White House officials have approved a plan to remove Food and Drug Administration Commissioner Marty Makary from his post, capping months of friction between the agency chief and the administration over vaping policy, abortion-drug oversight, and the broader direction of federal health regulation, the Washington Post reported, citing two individuals who spoke on condition of anonymity to describe internal operations.
The move, if carried out, would mark one of the fastest commissioner departures in modern FDA history. Makary was confirmed to lead the agency only in March 2025 after President Trump nominated him in late 2024. His tenure has been defined less by the sweeping regulatory reform supporters hoped for than by internal clashes, industry complaints, and staff turnover that left the FDA rudderless on several high-profile fronts.
The decision was described as not yet final. But the White House's sign-off on the plan signals that Makary's standing inside the administration has deteriorated past the point of easy repair, and raises hard questions about who will step into one of the most consequential regulatory jobs in the federal government.
Newsmax, citing the Wall Street Journal, reported that Trump grew especially frustrated with Makary over delays involving flavored vaping products. Applications for fruit-flavored e-cigarettes, including those from the company Glas, sat without resolution, a sore point for an administration that had signaled openness to harm-reduction approaches in tobacco policy.
Vaping was not the only flashpoint. The Wall Street Journal's reporting tied the ouster plan to months of internal disputes over abortion drugs and what it called "the broader direction of federal health policy." For an agency that touches everything from drug approvals to food safety to pandemic preparedness, those are not small disagreements.
White House spokesman Kush Desai offered a statement that did not directly address Makary's future but praised the administration's personnel record in broad terms:
"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."
That kind of boilerplate, conspicuously silent on the commissioner himself, rarely signals confidence in a sitting official.
Makary's reported removal would fit a broader pattern of swift, decisive staffing changes across the executive branch. The administration has not hesitated to push out officials whose pace or priorities fell out of alignment with the president's agenda.
At the Pentagon, Defense Secretary Pete Hegseth forced Army Chief of Staff Randy George into immediate retirement as part of a sweeping military overhaul. That move drew both applause from reform advocates and sharp criticism from those who saw it as destabilizing.
Hegseth also ordered the removal of other senior military officials, part of a broader Pentagon shakeup that has reshaped the chain of command in ways not seen in decades. The FDA situation is different in substance, health regulation is not warfighting, but the management philosophy is the same: deliver results on the president's timeline or make room for someone who will.
Separately, even allies in conservative media have questioned whether the pace of firings risks creating institutional chaos. That tension, between the urgent need for accountability and the practical cost of constant turnover, is exactly the tension playing out at the FDA right now.
Makary arrived at the FDA with a strong résumé and genuine credibility among conservatives. A Johns Hopkins surgeon and public-health commentator, he had been one of the most prominent voices challenging pandemic-era orthodoxy on school closures, natural immunity, and regulatory overreach. His nomination was greeted as a signal that the FDA would finally get a leader willing to challenge the agency's institutional inertia.
But running a sprawling regulatory agency with roughly 18,000 employees is a different challenge from writing op-eds or appearing on cable news. The Washington Post's reporting describes "months of turmoil" without specifying every episode, but the Wall Street Journal's account fills in some of the gaps: clashes with White House officials, criticism from regulated industries, and internal turnover that sapped the agency's capacity to move on the administration's priorities.
The vaping file is instructive. The FDA has sat on applications from e-cigarette manufacturers for years, a carryover problem from the Biden era. Makary inherited a backlog, but the administration expected him to clear it. Instead, delays persisted. For a White House that views regulatory bottlenecks as a policy failure and a political liability, patience ran thin.
The abortion-drug dispute added another layer. The FDA's handling of mifepristone, the chemical abortion pill, has been a legal and political minefield for years. How Makary navigated that minefield apparently did not satisfy key players inside the West Wing.
Neither the Washington Post nor the Wall Street Journal reporting identifies a successor. That gap matters. The FDA commissioner oversees drug approvals, medical-device regulation, food safety, tobacco policy, and the agency's role in any future public-health emergency. A prolonged vacancy or an acting commissioner without Senate confirmation would leave the agency in limbo at a moment when the administration has ambitious deregulatory goals.
The White House has shown it can move fast on nominations when it wants to. Whether it has a replacement ready, or whether Makary's ouster becomes a drawn-out transition, will say a lot about how seriously the administration is treating the FDA's mission going forward.
There are also open questions the reporting does not answer. Has Makary been formally asked to resign, or is this still a plan awaiting execution? Did Makary have any opportunity to address the White House's concerns before the decision was made? And who, specifically, among White House officials drove the push to replace him?
The administration's willingness to act on personnel problems is, in principle, a strength. Voters sent Trump back to Washington in part because they were tired of watching federal agencies drift without direction or accountability. Senior White House officials have demonstrated a capacity for rapid, decisive action on other fronts when circumstances demand it.
But speed without stability carries its own risks. The FDA is not an agency that can run on autopilot. Every week it does not have a fully empowered, Senate-confirmed leader is a week that drug approvals, food-safety inspections, and regulatory reforms slow down or stall. The people who pay the price for that are not Beltway insiders, they are patients waiting on new treatments, farmers navigating food-safety rules, and small manufacturers trying to bring products to market.
Conservative critics of the FDA have spent years arguing that the agency is too slow, too risk-averse, and too captured by the industries it regulates. Makary was supposed to be the answer to those complaints. If he wasn't, the next commissioner needs to be, and needs to arrive with a clear mandate, a workable relationship with the West Wing, and the management chops to run an agency that has resisted reform for decades.
The administration has shown, across multiple agencies, that it will not tolerate officials who cannot or will not execute the president's agenda. That standard is fair. But the measure of success is not how many people you replace, it's whether the replacements deliver.
Accountability without follow-through is just churn. The FDA needs a leader, not another vacancy.
