President Donald Trump has reportedly approved a plan to dismiss Food and Drug Administration (FDA) Commissioner Marty Makary, although sources indicate that the decision is not yet final. This news follows a tumultuous year for Makary, characterized by controversies surrounding various FDA issues, including the approval of flavored vapes and personnel conflicts. Insiders revealed to The Wall Street Journal that Makary faced criticism from Trump for not expediting the approval of flavored nicotine products, which the president views as crucial to his campaign promises. The FDA's recent authorization of certain vape flavors came after pressure from the Trump administration. Makary's leadership has been challenged by complaints from the pharmaceutical industry and conflicts with other health officials. If Makary is removed, it would contribute to a trend of high-level vacancies in health agencies under the Trump administration, which has seen significant turnover, including the CDC and the National Institutes of Health lacking permanent directors.