Trump Approves Plan to Oust FDA Chief Makary Amid Vaping, Drug and Abortion Disputes

President Donald Trump has signed off on a plan to fire Food and Drug Administration Commissioner Marty Makary, according to multiple reports citing administration officials and people familiar with the matter. The move, first reported by The Wall Street Journal and corroborated by CNN and others, caps months of internal friction over flavored nicotine products, the abortion medication mifepristone, and a string of drug approval decisions that frustrated biotech companies and conservative allies.

Makary, a Johns Hopkins surgeon who gained prominence during the COVID-19 pandemic for criticizing public health orthodoxy, was confirmed to lead the FDA in March 2025. He arrived as an ally of the Make America Healthy Again movement led by Health Secretary Robert F. Kennedy Jr., promising to restore what he called “gold standard science,” reduce regulatory capture by pharmaceutical interests, and improve the nation’s food supply. In a recent interview with The Daily Wire, Makary said the agency was “taking politics out of the process” and had launched a detailed safety study of mifepristone, the medication used in the majority of U.S. abortions. He positioned himself as someone willing to challenge both Big Pharma and entrenched bureaucratic habits.

Yet those efforts placed him at odds with key factions in the Trump orbit. The most immediate trigger appears to have been Makary’s reluctance to greenlight fruit-flavored vaping products from the manufacturer Glas. In February he blocked blueberry, mango, and similar varieties, citing evidence that sweet and fruity flavors drive uptake among teenagers and underage users. That stance collided with Trump’s campaign pledge to “save vaping” and his interest in regaining ground with young voters. Recent polls show Trump’s approval among Gen Z voters has collapsed to 24 percent, erasing gains from the 2024 election. After White House pressure, the FDA ultimately approved the products.

The vaping dispute was not isolated. Anti-abortion groups have lobbied aggressively for Makary’s removal since he allowed the approval of a generic version of mifepristone, which lowers the cost and could expand access in states where surgical abortion is heavily restricted. Marjorie Dannenfelser, president of Susan B. Anthony Pro-Life America, called the decision “reckless” and “unconscionable,” arguing it undermined state pro-life laws and endangered young women. Those groups are scheduled to meet with senior White House officials this week. Former Senator Rick Santorum has also criticized Makary for personnel decisions he said left the agency in the hands of “anti-Trump leftists.”

Biotech industry voices have voiced parallel complaints. Makary’s team rejected several new drug applications, prompting warnings that the uncertainty was driving innovation overseas and harming patients waiting for therapies. Pharmaceutical executives and conservative lobbyists who once welcomed a Trump-appointed FDA now see Makary as an obstacle to faster approvals and a friendlier regulatory climate.

The convergence of these grievances, spanning youth nicotine policy, reproductive medicine, and pharmaceutical innovation, reveals the tightrope the administration is attempting to walk. On one side stands the MAHA vision of skepticism toward processed foods, chronic-disease drivers, and over-medicalization. On the other are political debts to the tobacco-vaping sector, the anti-abortion movement, and an industry eager for lighter oversight. Makary tried to serve both impulses and ultimately satisfied neither.

His high public profile, frequent media appearances, and willingness to discuss agency morale after significant staff departures also appear to have irritated some in the White House. Trump himself has not commented publicly on Makary’s status, and officials caution that the president’s decisions can shift. Makary has previously managed to talk his way out of earlier ouster attempts.

The impending change comes at a moment when public trust in American health institutions remains near historic lows. The FDA’s decisions on everything from vaccine schedules to food additives to drug pricing carry immediate consequences for millions of people. Removing a commissioner who, whatever his flaws, was attempting to reassert evidence-based processes risks deepening the very politicization Makary claimed to oppose.

White House spokesman Kush Desai offered the standard defense: “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.” The statement does little to clarify what victory looks like on vaping regulation, where the tension between adult choice and protecting adolescent brains has long bedeviled regulators of both parties. Nor does it address the data showing rising vaping rates among high school students after flavored products returned to the market.

Makary’s departure would represent the latest high-profile turnover in federal health agencies under Trump. It also signals that even figures aligned with the MAHA worldview can be sidelined when they prioritize long-term public health data over short-term political deliverables. The administration must now find a successor who can navigate the competing demands of youth protection, reproductive policy, pharmaceutical innovation, and the restoration of institutional credibility, all while the president’s own approval with younger Americans continues to sag.

How that successor balances those pressures will shape not only the FDA’s immediate agenda but the country’s broader capacity to make credible, science-driven decisions in an era when skepticism of expertise runs deep. For now, the agency enters another period of uncertainty, with a commissioner effectively on notice and the policy fights that felled him still unresolved.