Trump approves plan to fire FDA commissioner Marty Makary

President Donald Trump has given the green light to a plan to remove Dr. Marty Makary from his post as commissioner of the Food and Drug Administration (FDA).

The news, first reported by the Wall Street Journal, marks the end of a series of strategic clashes between the regulatory agency and various sectors of the conservative coalition that brought Trump to the White House.

Makary, an oncologic surgeon and researcher at Johns Hopkins University before joining the Cabinet, was noted for an unusually high media profile for an FDA commissioner.

During his tenure, he attempted to balance the priorities of the MAGA movement, focused on business deregulation, with the "Make America Healthy Again" (MAHA) agenda pushed by Health Secretary Robert Kennedy Jr.

One of the main triggers for the rift was the FDA's policy regarding flavored e-cigarettes. According to sources close to the White House quoted by the New York Times, the administration pressured Makary for months to clear these products, a priority request for big tobacco companies and industry donors.

In March, the agency issued a restrictive memo that limited clearances to flavors such as mint, tea and spice, warning that fruit or candy flavors would be unlikely to be approved because of their appeal to young people.

Although the FDA recently cleared blueberry- and mango-flavored e-cigarettes from a small Los Angeles company, the move appears to have come too late to ease tensions with the executive.

Makary's administration also faced severe criticism from the conservative wing on reproductive health issues. Organizations such as SBA Pro-Life America and figures such as former Vice President Mike Pence demanded his firing, accusing him of delaying a safety review of mifepristone, the drug used for chemical abortion.

For these groups, Makary's slowness prevented him from highlighting the potential risksthe drug poses to women.

Divergences with Robert F. Kennedy Jr.

The commissioner had a complex relationship with Secretary of Health Robert Kennedy Jr. While Makary supported popular measures such as eliminating artificial dyes and promoting hormone replacement therapy for women, he was reticent about other Kennedy goals.

Kennedy has publicly advocated ending the FDA's "war" against stem cell treatments, peptides and raw milk.

In particular, he pressed the agency to reverse the ban on certain peptides, compounds often used for anti-aging or muscle recovery, but whose efficacy has not been fully demonstrated under the agency's traditional standards.

Despite the approval of the firing plan, sources in the presidential entourage note that the decision could still change.

Makary has previously proved persuasive with Trump,managing to thwart previous removal attempts. However, the accumulation of complaints from political allies and industry sectors appears to have tipped the balance toward his ultimate departure.