The Trump administration continues to lose pieces at the top of American federal institutions. After the exits of the last few months, from the Minister of Internal Security Kristi Noem to the Attorney General Pam Bondi up to the Secretary of the Navy John Phelan, Marty Makary, head of the Food and Drug Administration (Fda), the agency that regulates drugs, vaccines, medical devices and tobacco products in the United States, is now also leaving.
Trump’s comment and the “clash” over electronic cigarettes
Donald Trump himself confirmed the farewell when speaking to journalists at the White House. “He was having some difficulties,” said the American president, explaining that the leadership of the FDA will be temporarily entrusted to a deputy pending the appointment of a stable successor. Trump, however, defined Makary as “a great doctor” and “a friend”, without clarifying whether it was a voluntary resignation or a decisive departure from the White House.
British-American surgeon and former professor at Johns Hopkins University in Baltimore, Makary had been chosen by Trump in 2025 as one of the faces of the new Republican health policy together with Health Secretary Robert F. Kennedy Jr. In recent months, however, his relationship with the administration has progressively deteriorated.
One of the main points of friction was flavored e-cigarettes. According to the Wall Street Journal, Makary had held back the approval of new fruit-flavored vapes, despite the technical green light from the FDA’s own experts. A position that clashed with Trump’s overtures towards the sector. Health associations have long called for severe restrictions on flavored e-cigarettes, accused of attracting mainly teenagers and young consumers.
The controversies over abortion and the failure to approve drugs
The controversy over medical abortion also exacerbated the climate. The recent authorization by the FDA of a generic version of the abortion pill mifepristone had provoked the anger of conservative anti-abortion movements, who had openly called for the commissioner’s removal.
Makary had also attracted criticism from the pharmaceutical industry for a series of rejections of new medicines, especially in the field of cancer treatments and rare diseases. Decisions considered too rigid by several companies in the sector.
During the Covid pandemic, the doctor became known in the United States for his critical positions towards some federal health strategies and for his skepticism about part of the vaccination policies adopted by the Biden administration.
His exit is part of a phase of strong instability at the top of American healthcare. In recent months, Deputy Health Secretary Jim O’Neill and Susan Monarez, former director of the Centers for Disease Control and Prevention (CDC), had also left their positions. A sign of the internal tensions running through Trump’s team on issues such as vaccines, healthcare regulation and the pharmaceutical industry.