President Donald Trump is considering firing Dr. Marty Makary after simmering frustration with his performance as Food and Drug Administration commissioner, though he has not made a final decision, according to a source familiar with the matter.
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Makary’s tenure as FDA chief has been marked by months of upheaval at the agency, including unexpected drug rejections, staff departures and mounting pressure on the agency to act on abortion pills.
The president could always change his mind, the source cautioned.
“President Trump has assembled the most experienced and talented administration in history, an administration that continues to focus on delivering more historic victories for the American people,” said White House spokesman Kush Desai.
Makary, a former John Hopkins surgeon, was confirmed as FDA commissioner in March 2025.
He was seen as an ally to Health Secretary Robert F. Kennedy Jr., sharing skepticism of the Biden administration’s Covid response and embracing the “Make America Healthy Again” movement. Within months of Makary’s appointment, the FDA announced an initiative to phase out artificial dyes from the nation’s food supply and Makary helped implement a stricter framework for approving Covid shots.
But frustration with the FDA had been building on Capitol Hill in recent months.
Makary had yet to release a promised safety review of the abortion pill mifepristone, something he told Republican senators he would pursue during his confirmation process last year. More than a year later, no review has been released. In December, Bloomberg News reported that Makary had told officials to delay releasing the review until after the midterm elections. The debate over abortion pills has intensified ahead of the election, with anti-abortion advocates pressuring the FDA to reinstate its in-person dispensing requirement.
The FDA under Makary has also faced blowback for the agency’s rejection of rare-disease drugs.
Earlier this year, the agency decided not to review an application for a gene therapy to treat Huntington’s disease developed by drugmaker UniQure. The decision led to outrage, including from Republicans, and ultimately led to the second ouster of Dr. Vinay Prasad, who led the office responsible for the drug. (Prasad was also briefly forced out last year after the FDA’s decision to pause shipments of a gene therapy for Duchenne muscular dystrophy, a neuromuscular disorder. He returned two weeks later.)
The FDA also declined to review Moderna’s application for an mRNA flu vaccine — but reversed its decision about a week later.
The Wall Street Journal reported Tuesday that Trump was frustrated with Makary for not moving quickly enough to approve flavored vapes and nicotine products. During his 2024 presidential election campaign, Trump had vowed to “save” vaping.
On Tuesday, the FDA announced its first authorization of fruit-flavored vapes — a move opposed by health groups and parent organizations that argue the flavors are a driver of underage vaping.
