FDA commissioner Makary resigns amid White House pressure and flavoured vape dispute

Marty Makary has resigned as commissioner of the US Food and Drug Administration after months of internal turmoil, with White House staff having signed off on a plan to replace him last week.

President Donald Trump announced on Truth Social that Kyle Diamantas, who oversees the FDA's food programme and was recently elevated to serve as a senior counsellor to Health Secretary Robert F. Kennedy Jr., would serve as acting commissioner. A broader shake-up of the agency's senior leadership is expected in the coming days, with several officials set to depart or be reassigned, according to people familiar with the matter.

Makary's departure was precipitated in part by a clash over flavoured vapes. He had raised concerns about their appeal to young people, but the FDA last week authorised the first fruit-flavoured vaping products for adults aged 21 and over, in line with Trump's previous pledges to protect the vaping industry. Allies of Makary characterised his exit as a matter of principle.

Kennedy had also grown frustrated with Makary's leadership, the people said. Makary, a Johns Hopkins surgeon and former Fox News contributor who rose to prominence criticising the medical establishment during the Covid-19 pandemic, had no prior senior government experience before being confirmed to lead the FDA in March 2025 in a 56-44 Senate vote.

During his tenure he drew criticism from pharmaceutical groups, anti-abortion advocates frustrated by the agency's handling of the abortion pill mifepristone, and former FDA commissioners alarmed by proposals to tighten vaccine approvals. He dismissed such criticism as "corporate spin."

Diamantas is regarded within the agency as a relatively uncontroversial interim choice. A former partner at law firm Jones Day, he joined the FDA last year and has cultivated relationships across the Department of Health and Human Services, the MAHA movement and career agency staff.

Makary's exit is the latest in a series of personnel upheavals across HHS, where some of Kennedy's initial picks have been replaced by officials with more conventional regulatory backgrounds. Trump said he was searching for a new permanent commissioner, describing Makary as "a terrific guy" while declining to say whether he had resigned or been dismissed.