Marty Makary’s forced exit from the Food and Drug Administration is not just another personality drama in Washington; it is a symptom of a deeper, structural problem.
Under HHS Secretary Robert F. Kennedy Jr. typically apolitical scientific institutions have become revolving doors with unqualified appointees, who, when they do decide to stand for something, are unceremoniously ousted.
The final straw? It is rumored that Makary disagreed with the FDA approving fruit flavored tobacco products often marketed to children and relaxing review processes on tobacco products. THIS apparently was a bridge too far for the Trump administration and the Make America Healthy Again (MAHA) movement. It’s clear that what MAHA really stands for is forever chemicals in our water, e.coli outbreaks, and tobacco products targeting children.
It is clear that the recent firing resigning is less about one commissioner’s missteps and more about a governing style that treats regulatory leadership as disposable whenever it becomes politically inconvenient.
By all available reporting, Makary did not simply “decide to move on.” He resigned under visible duress, after weeks in which it was openly reported that President Donald Trump had already agreed with RFK Jr’s decision to oust him and that a plan to remove him was in motion. The White House, according to statements from anonymous sources, had grown tired of controversies around drug and device decisions, while RFK Jr. with his historical fascination with roadkill, dead whales and bears, wanted a different kind of FDA all together. Unclear what a man who straps the rotting head of a whale to the family station wagon and has a personal fascination with roadkill has in mind regarding drug safety approval.
Makary’s tenure was undeniably chaotic, and he was marked for removal due to 1. Resistance over abortion‑related drug regulation: Abortion activists have been calling for a re-review of a 25 year old approved drug that has more approved uses than abortion, and have accused him of slow-walking this as if a drug proven safe and effective across numerous countries should be the top priority (not cancer drugs). 2. the push to relax marketing regulations and approving flavored e‑cigarettes, and 3. A series of high‑profile drug evaluations that left both industry and patient advocates confused and frustrated. Despite his foibles, Makary at the very least did not abandon some basic tenants of public health, one being that children shouldn’t be marketed addictive nicotine products.
What’s troublesome is that this ousting supports the pattern that science and medicine under the Trump administration is purely political. Data and health be damned, if RFK Jr and Trump want it, so be it and we will all pay the price.
Into this vacuum steps Kyle Diamantas, the FDA’s food chief, now elevated as acting commissioner. On paper, Diamantas is experienced in the food‑safety arena; he has already managed complex negotiations with food manufacturers but the additives he has been charged with removing are of little consequence to human health. And this is not the same as being prepared to oversee the pharmaceutical approval and review engine that is the FDA: drug approvals, biologics, high‑risk devices, and vaccines, all while navigating an HHS leadership that has made clear it wants nothing less than to strong-arm agency’s direction.
Despite Diamantas’ experience as deputy food commissioner (starting in early 2025) he is a lawyer by training and lacks any significant background in health, medicine, pharmaceutical development or safety analysis. Testing beef is not the same as developing a next generation protocol for treating malignant cancer.
And frankly under the Diamantas tenure we have seen several major outbreaks of foodborne illness including an e.coli outbreak traced to one farm selling raw milk and cheese that the FDA has failed to shut down while children have been hospitalized with serious complications. The median age of impacted children is 2 years old.
Diamantas’s group did request a voluntary recall, but when RAW FARM failed to comply they did nothing more allowing tainted products to remain on the shelves. It took the Congressional Food and Safety Caucus demanding a mandatory recall of the RAW FARM products (a company promoted by RFK Jr in the past) for them to finally comply with the voluntary recall while issuing a statement that it was “under protest” all while children were still hospitalized from eating their products. RAW FARM has failed the ethics test in a significant way and so did Diamantas.
This shake up will send ripples through the biopharma industry. Most have little to no respect for the people in charge of these agencies at the moment beyond what is required for continuing to do business in the United States. They are the least experienced, most adversarial group of charlatans ever put in a position of this much power. Within just a few short months their missteps have made Americans less healthy, have landed them with costly lawsuits, and resulted in children being hospitalized with a refusal to hold the industry that hurt them accountable.
RFK Jr. entered office at HHS promising to challenge regulatory capture and restore integrity. But what we’ve seen instead is an attack on science and health like the United States has never witnessed before. Makary’s forced departure with no competent replacement in sight puts the FDA in the same position as the CDC, gutted, kneecapped, and at the whims of the most anti-science administration in history.
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