Dr. Tracy Beth Høeg, the acting head of the Food and Drug Administration's Center for Drug Evaluation and Research, says she was forced out of her post Friday, making her the second high-ranking FDA official to leave the agency in a single week, Fox News Digital reported.
Her departure came just days after FDA Commissioner Dr. Marty Makary publicly resigned Tuesday. Rumors had swirled for days that President Donald Trump was unhappy with Makary, though no official explanation has been given for either exit.
The rapid-fire personnel moves have left the nation's chief drug-approval agency without stable leadership at a moment when it oversees everything from COVID-era therapeutics to new antidepressant reviews. And they may not be over: STAT News reported that Katherine Szarama, former director of the FDA's Center for Biologics Evaluation and Research, and FDA Chief of Staff Jim Traficant are also leaving.
In an interview published Friday by MD Reports, Høeg described the circumstances of her removal in blunt terms. She said she was told to resign, and refused.
"I said I didn't want to resign. I said I'm not signing a letter of resignation if it's not my choice."
Høeg added that the people who delivered the message made clear it did not originate with them.
"They made it clear that it wasn't their decision. They said it was from someone above them, from someone way above their pay grade."
She did not name the person or office behind the order. The White House had yet to officially comment on her departure at the time Fox News Digital reached out. The Department of Health and Human Services also did not respond.
An FDA email to staff, obtained by The Associated Press, stated that Høeg's former deputy, Dr. Mike Davis, would replace her at the helm of CDER, the FDA division responsible for evaluating and approving prescription drugs.
Høeg had worked closely with Makary on drug regulation before being elevated to the CDER leadership role in December. Her tenure placed her at the center of some of the agency's most politically charged work, including scrutiny of COVID-era treatments and antidepressant approvals.
AP News reported that Høeg was closely aligned with both Makary and Health Secretary Robert F. Kennedy Jr., and described her rise and removal as part of an ongoing shakeup at the FDA. After her firing, Høeg posted on social media: "I learned so much and leave with no regrets."
That alignment makes the firing more difficult to read as a simple policy disagreement. When an administration removes officials who share its own stated priorities, the signal is less about ideology and more about internal power struggles, personal friction, or pressure from competing factions.
Makary's resignation Tuesday set the stage. The former Johns Hopkins surgeon had been Trump's pick to lead the FDA and was seen at a press conference with Kennedy at HHS headquarters in Washington on Oct. 29, 2025, discussing drug costs. By December, he had elevated Høeg. By this week, both were gone.
The administration has not been shy about making personnel changes across the federal government. Border Patrol chief Mike Banks stepped down as part of a broader DHS leadership overhaul, and the pattern extends well beyond health agencies.
No official reason has been given for Makary's departure. No official reason has been given for Høeg's. The White House has stayed quiet. That silence leaves reporters, Congress, and the public guessing, and it leaves the FDA in limbo.
The additional departures of Szarama from the Center for Biologics Evaluation and Research and Traficant from the chief of staff role, as STAT News reported, suggest the turnover extends beyond the commissioner's office. When a commissioner resigns and his top drug regulator, biologics chief, and chief of staff all leave in the same stretch, what remains is not a leadership team. It is a vacancy list.
The Center for Drug Evaluation and Research is not a backwater. CDER reviews and approves the prescription drugs Americans depend on. It sets the terms for clinical trials, evaluates safety data, and decides which treatments reach pharmacy shelves. The Center for Biologics oversees vaccines, blood products, and gene therapies.
Disruption at the top of these divisions has real consequences. Drug approvals slow. Safety reviews stall. Industry players face uncertainty about who is making decisions and on what basis. The people who pay the price are patients waiting on treatments and taxpayers funding an agency that cannot keep its own leadership in place.
The Trump administration has shown a willingness to remove senior officials who do not meet expectations, from the Pentagon to the border. That instinct, holding appointees accountable, is not inherently wrong. Voters elected a president who promised to shake up a federal bureaucracy that had earned public distrust, and the FDA's pandemic-era record gave reformers plenty of material.
But accountability requires clarity. When officials are removed without stated reasons, when the White House declines to comment, and when the departing officials themselves say they were blindsided, the public cannot distinguish between a purposeful housecleaning and a disorganized mess.
Several critical questions remain open. Who specifically ordered Høeg's removal? She described the directive as coming from "someone way above their pay grade," but neither she nor anyone else has named the decision-maker. Was her firing connected to Makary's resignation, or were the two events driven by separate grievances?
What prompted Makary's departure? The former commissioner has not spoken publicly about his reasons. If Trump was unhappy with his performance, as rumors suggested, what specifically fell short?
And perhaps most pressing: who is running the FDA now? Mike Davis has been named to lead CDER, but the commissioner's chair is empty. The biologics center and chief of staff positions are in flux. The agency responsible for approving the drugs and vaccines Americans use every day is operating without a clear chain of command.
The administration has faced friction with departing federal officials in other agencies as well, sometimes resulting in messy transitions. The FDA cannot afford that kind of disorder. Its decisions carry life-and-death weight.
None of this means the FDA did not need reform. The agency's handling of COVID-era guidance, its sluggish approval processes, and its cozy relationships with pharmaceutical companies had drawn bipartisan criticism long before Trump took office. Kennedy's appointment to HHS and Makary's selection to lead the FDA were signals that the administration intended to challenge an entrenched public-health establishment.
That mission has broad support among conservatives and among Americans who watched federal health agencies stumble through the pandemic. The question was never whether the FDA needed new leadership. The question was whether the administration could install reformers and keep them in place long enough to change the institution.
This week's events raise serious doubts on that score. Makary lasted months, not years. Høeg lasted weeks in her elevated role. The officials brought in to fix the FDA are already gone, and the administration has not explained why.
The pattern is not unique to health agencies. Leadership turnover has marked several corners of the federal government, from legal battles over executive authority to personnel disputes at the Department of Homeland Security. Some of that churn reflects an administration willing to act decisively. Some of it reflects something less flattering.
Høeg, for her part, did not leave quietly. Her public account, that she was told to go by people acting on orders from far above, that she refused to pretend the departure was voluntary, is the kind of transparency that should be welcomed regardless of party. If the administration had good reason to remove her, it should say so. If it didn't, the firing looks arbitrary.
Reforming a bloated, unaccountable federal agency is hard work. It requires leaders who stay long enough to change the culture, a clear chain of command, and a White House willing to explain its decisions to the public that elected it. Right now, the FDA has none of those things.
You can't drain a swamp if you keep firing the people holding the pump.