Dr. Marty Makary has resigned as FDA commissioner after 13 months, with President Trump naming Kyle Diamantas as acting successor. The departure follows policy disputes over flavored vaping products and mifepristone, alongside reported leadership tensions and agency dysfunction.
Makary's Departure and Successor
Dr. Marty Makary announced his resignation as commissioner of the Food and Drug Administration (FDA) on May 13, 2025, following 13 months in the role. President Donald Trump confirmed the departure in a Tuesday press briefing, stating that Makary’s deputy, Kyle Diamantas, would serve as acting commissioner. The resignation comes amid reported internal disagreements over key policy decisions, including the approval of flavored vaping products and the FDA’s handling of the abortion pill mifepristone.
Makary, a surgical oncologist and former Johns Hopkins professor, was confirmed by the U.S. Senate in March 2025 with bipartisan support. His tenure was marked by conflicts with administration priorities, including delays in approving flavored vaping products and the FDA’s continued allowance of mail-order mifepristone, which remains accessible in states with abortion restrictions. Multiple sources reported that Trump had signed off on plans to remove Makary before the resignation was announced.
Leadership Transition and Immediate Aftermath
Trump described Makary as a "great guy" and "friend" during a Tuesday press conference, though he declined to detail the circumstances of his departure. "He’s going to go on and he’s going to lead a good life," Trump said. Diamantas, the FDA’s deputy commissioner for food, will assume the acting commissioner role. Makary was scheduled to testify before the Senate Appropriations Committee on May 14 but will be replaced by Diamantas.
Policy Disputes and External Pressure
The resignation follows months of reported tension between Makary and administration officials over several high-profile issues:
Flavored Vaping Products: The FDA approved fruit-flavored e-cigarettes for adults 21 and older on May 13, a move Trump had reportedly pressured Makary to expedite. The Wall Street Journal previously reported that Trump criticized Makary for slow-walking the approval of flavored vapes, which the administration viewed as a key policy initiative.
Abortion Pill Regulation: Anti-abortion advocacy groups, including Susan B. Anthony Pro-Life America, had called for Makary’s removal over the FDA’s refusal to reinstate in-person dispensing requirements for mifepristone. The FDA removed this requirement in 2023 under the Biden administration, allowing the medication to be mailed to states with abortion restrictions. Makary’s successor will inherit this ongoing review.
Drug Approval Delays: Reports indicated that Makary faced criticism for increasing drug rejections and missing application review deadlines, with some conservatives arguing the FDA was obstructing Trump’s healthcare agenda. The agency’s approval rate for new drugs dropped by 14% in 2025, according to one source.
Internal Agency Impact
Makary’s tenure was characterized by internal turmoil, including layoffs and departures of career scientists. Dr. Richard Pazdur, a longtime cancer regulator, cited Makary’s leadership as a factor in his departure. Staff morale at the FDA reportedly declined during this period, with some officials describing the agency as dysfunctional.
Makary highlighted his accomplishments in a statement, including the launch of a priority voucher program aimed at accelerating drug reviews. However, his critics argued that the program had not sufficiently addressed backlogs or streamlined approvals.
Next Steps and Political Implications
The FDA’s future direction under Diamantas remains uncertain, particularly regarding the agency’s approach to vaping regulations, abortion-related medications, and drug approval timelines. The resignation also underscores broader tensions within the Department of Health and Human Services, where other Trump-appointed officials, such as vaccine chief Vinay Prasad, have recently departed.
Makary’s exit comes as the administration seeks to reshape healthcare policy ahead of the midterm elections, with GOP advisers pushing to align the FDA’s agenda with Trump’s campaign promises. The agency’s handling of these contentious issues will likely remain a focal point in political and public health debates.