In another appointment with potential to shake up the federal health regime, Donald Trump on Friday nominated Dr. Martin Makary to lead the Food & Drug Administration. Makary, a Johns Hopkins University pancreatic surgeon and author of three New York Times bestsellers, has been critical of the government's role in health care. The role requires Senate confirmation. 

Declaring that the FDA has "lost the trust of Americans," Trump said Makary will "course-correct and refocus the agency," to include "properly evaluat[ing] harmful chemicals poisoning our nation's food supply  and drugs and biologics being given to our nation's youth, so that we can finally address the childhood chronic disease epidemic." 

Makary grew to national notoriety as one of several highly-credentialed physicians who pushed back on many elements of the federal response to the Covid-19 pandemic. Testifying before Congress, Makary said:

"The greatest perpetrator of misinformation during the pandemic has been the United States government.  Misinformation that Covid was spread through surface transmission, that vaccinated immunity was far greater than natural immunity...that myocarditis was more common after the infection than the vaccine...that young people benefit from a booster..."  

While not broadly opposing Covid-19 vaccines, Makary condemned the Biden administration for pushing boosters on young patients for whom the virus presented a far lower threat, and has declared that heavy-handed vaccine mandates "created never-vaxxers." He co-wrote a study that concluded that Covid vaccine booster mandates for college students created net harm, with adverse reactions like myocarditis in young men outweighing slim benefits from vaccination.

Makary also ridiculed fear-mongering about the Omicron variant as "fueling...a pandemic of lunacy," and urged a rollback in Covid testing in low-risk situations, saying, "If you test everyone in the United States, you will find a virus particle in the nose of some fraction of Americans forever."  

That said, some feel Makary was too slow to question some elements of the Covid regime, and was initially too credulous about the benefits of vaccination. In June 2020, he touted the "liberating" qualities of "universal masking." In March 2021, he tweeted, "The data show that vaccines confer near perfect protection against death and hospitalization from Covid." 

With a $7 billion budget and 18,000 employees, the FDA has enormous influence over Americans' lives, with regulatory influence over products that account for about a fifth of all US consumer spending. Makary, who has degrees from Bucknell University, Thomas Jefferson and Harvard, would report to Robert F. Kennedy, Jr -- if the controversial Kennedy is confirmed by the Senate or manages to achieve a recess appointment to lead the Department of Health and Human Services.

Kennedy has said the FDA is in need of a major trimming. “There are entire departments, like the nutrition department at the FDA ... that have to go—that are not doing their job. They’re not protecting our kids,” Kennedy said earlier this month. In a more aggressive post to X in October, Kennedy said "FDA's war on public health is about to end," and said that, for employees who were part of corruption that serves the pharmaceutical industry to the detriment of the public's health, "I have two messages for you: 1. Preserve your records, and 2. Pack your bags."

The Washington Post reports that Kennedy was influential in Makary's selection, as Kennedy urged Trump to favor candidates that are not tightly linked to either the health care industry or government. Kennedy is said to consider Makary as a likeminded reformer. Much like Kennedy, Makary has harshly criticized the federal government's approach to food and health, saying root causes of serious conditions are ignored in favor of simply prescribing drugs: 

"We are right now witnessing the largest uncontrolled experiment in modern health history...we have introduced tons of chemicals, pesticides, micro-plastics, ultra-processed foods, seed oils into the modern diet, altering the microbiome and no one talks about it. They're too busy demonizing saturated fat and trying to defend the old food pyramid. They just replaced it with a food compass that's almost worse...it says Lucky Charms is healthier than a steak."

Makary's new book is "Blind Spots: When Medicine Gets It Wrong, and What It Means for Our Health." Makary makes a case that government malpractice has been at the root of many modern health crises, from opioid addiction to peanut allergies to obesity and drug-resistance bacteria. Here he is recounting how the National Institutes of Health, on the basis of its own profoundly flawed study, wrongly discouraged doctors from prescribing hormone replacement therapy for menopausal women, creating a reluctance that still persists today: 

However tardy Makary may have been in challenging some public health approaches to the Covid-19 pandemic, it seems clear he is poised to shake things up at the all-too-powerful FDA. January 20 can't come quickly enough.