President Donald Trump’s pick to lead the US Food and Drug Administration told senators in a tense confirmation hearing Thursday that, if confirmed as FDA commissioner, he plans to evaluate school lunches, the abortion pill mifepristone and agency advisory committees.
Dr. Marty Makary, a surgeon and researcher at Johns Hopkins University, has long called for “a change in culture” at the FDA.
Senate confirmation votes for Makary and for Dr. Jay Bhattacharya to lead the US National Institutes of Health are scheduled for March 13, as is the confirmation hearing for Dr. David Weldon, Trump’s pick to head the US Centers for Disease Control and Prevention.
If confirmed as FDA commissioner, Makary will report to Robert F. Kennedy Jr., secretary of the US Department of Health and Human Services, who has advocated for regulating chemicals in food and limiting access to soda and processed foods through school lunches.
‘Transition to healthier foods’
Makary wants to look at the ingredients in school lunches, as well as the use of seed oils and dyes in food, he said in Thursday’s hearing, held by the Senate Health, Education, Labor and Pensions Committee.
“We have to look at the totality of every single thing in school lunch programs, in the diet of our nation’s children. When we’re using tax dollars to make purchases of foods that we know make our nation’s children sick, we have to re-examine how we’re spending those tax dollars,” Makary said.
“One thing I would like to work on is a school lunch program for some school districts on a pilot basis, to transition to healthier foods,” he said. “A lot of school districts want to, but they don’t know how, and they may not have the funds.”
Makary added that he thinks seed oils are a good example of where the nation could benefit from a “consolidation of the scientific research,” as well as the use of dyes in food.
In January, the FDA banned the use of red dye No. 3 in food, beverages and ingested drugs, more than 30 years after scientists discovered links to cancer in animals. Manufacturers using red dye No. 3 in food and ingested drugs have until January 15, 2027, and January 18, 2028, respectively, to reformulate their products.
“Half of our nation’s children are sick, and nobody has really been doing anything meaningful on this front until we have gotten new momentum and enthusiasm from Secretary Kennedy and President Trump to finally address the root causes of these diseases – general body inflammation and generalized insulin resistance – and food has a part of it. Food has a big part of it,” Makary said.
“When we eat foods with a lot of molecules that do not appear in nature, these are chemicals,” he said. “There’s a body of research now that suggests concern with some of these ingredients. We have to look at those ingredients, and you have my commitment to do so if confirmed as FDA commissioner.”
An ‘expert coalition’ to review mifepristone
Makary also said he plans to build an “expert coalition” to review data on the abortion pill mifepristone if he’s confirmed.
“I have no preconceived plans on mifepristone policy except to take a solid, hard look at the data and to meet with the professional career scientists who have reviewed the data at the FDA, and to build an expert coalition to review the ongoing data, which is required to be collected as a part of the REMS program, the Risk Evaluation and Mitigation Strategy,” Makary said in the hearing. “If we’re going to collect data, I believe we should look at it.”
Mifepristone is a pill used in a medication abortion, also known as medical abortion, in which someone ends their pregnancy by taking two pills – mifepristone and misoprostol – rather than having a surgical procedure. Medication abortions account for nearly two-thirds of all abortions in the US. Mifepristone is also used for miscarriage care.
Mifepristone was approved by the FDA decades ago and has been shown to be safe and effective, but it has been the focus of abortion restrictions in some states since the overturning of Roe v. Wade in 2022.
Makary said he will “follow the law” when reviewing data on the abortion pill.
“You have my commitment that once I’m in office, I will do a review of the data. I have no preconceived plans to make changes to the mifepristone policy, and I do plan to follow the law and the regulation of the REMS to look at ongoing data. It could be that there could be a drug-drug interaction that we could identify,” Makary said.
“I have never been afraid to speak my honest scientific opinion,” he added. “And I have no preconceived plans to make changes on that medication.”
Re-evaluating vaccine advisers’ meeting
Tensions rose at Thursday’s hearing when senators questioned Makary about a meeting of the FDA’s Vaccines and Related Biological Products Advisory Committee, or VRBPAC, that was canceled late last month without explanation. The advisers were set to discuss the composition of flu vaccines for the upcoming flu season.
When asked whether he would reinstate meetings of the committee, Makary said, “the VRPAC committee will be meeting if confirmed and I’m commissioner, yes.”
The FDA said in a statement last week that it would make public its recommendations to manufacturers in time for updated flu shots to be available for the 2025-26 influenza season.
Democratic Sen. Patty Murray of Washington asked Makary directly whether, if he is confirmed as FDA commissioner, he will commit to immediately reschedule that vaccine advisory committee meeting.
“I will immediately re-evaluate,” he said. “I would re-evaluate which topics deserve a convening of the advisory committee members on VRBPAC and which may not require a convening.”
‘We need to review the ethics policy’
Makary said in the hearing that the FDA should review members of its advisory committees to determine whether they have conflicts of interest.
“We need to review the ethics policy, because people see things that appear to be a cozy relationship between industry and the regulators that are supposed to be regulating the products,” Makary said.
“I want American companies to thrive. I want life sciences companies to thrive. But we need to call balls and strikes and to keep that independent scientific review process free of any conflicts,” he said. “So I do think it deserves a look.”
But some VRBPAC members have noted that there are already rules against such conflicts of interest.
VRBPAC member Dr. Stanley Perlman, a pediatrician and immunologist at the University of Iowa, made similar comments last week.
“When we do our conflict-of-interest forms, we have to put down everything. Even if our significant other has money invested in a health care fund rather than an individual stock, we have to put it down; that’s considered a conflict of interest,” he said. “When I get invited to speak by a pharmaceutical company or to consult for them, to review data or anything, I say, ‘Sorry, I cannot do it, because I’m on the VRBPAC.’”