Changes at the top of US health agencies

A sudden shake-up is coming in Washington’s health leadership. Dr. Marty Makary, who has been leading the FDA for just over a year, appears set to leave his post. The move follows months of behind-the-scenes tension and multiple reports predicting his departure. His exit adds another empty chair at a table already short on permanent leaders. Makary’s time in charge was busy. He pushed for faster drug reviews, cracked down on misleading product ads, and tried to get food companies to stop using certain chemical colors. Those goals were ambitious, but progress wasn’t smooth. Reports describe his team as unsettled, with key staff leaving and political pressure interfering with science. At the same time, he faced tough choices that upset different groups. He slowed a safety review of the abortion pill mifepristone, which frustrated anti-abortion advocates and some Republican lawmakers. He also clashed with the White House over flavored vapes, which Trump wanted to approve quickly to win over young voters.Three major agencies now lack permanent chiefs. The CDC hasn’t had a confirmed director for months, and there’s no surgeon general either. The FDA itself has two main branches running without permanent bosses. Hiring new leaders isn’t quick—the Senate has to approve them, and that process can take time. The administration has already shaken up leadership at HHS three months ago, trying to realign the department with more popular health priorities like better nutrition. Rumors of Makary’s firing have been swirling since late 2025 among lobbyists and Capitol Hill aides. The reports haven’t been officially confirmed, and plans can still change. Neither the White House nor Makary’s team has responded to requests for comment. Whatever happens, his departure would be one more shift in a department struggling to find stability under constant political scrutiny.