Why FDA Commissioner Makary is on the ropes after months of turmoil

Key Points:

• President Trump is reportedly planning to fire FDA Commissioner Marty Makary after a turbulent tenure marked by criticism from the White House, pharmaceutical groups, and political factions.
• Makary faced frustration from Trump over the slow handling of flavored vape regulations, culminating in recent FDA approval of blueberry- and mango-flavored vapes, which conflicted with the administration's agenda.
• The FDA under Makary has been described as dysfunctional, with internal conflicts involving the Department of Health and Human Services and the White House, and concerns about his management style dating back to last year.
• Pharmaceutical companies have expressed dissatisfaction with inconsistent FDA regulatory decisions, particularly involving drug and clinical trial approvals, which some attribute to changes in leadership within the agency's vaccine division.
• Controversy over Makary's handling of mifepristone, a medication used for abortions, including failure to restrict its access despite anti-abortion pressure, contributed to political tensions; the president's decision to fire him may be announced soon, with plans to appoint an acting commissioner and a new nominee.