- Food and Drug Administration Commissioner Marty Makary resigned on Tuesday, President Donald Trump said.
- FDA Deputy Commissioner Kyle Diamantas was named acting commissioner, according to two sources.
- A source familiar with Makary said a dispute over fruit-flavored vapes was what drove him to resign.
WASHINGTON — U.S. Food and Drug Administration Commissioner Marty Makary has resigned, President Donald Trump said on Tuesday, after weeks of clashing with top White House and health advisers and drawing scrutiny for a series of controversial agency decisions, according to several people familiar with internal dynamics.
Food and Drug Administration Deputy Commissioner for Food Kyle Diamantas will lead the agency in an acting capacity, according to two sources familiar with the situation. Politico first reported the development.
"Marty is a terrific guy, but he's going to go on and he's going to lead a good life. He was having some difficulty," Trump told reporters. "The assistant, the deputy, is taking over temporarily until we find someone."
Makary's departure follows weeks of intensifying pressure from powerful Republicans, anti-abortion groups, and The Wall Street Journal editorial board, all while he clashed with top officials at the White House and Department of Health and Human Services, according to multiple sources.
On Friday, Reuters and other outlets reported that Trump had signed off on a plan to fire him. Trump had rebuked Makary earlier this month for not moving quickly to approve flavored vapes and nicotine products, two people familiar with the conversation said. The FDA approved them days later.
A source familiar with Makary's thinking said that was what drove him to resign.
"It really came down to the fruit-flavored vapes issue," the source said. "He is at peace with the decision. He is a principled guy, didn't want to sign off on something he doesn't believe in."
The White House has not yet found someone to replace Makary on a permanent basis, according to three of the sources. That, in large part, had delayed White House plans to fire Makary on Friday, they said.
Makary's exit simultaneously leaves the United States without a permanent head of the FDA or the Centers for Disease Control and Prevention, and leaders at other public health agencies.
Mounting pressure on Makary
Makary was criticized for actions including his handling of reintroducing flavored vapes into the market, a stalled abortion-pill review and public disagreements with drugmakers over reviews of potentially lifesaving medicines and vaccines.
The Journal's editorial page has featured at least half a dozen op-eds blasting Makary for controversial drug rejections, including, most recently, a cancer drug from Replimune, and calling for his ouster.
Makary, a Johns Hopkins University School of Medicine surgical oncologist who criticized vaccine mandates during the COVID-19 pandemic, was confirmed by the Senate as FDA commissioner last March.
He oversaw a sharply smaller agency as thousands of employees were forced out. The FDA had five different vaccine chiefs in the span of a year, including one who was fired, hired back a month later, then left again less than a year after that.
A growing number of top Trump advisers had grown frustrated with Makary's tumultuous tenure at the agency, the public criticism and negative news cycles about its decision-making under his leadership, and several advisers have clashed with him personally, said the people familiar with internal dynamics.
Searching for a candidate
The White House has exerted more control over the health agency in recent months and has sought more conventional candidates for top health jobs that require Senate confirmation.
Among those under consideration are former FDA Commissioner Steve Hahn and former acting commissioner and Assistant Health Secretary Brett Giroir, according to three sources.
Finding such candidates has often proven difficult, including in the search for an FDA head, as many are wary of working under Health Secretary Robert F. Kennedy Jr., who has espoused views, particularly on vaccines, that contradict scientific evidence. They would also be leading the agency after the staffing cuts and departures, the people said.
Trump allies, supporters of Kennedy's Make America Health Again movement, conservative media, pharmaceutical companies, and anti-abortion groups have all taken public shots at Makary over the past few weeks.
One Wall Street Journal op-ed asked whether any administration official had created more headaches for Trump than Makary, citing the FDA's two rejections of Replimune's melanoma therapy.
Flavored vapes controversy
Makary's handling of flavored e-cigarettes drew Trump's ire as the president had pledged to protect the product during his 2024 campaign.
Regulators had avoided granting licenses to vapes due to concern over their youth appeal with fruit and candy flavors, and demanded evidence that the products could help smokers quit.
A few days after authorizing the first fruit-flavored e-cigarettes in the United States, the FDA said it would ease its crackdown on some unauthorized vapes under review.
Tobacco companies have been lobbying Trump and administration officials for changes, including a faster, clearer FDA authorization process for the products.
Contributing: Gram Slattery, Daphne Psaledakis and Bhargav Acharya
