FDA chief to depart after Trump signed off on ousting him

By Kaitlan Collins, Ben Tinker, Adam Cancryn, Sarah Owermohle, CNN

(CNN) — Food and Drug Administration Commissioner Marty Makary is leaving the Trump administration, according to three people familiar with the situation, after President Donald Trump signed off on a plan to fire him last week.

The FDA chief had come under intense and sustained pressure from within the administration — including over his resistance to approving the sale of flavored e-cigarettes, an episode that prompted Trump to confront him directly — and from outside allies, including in the pharmaceutical industry and anti-abortion interest groups. And he oversaw constant turnover within the agency’s senior ranks.

Trump is expected to appoint Kyle Diamantas, a deputy commissioner who heads the agency’s food program, as acting FDA chief, according to two people familiar with the decision. Trump later confirmed that Makary was leaving and that he had tapped Diamantas in a Truth Social post.

Still, Makary’s resignation means Trump will now need to fill yet another vacancy — the eventual permanent pick requires Senate confirmation — in the top ranks of the US Health and Human Services Department. The administration already lacks a permanent leader atop the Centers for Disease Control and Prevention and a permanent surgeon general, who traditionally serves as the nation’s top doctor.

A source familiar with Makary’s departure said it was largely due to disagreements over the vape issue. “He doesn’t want to approve youth-appealing flavors, but has been forced to by the powers that be,” the person said.

Makary’s departure comes one day before he was set to testify about the FDA’s proposed budget before the Senate Appropriations Committee.

Politico first reported his resignation.

A push to oust Makary had accelerated in recent days, driven by a faction of White House and HHS officials who had soured on an FDA that had been marked by constant chaos, internal clashes and policy confusion, people familiar with the matter said.

Makary over the last week sought to shore up his standing with Trump, telling associates at some points that he believed the president still retained confidence in him.

So it caught Makary and his allies by surprise when several reports surfaced Friday that Trump had approved a plan to fire him. That prompted widespread speculation within the administration over who was behind the push, as well as when and whether Trump would make his removal official.

Despite the widespread dissatisfaction with Makary’s performance, some Trump aides had argued that ousting yet another senior health official would amount to a political misstep — further angering a portion of the administration’s “Make America Healthy Again” base. It would also create another high-level vacancy, forcing the Senate to devote precious floor time to confirming a replacement ahead of the midterms.

Others within the White House and HHS, however, saw Makary’s departure as inevitable. And they welcomed the opportunity to reset leadership at the FDA and shore up relationships with key constituencies in the anti-abortion movement and drug industry before November.

In addition to Makary’s planned ouster, White House and HHS officials were also weighing a restructuring of the agency’s senior staff.

Makary, a surgeon and author, had pledged to accelerate FDA decisions on drugs, devices and vaccines following his confirmation in March 2025. But he frequently found himself mired in controversy over the subsequent year — both from pharmaceutical companies unhappy with his management of the drug approval process and administration officials who questioned his handling of other areas of FDA’s sweeping portfolio, including tobacco regulation.

In a recent flashpoint that renewed talk among Trump and his advisers about firing Makary, the FDA chief resisted internal efforts to approve the sale of fruit-flavored e-cigarettes. The issue prompted an angry Trump to directly press Makary over vapes decisions, two people familiar with the episode said. The FDA subsequently reversed course on flavored e-cigarettes last week.

And in another major episode, Susan B. Anthony Pro-Life America President Marjorie Dannenfelser — a significant figure in anti-abortion efforts — met with White House officials on Friday, pushing for the FDA to reverse regulations that allow providers to send the abortion pill mifepristone through the mail.

Such a move would have repercussions across the country for abortion access, as the FDA sets the nationwide rules for prescribing the drug. Medication abortion now accounts for roughly two-thirds of all US abortions and has helped fuel an overall increase in the procedure since the Supreme Court ended nationwide protections in 2022.

Social conservatives had warned for months that it could be a motivating issue in the upcoming midterm elections, and the Supreme Court is signaling it could take up the issue. But activists had long argued that part of the blame rested on Makary.

“FDA Commissioner Makary should be fired immediately,” Dannenfelser said in a statement days before the White House meeting. “Indifference is completely unacceptable to millions of pro-life voters expecting the administration to act to save lives.”

The FDA commissioner has also divided the “Make America Healthy Again” coalition sparked by Health and Human Services Secretary Robert F. Kennedy Jr. Some vaccine critics have lamented that Makary has not pulled Covid-19 vaccines off the market. Others, advocating for improved food policies, have praised him for taking steps to remove artificial food dyes and crack down on ultraprocessed foods.

This story has been updated with additional reporting.

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CNN’s Kit Maher contributed to this report.