WASHINGTON — Food and Drug Administration (FDA) Commissioner Marty Makary resigned on May 12, 2026, marking another high-profile leadership shakeup in the Trump administration’s health agencies. His departure followed a weeks-long pressure campaign from anti-abortion activists and conservative allies, but the immediate catalyst was his refusal to approve flavored vapes—a decision that directly contradicted President Donald Trump’s stated priorities.

Trump announced Makary’s resignation in a brief statement before departing for a three-day trip to China, calling him “a terrific guy” but acknowledging “difficulties” in his tenure. The White House has since named Kyle Diamantas, the FDA’s Deputy Commissioner for Food, to serve as acting commissioner while a search for a permanent replacement begins.

Makary’s exit underscores the politicization of public health under the Trump administration, where ideological battles over abortion drugs, vaping regulations, and vaccine policies have led to unprecedented turnover in key health agencies. With the FDA now lacking a confirmed commissioner, the U.S. Is left without a permanent leader at the CDC, FDA, or surgeon general’s office—a rare gap in federal health leadership.

How Flavored Vapes Became the Final Straw

While Makary’s resignation was framed as a voluntary departure, reports from The Wall Street Journal and Politico confirmed that Trump had approved a plan to remove him. The immediate trigger was his opposition to flavored vapes, which Trump has championed as part of his 2024 campaign promise to “save vaping.”

On May 9, 2026, the FDA issued new guidance allowing fruit-flavored e-cigarettes to remain on the market, reversing a stricter stance under previous administrations. Public health officials, including the American Academy of Pediatrics, have warned that flavors like mango, blueberry, and cotton candy make vaping more appealing to teenagers, contributing to a surge in youth nicotine addiction.

Trump’s push for flavored vapes aligns with his broader strategy to appeal to younger voters, but it has drawn criticism from health advocates. In a May 12 statement, Senator Josh Hawley (R-MO) called Makary “uniquely destructive to the pro-life movement,” while Senator Bill Cassidy (R-LA) criticized the administration’s handling of reproductive health policies. Makary, however, had also faced backlash from pharmaceutical executives and vaping lobbyists for his regulatory approach.

Broader Context: A Health Agency in Turmoil

Makary’s resignation is the latest in a series of leadership upheavals under Health and Human Services Secretary Robert F. Kennedy Jr., whose tenure has been marked by clashes over vaccine policies, opioid regulations, and environmental health standards. The CDC has been without a confirmed director since Susan Monarez was forced out in August 2025, and the surgeon general’s position remains unfilled after Trump’s third nominee for the role has yet to be confirmed.

Health experts warn that the instability at the FDA and CDC could have serious consequences. With 11 million Americans currently using e-cigarettes—including 2.55 million teenagers—the FDA’s decision on flavored vapes will shape public health for years to come. Meanwhile, the agency’s drug approval processes, including reviews of mifepristone and new gene therapies, could face further delays without permanent leadership.

Who Benefits? Who Loses?

The political and industry fallout from Makary’s resignation is already clear:

• Winners:
  • Tobacco and vaping companies: The FDA’s new guidance on flavored e-cigarettes is seen as a victory for manufacturers like Juul Labs and R.J. Reynolds, which have lobbied for expanded market access.
  • Anti-abortion activists: Their pressure on Makary over mifepristone appears to have contributed to his departure, though the drug remains legally available.
  • President Trump: The resignation allows him to install a more compliant FDA leader ahead of the 2026 midterm elections.
• Losers:
  • Public health advocates: The FDA’s weakened stance on flavored vapes could lead to increased youth vaping, reversing progress made under previous administrations.
  • Pharmaceutical innovators: Delays in drug approvals may leisurely the development of new treatments for rare diseases and gene therapies.
  • FDA employees: The agency’s leadership instability has created uncertainty for staff and could deter top talent from joining.

What Happens Next?

The FDA will now operate under acting Commissioner Kyle Diamantas, a career official who has not publicly commented on his priorities for the role. Meanwhile, the White House has begun a search for a permanent replacement, though no timeline has been announced.

Key developments to watch:

• FDA’s next steps on flavored vapes: The agency may face legal challenges from public health groups over its new guidance.
• Mifepristone review: Anti-abortion lawmakers may push for stricter regulations, though legal barriers remain.
• Surgeon general nomination: Trump’s third pick for the role could face Senate confirmation hurdles.
• CDC leadership: The agency’s ongoing staffing crisis may lead to further operational disruptions.

For the latest updates, monitor the FDA Newsroom and HHS press releases. The next critical checkpoint will be the FDA’s June 2026 regulatory meetings, where new policies on vaping, drugs, and medical devices will be discussed.