President Trump has rightly earned his place as the most consequential pro-life president in modern American history. From his transformative judicial appointments, including three Supreme Court justices who made the overturning of Roe v. Wade possible, to his reinstatement of the Mexico City Policy and his defunding of abortion providers through Title X, he has backed his convictions with action at every turn. He signed those directives on the same day he addressed the March for Life, making governing commitments publicly and ensuring they are kept.
Pro-life Americans were not passive supporters of Donald Trump. They worked for him, prayed for him, and voted for him in numbers that mattered. They did so because he gave them reason to trust him, and he delivered.
That is precisely why the conduct of FDA Commissioner Marty Makary demands scrutiny and accountability.
Let's be honest about who Marty Makary is. His record on life issues is not only disappointing but also disqualifying. His instincts on healthcare policy track far closer to Bernie Sanders than to the voters who put this president in office. Anyone who followed his career before his appointment shouldn't be shocked. His handling of abortion-related pharmaceuticals at the FDA has made clear that the pro-life community is, at best, an afterthought to him.
People sometimes treat the FDA as a technical backwater, a place where scientists argue over approval timelines and label language. That is a mistake. When it comes to life issues, the FDA may be the most important regulatory body in Washington. Chemical abortion drugs, prescribing guidelines, distribution rules — these decisions flow through that agency. The person running it shapes outcomes that no single piece of legislation can easily reverse. Right now, the wrong person is running it.
President Trump has earned the trust of the pro-life movement, but Makary is squandering it. Through a pattern of sloppy management and decisions that have left pro-life leaders questioning his basic commitment to the cause, Makary has become a liability to the very president who appointed him. SBA Pro-Life America has called for his immediate termination, with President Marjorie Dannenfelser warning that he is "severely undermining President Trump and Vice President Vance's pro-life credentials." The pro-life movement did not fight for decades to put a careless, unreliable FDA commissioner in charge of the most consequential drug decisions in America.
And the timing could not be worse. Pro-life voters are not a special interest group that shows up every four years and goes home. They are the backbone of Republican turnout operations. They knock on doors in October. They write checks when the cause calls for it. They drag their neighbors to the polls. What drives them is genuine moral conviction, which means they are also paying genuine attention. You cannot take them for granted and expect them not to notice.
When a cabinet appointee signals that their priorities don't matter, they notice. Enthusiasm doesn't collapse all at once. It bleeds out slowly, through a series of small disappointments that add up to the conclusion that nobody in power is fighting for us. Commissioner Makary has been delivering those disappointments consistently, and the political damage lands on Republican candidates across the ballot in 2026.
The White House built something real with the pro-life movement. That relationship took years of kept promises and hard fights to develop. It would be a serious mistake to let one bureaucrat destroy that trust. Pro-life Americans were asked to be foot soldiers for this administration. They showed up. They deserve a commissioner who shares their values, not one who treats those values as an inconvenience.
President Trump should consider replacing Dr. Makary with someone who understands that protecting life is a governing responsibility, not a campaign applause line. The movement that delivered for this president is still watching. The question is whether this administration is still listening.
Ken Blackwell is an adviser to the Family Research Council in Washington, D.C.
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