FDA chief’s resignation widens a leadership gap at the nation’s health department

WASHINGTON (AP) 鈥� When the week began, several senior positions at were already sitting empty.

There was no Senate-confirmed . The head of the National Institutes of Health was of the U.S. Centers for Disease Control and Prevention. The Food and Drug Administration lacked a permanent vaccine chief after that official for a second time in a year.

Then on Tuesday Dr. Marty Makary , leaving another major health agency with only an acting commissioner. Makary’s departure widens a leadership gap that has plagued HHS throughout Health Secretary Robert F. Kennedy Jr.鈥檚 tenure.

Across a vast and multilayered government, in which many leadership positions must be confirmed by a Senate that shares only a narrow partisan majority with the administration, it鈥檚 typical for some roles to remain unfilled or be occupied by interim leaders. But critics say the level of upheaval in the current HHS is unusual and the lack of scientific expertise among its leadership is concerning.

鈥淚t’s a sign that something is not right in this department,鈥� said Dr. Daniel Jernigan, a former senior employee at the CDC.

Critics say the problem has only been compounded by and by the broader disruption brought by .

HHS didn’t immediately respond to a request for comment Wednesday.

Kathleen Hall Jamieson, director of the Annenberg Public Policy Center at the University of Pennsylvania, said most Americans don鈥檛 pay attention to these agencies鈥� leaders until a public health concern arises 鈥� like with . At moments like this, she said, there are opportunities to build public trust in federal health agencies, which .

鈥淭he key question for me is, when we need these agencies to speak, will they have the capacity to draw the science together and tell us what we need to know?鈥� Jamieson said.

FDA鈥檚 leadership void happens as it faces ongoing challenges

At the FDA, Makary leaves behind unfinished initiatives and ongoing reviews under scrutiny, including work on ultra-processed foods, food dyes, antidepressants and COVID-19 shots.

Whoever steps into the role on a permanent basis will inherit the same challenge that dogged Makary鈥檚 tenure: balancing the anti-regulatory interests of traditional Republicans with the anti-corporate priorities of Kennedy, who is focused on scrutinizing ingredients in food, medicines and vaccines.

The FDA is developing a first-of-its-kind definition of 鈥渦ltra-processed foods,鈥� which Kennedy blames for elevated rates of diabetes, obesity and other chronic conditions among Americans. That task has fallen to the FDA鈥檚 deputy commissioner for foods, Kyle Diamantas, who recently described the effort on ultra-processed foods as 鈥渞eally hard,鈥� at a health conference.

Diamantas was tapped by Trump to lead the FDA on an acting basis. He is also serving as a chief counselor to Kennedy. An attorney and friend of Donald Trump Jr, he is the first person in more than a half-century to head the FDA without a degree in medicine or science.

鈥淜yle Diamantas now has a nearly impossible charge,鈥� said Dr. Peter Lurie, a former FDA official now at the Center for Science in the Public Interest. 鈥淟eading, as a non-scientist, a science-based agency under an unqualified secretary who puts his own medical and nutritional pet peeves over evidence-based public health.鈥�

CDC has cycled through a revolving door of short-term directors

The Trump administration鈥檚 first pick to run the CDC was former Florida Rep. Dr. David Weldon, but his March 2025 Senate confirmation hearing an hour before it was to begin. Weldon said at the time that he鈥檇 been told not enough senators were willing to vote for him.

The White House then to Susan Monarez, who was confirmed by the Senate, but she in less than a month over disagreements on the administration’s agenda. Several key CDC scientific leaders resigned in protest, saying Monarez鈥檚 dismissal dashed their hopes that a CDC director would be able to guard against political meddling in the agency鈥檚 scientific research and health recommendations.

Since then, multiple HHS officials have been acting director. National Institutes of Health Director Jay Bhattacharya has been overseeing the CDC since February. Last month, Trump nominated Dr. Erica Schwartz, a former deputy surgeon general, to be the next CDC director, a choice the Senate must confirm.

Current and former CDC employees say that there鈥檚 been a void in experienced public health leadership at the agency and that Kennedy鈥檚 aides have slowed and sometimes choked off its ability to communicate with the public and do the full scope of science-based work it was doing in the past.

HHS officials have said that the CDC鈥檚 critical public health functions have remained 鈥渋ntact and effective鈥� and that changes at the agency have been part of an effort 鈥渢o restore credibility through transparency, gold standard science, and accountability.鈥�

Jernigan, who last August resigned from a senior role at the CDC that has yet to be filled by a permanent replacement, said the leadership shuffle means there hasn’t been a 鈥渟trong, present CDC director鈥� in place to campaign for important agency funding, hiring or retention of skilled scientists.

As the current hantavirus outbreak unfolded, the CDC deployed teams to evacuate and quarantine Americans who may have been exposed, health officials briefed reporters and Bhattacharya went on a Fox 草莓传媒 program to urge Americans not to worry. But he got some details wrong and overstated what was known at the time about the outbreak. Jernigan urged the CDC to let more career scientists speak to the public.

鈥淭hat will do more for trust and for calming the nerves of the U.S. right now,鈥� he said.

Changes come as the White House and HHS have shifted messaging

Leadership shake-ups come as HHS and the White House have shifted their focus to health initiatives related to diet, lifestyle and affordability in recent months ahead of the midterm elections, publicly veering away from Kennedy鈥檚 first-year effort to roll back vaccine guidelines.

While Kennedy boasted about being allowed to pick his own deputies at the beginning of his term, the administration’s recent picks signal that the health secretary’s close allies may no longer be at the top of the list.

For example, last month, after who was embedded in Kennedy’s Make America Healthy Again movement, Trump nominated radiologist and former Fox 草莓传媒 personality Dr. Nicole Saphier. She has advocated vaccines more forcefully than Kennedy, and at times she has as 鈥渆mbarrassing.鈥� She will need to be confirmed by the Senate.

Still, as the leadership turmoil creates a vacuum within the nation鈥檚 health agencies, Kennedy has remained prominent at the top as a voice for them all. That worries Jernigan, who said Kennedy won鈥檛 always center the best science in his decisions.

鈥淭he driver for the secretary is the ideology,鈥� Jernigan said. 鈥淎nd that鈥檚 not a strategy for really improving the health of Americans.鈥�

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Stobbe and Swenson reported from New York.

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