit-flavored electronic cigarettes for the first time, after months of pressure by Trump and the tobacco industry. Previously, the agency had only authorized tobacco or menthol flavors.

According to reporting by The Wall Street Journal, Makary tried to block agency scientists from authorizing the new products, but he was angrily reprimanded by Trump, who demanded he do it to appease young voters in the Make America Great Again movement.

Politico was the first to report Makary’s exit on Tuesday.

Sources who spoke with NewsNation said the FDA commissioner’s departure was in large part tied to his reticence to authorize the fruit-flavored e-cigarettes.

Trump during his campaign promised to “save vaping,” but the industry had been growing frustrated by the FDA’s inaction.

Tony Abboud, president of the Vapor Technology Association, said he thinks the president is now finally trying to fulfill that promise.

Abboud, whose organization donated more than $1 million to Trump’s inauguration, said he met with Makary last week to talk about a “predictable” regulatory framework for vaping products.

Abboud said while Makary seemed to be coming around, his efforts apparently were “too little, too late.”

Abboud said Makary generally seemed “very hostile to vaping products” and was “preoccupied” with the idea that there is a youth vaping epidemic tied to fruity flavors, even though 2024 federal data showed youth vaping dropped to its lowest level in a decade.

“As a result, he continued the policies of the previous administration, which were hostile to flavors,” Abboud said.

Democratic Sen. Dick Durbin (Ill.) commended Makary for standing up to Trump on e-cigarettes.

“I voted for Dr. Makary to head the FDA based upon his commitment to say ‘no’ if President Trump asked him to do something that would harm America. Dr. Makary kept his word,” Durbin said in a statement. “He resisted Trump’s plan to expose millions of children to the dangers of vaping.”

But the e-cigarette industry was far from the only constituency Makary angered.

When Trump first tapped Makary, the Johns Hopkins surgeon garnered some optimism among drug and biotechnology companies. But they quickly soured on him amid an FDA staff exodus, a string of controversial decisions and delays in novel drug approvals.

He also came under fire from anti-abortion advocates who accused him of dragging out an agency review of the abortion pill mifepristone.

It’s the latest shakeup at HHS, where the White House has elevated some more conventional staff over more controversial allies of Secretary Robert F. Kennedy Jr.

Makary’s exit leaves yet another vacant senior position in the health department, where there’s no permanent surgeon general or director of the Centers for Disease Control and Prevention.

Makary’s predecessor lamented that his exit is evidence of the ongoing chaos within the agency.

“I think the continued upheaval at FDA has been detrimental to the agency, not just the speculation about Marty’s