Califf Closes in on Second Stint as FDA Commissioner Despite Opposition

Robert Califf’s nomination to resume his role as FDA Commissioner continues to advance in the U.S. Senate, despite some noted opposition from a key Democrat, Sen. Joe Manchin of West Virginia, over the opioid epidemic and the role the FDA has played in the ongoing crisis.

Manchin, who has been a key swing vote for both sides of the Senate regarding President Biden’s Build Back Better program, among other key White House objectives, took to the Senate floor Monday night to voice his objection to Califf’s nomination had been stalled due to a filibuster.

The filibuster was broken Monday night when five Republicans voted to advance the Califf nomination forward. As Politico noted, one of the Republicans was Sen. Richard Burr of North Carolina, the top Republican on the Senate’s Health, Education, Labor and Pension committee. That committee voted last month to advance Califf’s nomination. With Burr and the other Republicans voting to move along the nomination, the filibuster was broken with a 49-45 vote.

A cardiologist, Califf previously served as commissioner of the U.S. Food and Drug Administration in the administration of President Barack Obama. He held the role from February 2016 to January 2017. Current President Joe Biden, who served as vice president under Obama, tapped Califf for the role in the fall of 2021 as acting Commissioner Janet Woodcock’s brief time in the role was running out.

Dr. Robert Califf/courtesy Win McNamee/Getty Images

Manchin has been opposed to Califf’s nomination since the president first nominated the former commissioner of the U.S. Food and Drug Administration last fall. In November, Manchin said he would not vote to confirm Califf because he believed that having a former FDA Commissioner resume the position would not bring about a change in culture at the regulatory agency.

“Dr. Califf’s nomination makes no sense as the opioid epidemic continues to wreak havoc on families across this country with no end in sight. 2020 was the deadliest year on record for drug-related overdose deaths with 1,386 West Virginians and nearly 95,000 Americans dying from a drug-related overdose. I have made it abundantly clear that correcting the culture at the FDA is critical to changing the tide of the opioid epidemic,” Manchin said in November.

He said that Califf’s nomination “is an insult” to the families who have suffered from the opioid epidemic Manchin also did not support Califf’s nomination in 2016, citing his ties to the pharmaceutical industry. Manchin said he wants the administration to nominate a potential commissioner who “understands the gravity of the prescription drug epidemic and the role of the FDA in fighting back against the greed of the pharmaceutical industry.”

On Monday, he reiterated his opposition.

“Dr. Califf has shown us who he is, and he has shown a complete lack of interest in actually making the difficult decisions that we need the leader of the FDA to make,” Manchin said Monday. “Nothing that Dr. Califf has said or done has led me to believe he will operate the FDA any differently than he did during his previous tenure.”

In 2016, Califf was confirmed for the commissioner’s role in an 89–4 vote. A final vote to confirm Califf’s latest nomination could come later this week.