White House Requests Resignation of Top FDA Aide, Prompting Tensions with Commissioner Makary

The White House requested the resignation of Sanjula Jain-Nagpal, a top aide to FDA Commissioner Marty Makary, citing concerns over her promotion within the agency without prior White House approval13.

Makary attempted to promote Jain-Nagpal to deputy chief of staff, but her new title was not approved; after a review of the situation, Jain-Nagpal will keep her original title as associate director of policy and research strategy3.

Makary resisted the White House request for Jain-Nagpal's removal and pushback from his side further intensified existing tensions between the FDA, HHS, and the White House13.

The situation follows previous staffing controversies and infighting involving Makary's appointees, with top Trump administration officials—including HHS Secretary Robert F. Kennedy Jr.—reportedly expressing frustration with Makary's management style4.

Officials discussed the possibility of reducing Makary’s role at the FDA, although as of recently, senior leadership continues to publicly support him45.

Jain-Nagpal, formerly a professor at Johns Hopkins University, has a close working relationship with Makary and is a regular participant on his public FDA podcast13.

These recent events are part of a continuing pattern of high-profile staff changes and leadership disputes under Makary’s tenure at the FDA.

Sources:

1. https://www.investing.com/news/stock-market-news/white-house-asks-for-resignation-of-top-fda-aide-politico-reports-93CH-4373567

3. https://www.politico.com/news/2025/11/21/the-white-house-has-asked-for-the-resignation-of-a-top-aide-to-fda-chief-00664719

4. https://www.biospace.com/policy/signs-of-frustration-build-between-kennedy-makary

5. https://www.politico.com/news/2025/11/04/white-house-backs-fda-head-after-ouster-of-top-regulator-00636281