WASHINGTON— President-elect Donald Trump on Friday appointed Dr. Marty Makary nominated to head the Food and Drug Administration, selecting a surgeon and author who gained national attention for his opposition to vaccine mandates and some other public health measures during the COVID-19 pandemic.
Makary, a professor at Johns Hopkins University, is the latest in a series of Trump nominees who have declared the US health care system “broken” and promised a shake-up. As part of a series of nominations, Trump also appointed doctor and former Republican Rep. Dave Weldon of Florida late Friday night to lead the Centers for Disease Control and Prevention. Fox News contributor Janette Nesheiwat will be the nation’s next surgeon general.
Some of Makary’s views align closely with the man about to become his boss — prominent anti-vaccine activist Robert F. Kennedy Jr., whom Trump has put forward as the next secretary of the U.S. Department of Health and Human Services Services.
In books and articles, Makary has criticized the overprescription of drugs, the use of pesticides on food, and the outsized influence of pharmaceutical and insurance companies over doctors and government agencies.
Trump said Makary, trained as a surgeon and cancer specialist, “will restore the FDA to the gold standard of scientific research, and cut red tape at the agency to ensure Americans get the medical treatments and treatments they deserve.”
The FDA’s 18,000 employees are responsible for the safety and effectiveness of prescription drugs, vaccines and medical devices, as well as a range of other consumer goods, including food, cosmetics and vaping products. In total, these products represent an estimated 20% of US consumer spending per year, or $2.6 trillion.
Makary rose to prominence on Fox News and other conservative media for his contrarian views during the COVID-19 pandemic. He questioned the need for masking and while not opposed to the COVID-19 vaccine, he raised concerns about booster shots in young children. He was part of a group of doctors who called for greater emphasis on herd immunity to stop the virus, or for the idea that mass infections would quickly lead to population-level protection.
The CDC estimated that COVID-19 vaccinations prevented more than 686,000 U.S. deaths in 2020 and 2021 alone. While children suffered much lower hospitalizations and deaths from the virus, medical associations including the American Academy of Pediatrics concluded that vaccinations significantly reduced serious illness in this age group.
Makary has lamented how drugmakers used misleading data to encourage doctors to prescribe OxyContin and other opioids as low-risk, non-addictive painkillers. That marketing was allowed under FDA-approved labeling from the 1990s, which indicated the drugs were safe for common ailments such as back pain.
In more recent years, the FDA has come under fire for approving drugs for Alzheimer’s disease, ALS and other conditions based on incomplete data that failed to demonstrate meaningful benefits to patients.
A push for more oversight of drug safety and effectiveness would mark a major shift at the FDA, which has focused on speeding drug approvals for decades. This trend has been fueled by industry lobbying and fees paid by drug manufacturers to help the FDA recruit additional reviewers.
Kennedy has proposed ending these payments, which would require billions in new funding from the federal budget.
Other policy priorities would likely encounter similar roadblocks. For example, Kennedy wants to ban drug makers from advertising on TV, a billion-dollar market that supports many TV and cable networks. The Supreme Court and other conservative justices would likely overturn such a ban on First Amendment grounds that protect commercial speech, experts note.
Less is known about Trump’s choice of the Atlanta-based CDC, which develops and monitors vaccines for infectious disease outbreaks.
Weldon is a staunch Republican who calls himself “pro-life.” Legislation he introduced more than twenty years ago banned human cloning. He also struck a deal with lawmakers to ban patents on human organisms, including genetically engineered embryos. Weldon also argued against removing the feeding tube for Terri Schiavo, a Florida woman whose family battle over her vegetative state turned into a national debate.
Weldon’s appointment is likely to placate some abortion advocates concerned about Trump’s appointment of Kennedy, a longtime Democrat and abortion rights supporter, as the nation’s top health official.
Weldon retired from his congressional seat in 2008 after fourteen years in public office. Earlier this year, he lost in a Republican Party primary for a seat in the Florida Legislature. If confirmed, he will be in charge of more than 13,000 employees and nearly 13,000 contract workers.
Nesheiwat would oversee 6,000 members of the U.S. Public Health Service Corps if the Republican-controlled Senate approves her appointment as surgeon general. She is the medical director of an urgent care company in New York. She regularly appears on Fox News and has regularly expressed her support for Trump, sharing photos of them together on her social media pages.
Surgeons general also have the power to issue advisories, warning of threats to public health in the US. These advisories could impact how the government, public and medical community respond to health crises in the country.
Perrone and Seitz write for the Associated Press.