Nathaniel Weixel, The Hill, May 14, 2026
But the next head of the agency will have to navigate many of the same headwinds — political interference, funding cuts and balancing the demands of the “Make America Healthy Again” (MAHA) movement with the MAGA White House — that Makary faced.
Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. is pushing untested peptides with virtually no restrictions. Anti-abortion leaders and lawmakers want the agency to restrict access to the abortion pill mifepristone.
And after meeting with executives from Reynolds American, President Trump reportedly pressed Makary to approve flavored electronic cigarettes.
The next commissioner will inherit an FDA that’s viewed as less trustworthy and more politicized than it has been in any previous administration.
Lawrence O. Gostin, a professor at Georgetown University Law Center, said Makary did not push back against political interference from the White House or Kennedy, and that at times, he actively undermined the agency’s scientific integrity.
“The problem at FDA is not just one commissioner or one controversy. It’s the growing perception that scientific expertise is being subordinated to politics, instability and ideology,” Gostin said.
“While there have been periods of trust gaps with other agencies at HHS, the FDA is the oldest scientific agency. It’s the most revered and venerable, and yet there is profoundly eroding public trust in the institution,” and that’s a problem, Gostin said.
In a Tuesday post on social media, Kennedy said the search for a new agency head is underway “with urgency.”
“We have an outstanding team at FDA, and the work continues without pause,” Kennedy wrote.
The FDA has for decades been seen as a nonpartisan, often wonky part of the administration. Commissioners have largely been medical or scientific bureaucrats with experience running large organizations.
But with the Trump administration’s embrace of top-down governing, the worry among the public health community is that the next commissioner will be even more susceptible to pressure.
“Our concern is that although Marty Makary really did offend just about everybody, the reason why he lost his job seems to have been focused on a few decisions,” said Diana Zuckerman, president of the National Center for Health Research.
Public health leaders want to see “a more scientific-based, evidence-based FDA, and not one that has to change according to the whims of political appointees and also perhaps donors and friends of the White House,” Zuckerman said.
Makary fashioned himself as a MAHA champion. He criticized the Biden administration’s COVID-19 response and promoted the FDA’s work in getting companies to remove food dyes.
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But MAHA activists have increasingly found themselves at odds with the Trump administration.
Trump sided with major agricultural corporations over Kennedy and MAHA regarding expanded production of a weedkiller.
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Experts and analysts said navigating the administration’s inherent contradictions between the populist MAHA and mainstream industry groups will be a key challenge for the next FDA commissioner.
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Makary’s departure Tuesday was linked primarily to his reluctance to approve flavored e-cigarettes.
But before he resigned, Makary cleared mango and blueberry flavored e-cigarettes for marketing, reversing his previous decision to override agency scientists who were recommending approval.
Then, in what some anti-tobacco advocates described as a last-ditch attempt to save Makary’s job, the FDA published a final guidance that essentially allows the sale of e-cigarettes and nicotine pouches that haven’t been approved, so long as they’ve crossed certain regulatory hurdles.
“There’s always been White House interest in tobacco issues across administrations. That is not inherently new, but interest isn’t the same as interference,” said Brian King, a former FDA tobacco chief and vice president at the Campaign for Tobacco-Free Kids.
“What’s different here is that you actually have pressure to influence agency decisionmaking, which has occurred following sizable political donations and closed-door meetings between the tobacco industry and the administration.”